CH EMED EPR
2.0.0-ci-build - ci-build Switzerland flag

CH EMED EPR, published by CARA. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CARA-ch/ch-emed-epr/ and changes regularly. See the Directory of published versions

Resource Profile: CHEMEDEPRChangedMedicationRequest - Detailed Descriptions

Draft as of 2024-12-20

Definitions for the ch-emed-epr-medicationrequest-changed resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MedicationRequest
Invariantssplit-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. ((dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).count() = 1)
2. MedicationRequest.meta
4. MedicationRequest.meta.extension
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
6. MedicationRequest.meta.versionId
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
8. MedicationRequest.meta.lastUpdated
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
10. MedicationRequest.meta.source
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
12. MedicationRequest.meta.security
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
14. MedicationRequest.meta.tag
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
16. MedicationRequest.implicitRules
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
18. MedicationRequest.extension
Control1..?
20. MedicationRequest.extension:treatmentplan
Slice Nametreatmentplan
ShortA reference to the MedicationStatement that introduced this medication
Control1..?
22. MedicationRequest.modifierExtension
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
24. MedicationRequest.status
Pattern Valueactive
26. MedicationRequest.statusReason
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
28. MedicationRequest.intent
Pattern Valueorder
30. MedicationRequest.category
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
32. MedicationRequest.priority
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
34. MedicationRequest.doNotPerform
Comments

Use a PADV CANCEL/SUSPEND/REFUSE instead

Control0..0
36. MedicationRequest.reported[x]
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Standard StatusDraft (from Draft)
38. MedicationRequest.medication[x]
TypeReference(CH Core Medication), CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
40. MedicationRequest.medication[x]:medicationReference
Slice NamemedicationReference
TypeReference(CH EMED EPR Medication)contained
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
42. MedicationRequest.subject
TypeReference(CH EMED EPR Patient)referenced, bundled
44. MedicationRequest.encounter
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
46. MedicationRequest.supportingInformation:partOf
Slice NamepartOf
TypeReference(PADV Observation)referenced, bundled
48. MedicationRequest.requester
TypeReference(CH EMED EPR PractitionerRole)
50. MedicationRequest.performer
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
52. MedicationRequest.performerType
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
54. MedicationRequest.reasonCode
Definition

...Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').

ShortThe treatment reason(s) as text, and optionally coded
56. MedicationRequest.reasonCode.extension
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
58. MedicationRequest.reasonCode.text
ShortPlain text representation of the treatment reason(s)
Control1..?
60. MedicationRequest.reasonReference
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
62. MedicationRequest.instantiatesCanonical
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
64. MedicationRequest.instantiatesUri
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
66. MedicationRequest.basedOn
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
68. MedicationRequest.groupIdentifier
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
70. MedicationRequest.courseOfTherapyType
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
72. MedicationRequest.insurance
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
74. MedicationRequest.note
76. MedicationRequest.note.id
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
78. MedicationRequest.note.extension
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
80. MedicationRequest.note.author[x]
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ The note author is ignored, as it cannot be different than the document and/or entry's author
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Standard StatusDraft (from Draft)
82. MedicationRequest.note.time
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
84. MedicationRequest.note.text
ShortThe annotation text content (as raw text, no markdown allowed).
86. MedicationRequest.dosageInstruction:baseEntry
Slice NamebaseEntry
TypeDosage(Dosage (MedicationRequest))
88. MedicationRequest.dosageInstruction:additionalEntry
Slice NameadditionalEntry
TypeDosage(Dosage Split)
90. MedicationRequest.dispenseRequest
92. MedicationRequest.dispenseRequest.modifierExtension
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
94. MedicationRequest.dispenseRequest.initialFill
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
96. MedicationRequest.dispenseRequest.initialFill.modifierExtension
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
98. MedicationRequest.dispenseRequest.initialFill.quantity
TypeQuantity(Amount Quantity)
100. MedicationRequest.dispenseRequest.dispenseInterval
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
102. MedicationRequest.dispenseRequest.quantity
TypeQuantity(Amount Quantity)
104. MedicationRequest.dispenseRequest.expectedSupplyDuration
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
106. MedicationRequest.dispenseRequest.performer
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
108. MedicationRequest.substitution
ShortIf absent, substitution is assumed allowed. If present, the value is fixed to none (not allowed).
110. MedicationRequest.substitution.modifierExtension
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
112. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
Slice NameallowedCodeableConcept
BindingThe codes SHALL be taken from Substance Administration Substitution Codes
(required to http://fhir.ch/ig/ch-emed-epr/ValueSet/ch-emed-epr-substance-admin-substitution-code)
TypeCodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
114. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept.coding
Pattern Value{
  "system" : "http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution",
  "code" : "N",
  "display" : "none"
}
116. MedicationRequest.substitution.reason
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
118. MedicationRequest.priorPrescription
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Comments

Use the XDS mechanism to replace a prescription

Standard StatusDraft (from Draft)
120. MedicationRequest.detectedIssue
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)
122. MedicationRequest.eventHistory
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standard StatusDraft (from Draft)

Guidance on how to interpret the contents of this table can be found here

0. MedicationRequest
Definition

An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

ShortCH EMED MedicationRequest Changed (PADV)Ordering of medication for patient or group
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesPrescription, Order
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ch-dosage-medreq: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. ((dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-medicationrequest') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not()))
split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. ((dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).count() = 1)
2. MedicationRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. All modifiers SHALL be documented in the profile, in order to be usable.


Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..01
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control10..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. MedicationRequest.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. MedicationRequest.extension:treatmentplan
    Slice Nametreatmentplan
    Definition

    An Extension

    ShortA reference to the MedicationStatement that introduced this medication
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(CH EMED Extension Treatment Plan) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. MedicationRequest.modifierExtension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensionExtensions that cannot be ignored
    Comments

    All modifiers SHALL be documented in the profile, in order to be usable.


    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..0*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. MedicationRequest.identifier
    Definition

    Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

    ShortMedicationRequest IdentifierExternal ids for this request
    Comments

    This is a business identifier, not a resource identifier.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1*
    TypeIdentifier
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. MedicationRequest.identifier.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. MedicationRequest.identifier.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Comments

    Identifier.system is always case sensitive.

    Control10..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

    Fixed Valueurn:ietf:rfc:3986
    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. MedicationRequest.identifier.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortIdentifier value as UUIDThe value that is unique
    Comments

    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Example<br/><b>General</b>:123456 <br/><b>CH EMED</b>:urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. MedicationRequest.status
    Definition

    A code specifying the current state of the order. Generally, this will be active or completed state.

    Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

    A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Pattern Valueactive
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. MedicationRequest.statusReason
    Definition

    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


    Captures the reason for the current state of the MedicationRequest.

    Short✕ This element is not supportedReason for current status
    Comments

    This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

    Control0..1
    BindingFor example codes, see medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason
    (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

    Identifies the reasons for a given status.

    TypeCodeableConcept
    Is Modifierfalse
    Standard StatusDraft (from Trial Use)
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. MedicationRequest.intent
    Definition

    Whether the request is a proposal, plan, or an original order.

    Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Comments

    It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

    An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

    Control1..1
    BindingThe codes SHALL be taken from medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
    (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

    The kind of medication order.

    Typecode
    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Pattern Valueorder
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. MedicationRequest.category
    Definition

    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


    Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

    Short✕ This element is not supportedType of medication usage
    Comments

    The category can be used to include where the medication is expected to be consumed or other types of requests.

    Control0..*
    BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category
    (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

    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.

    TypeCodeableConcept
    Is Modifierfalse
    Standard StatusDraft (from Trial Use)
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. MedicationRequest.priority
    Definition

    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


    Indicates how quickly the Medication Request should be addressed with respect to other requests.

    Short✕ This element is not supportedroutine | urgent | asap | stat
    Control0..1
    BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

    Identifies the level of importance to be assigned to actioning the request.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Standard StatusDraft (from Trial Use)
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. MedicationRequest.doNotPerform
    Definition

    If true indicates that the provider is asking for the medication request not to occur.

    ShortTrue if request is prohibiting action
    Comments

    Use a PADV CANCEL/SUSPEND/REFUSE instead


    If do not perform is not specified, the request is a positive request e.g. "do perform".

    Control0..01
    Typeboolean
    Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. MedicationRequest.reported[x]
    Definition

    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


    Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

    Short✕ This element is not supportedReported rather than primary record
    Control0..1
    TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Standard StatusDraft (from Trial Use)
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. MedicationRequest.medication[x]
    Definition

    Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

    ShortMedication to be taken
    Comments

    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

    Control1..1
    TypeReference(CH Core Medication, Medication), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on MedicationRequest.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 36. MedicationRequest.medication[x]:medicationReference
      Slice NamemedicationReference
      Definition

      Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

      ShortReference to the contained medicationMedication to be taken
      Comments

      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

      Control01..1
      TypeReference(CH EMED EPR Medication, Medication)contained, CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. MedicationRequest.subject
      Definition

      A link to a resource representing the person or set of individuals to whom the medication will be given.

      ShortPatientWho or group medication request is for
      Comments

      The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

      Control1..1
      TypeReference(CH EMED EPR Patient, Patient, Group)referenced, bundled
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. MedicationRequest.subject.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. MedicationRequest.encounter
      Definition

      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


      The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

      Short✕ This element is not supportedEncounter created as part of encounter/admission/stay
      Comments

      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

      Control0..1
      TypeReference(Encounter)
      Is Modifierfalse
      Standard StatusDraft (from Trial Use)
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. MedicationRequest.supportingInformation
      Definition

      Include additional information (for example, patient height and weight) that supports the ordering of the medication.

      ShortInformation to support ordering of the medication
      Control10..*
      TypeReference(Resource)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationRequest.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 46. MedicationRequest.supportingInformation:partOf
        Slice NamepartOf
        Definition

        Include additional information (for example, patient height and weight) that supports the ordering of the medication.

        ShortReference to the Observation from type 'CHANGE'Information to support ordering of the medication
        Control10..1*
        TypeReference(PADV Observation, Resource)referenced, bundled
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationRequest.authoredOn
        Definition

        The date (and perhaps time) when the prescription was initially written or authored on.

        ShortWhen request was initially authored
        Control10..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. MedicationRequest.requester
        Definition

        The individual, organization, or device that initiated the request and has responsibility for its activation.

        ShortThe author of the medical decision, see also 'Guidance - Authorship'Who/What requested the Request
        Control10..1
        TypeReference(CH EMED EPR PractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. MedicationRequest.requester.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. MedicationRequest.performer
        Definition

        Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


        The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

        Short✕ This element is not supportedIntended performer of administration
        Control0..1
        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
        Is Modifierfalse
        Standard StatusDraft (from Trial Use)
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. MedicationRequest.performerType
        Definition

        Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


        Indicates the type of performer of the administration of the medication.

        Short✕ This element is not supportedDesired kind of performer of the medication administration
        Comments

        If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

        Control0..1
        BindingFor example codes, see ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-role
        (example to http://hl7.org/fhir/ValueSet/performer-role)

        Identifies the type of individual that is desired to administer the medication.

        TypeCodeableConcept
        Is Modifierfalse
        Standard StatusDraft (from Trial Use)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. MedicationRequest.reasonCode
        Definition

        The reason or the indication for ordering or not ordering the medication. Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').


        The reason or the indication for ordering or not ordering the medication.

        ShortThe treatment reason(s) as text, and optionally codedReason or indication for ordering or not ordering the medication
        Comments

        This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

        Control0..*
        BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
        (example to http://hl7.org/fhir/ValueSet/condition-code)

        A coded concept indicating why the medication was ordered.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. MedicationRequest.reasonCode.extension
        Definition

        Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        Short✕ This element is not supportedAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Standard StatusDraft (from Trial Use)
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MedicationRequest.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 62. MedicationRequest.reasonCode.text
          Definition

          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

          ShortPlain text representation of the treatment reason(s)Plain text representation of the concept
          Comments

          Very often the text is the same as a displayName of one of the codings.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. MedicationRequest.reasonReference
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          Condition or observation that supports why the medication was ordered.

          Short✕ This element is not supportedCondition or observation that supports why the prescription is being written
          Comments

          This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

          Control0..*
          TypeReference(Condition, Observation)
          Is Modifierfalse
          Standard StatusDraft (from Trial Use)
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationRequest.instantiatesCanonical
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

          Short✕ This element is not supportedInstantiates FHIR protocol or definition
          Control0..*
          Typecanonical
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Standard StatusDraft (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. MedicationRequest.instantiatesUri
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

          Short✕ This element is not supportedInstantiates external protocol or definition
          Control0..*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Standard StatusDraft (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. MedicationRequest.basedOn
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          A plan or request that is fulfilled in whole or in part by this medication request.

          Short✕ This element is not supportedWhat request fulfills
          Control0..*
          TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
          Is Modifierfalse
          Standard StatusDraft (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. MedicationRequest.groupIdentifier
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

          Short✕ This element is not supportedComposite request this is part of
          Control0..1
          TypeIdentifier
          Is Modifierfalse
          Standard StatusDraft (from Trial Use)
          Summarytrue
          Requirements

          Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. MedicationRequest.courseOfTherapyType
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          The description of the overall patte3rn of the administration of the medication to the patient.

          Short✕ This element is not supportedOverall pattern of medication administration
          Comments

          This attribute should not be confused with the protocol of the medication.

          Control0..1
          BindingFor example codes, see medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
          (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

          Identifies the overall pattern of medication administratio.

          TypeCodeableConcept
          Is Modifierfalse
          Standard StatusDraft (from Trial Use)
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. MedicationRequest.insurance
          Definition

          Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


          Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

          Short✕ This element is not supportedAssociated insurance coverage
          Control0..*
          TypeReference(Coverage, ClaimResponse)
          Is Modifierfalse
          Standard StatusDraft (from Trial Use)
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. MedicationRequest.dosageInstruction
          Definition

          Indicates how the medication is/was taken or should be taken by the patient.


          Indicates how the medication is to be used by the patient.

          ShortHow the medication should be taken
          Comments

          There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

          Control10..*
          TypeDosage(CH Core Dosage)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • profile @ $this
          • 80. MedicationRequest.dosageInstruction:baseEntry
            Slice NamebaseEntry
            Definition

            Indicates how the medication is/was taken or should be taken by the patient.


            Indicates how the medication is to be used by the patient.

            ShortCH EMED Dosage (MedicationRequest)How the medication should be taken
            Comments

            There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

            Control10..1*
            TypeDosage(Dosage (MedicationRequest))
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ch-dosage-4: For split dosage timing event and dose/rate are required (sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists()))
            ch-dosage-3: Patient instruction/free text dosage instruction, or timing and dose/rate has to be specified (patientInstruction.exists() or (timing.exists() and doseAndRate.exists()))
            base-dosage-text: It is a strong recommendation that the base dosage should contain the whole dosage information as narrative, including the information from split dosage elements. (text.exists() and text.trim().length() > 0)
            82. MedicationRequest.dosageInstruction:additionalEntry
            Slice NameadditionalEntry
            Definition

            Indicates how the medication is/was taken or should be taken by the patient.


            Indicates how the medication is to be used by the patient.

            ShortCH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)How the medication should be taken
            Comments

            There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

            Control0..*
            TypeDosage(Dosage Split)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. MedicationRequest.substitution
            Definition

            Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

            ShortIf absent, substitution is assumed allowed. If present, the value is fixed to none (not allowed).Any restrictions on medication substitution
            Control0..1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. MedicationRequest.substitution.modifierExtension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensionExtensions that cannot be ignored even if unrecognized
            Comments

            All modifiers SHALL be documented in the profile, in order to be usable.


            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..0*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            88. MedicationRequest.substitution.allowed[x]
            Definition

            True if the prescriber allows a different drug to be dispensed from what was prescribed.

            ShortWhether substitution is allowed or not
            Comments

            This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

            Control1..1
            BindingFor example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
            (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

            Identifies the type of substitution allowed.

            TypeCodeableConcept, boolean
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationRequest.substitution.allowed[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 90. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
              Slice NameallowedCodeableConcept
              Definition

              True if the prescriber allows a different drug to be dispensed from what was prescribed.

              ShortWhether substitution is allowed or not
              Comments

              This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

              Control01..1
              BindingThe codes SHALL be taken from For example codes, see Substance Administration Substitution Codeshttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
              (required to http://fhir.ch/ig/ch-emed-epr/ValueSet/ch-emed-epr-substance-admin-substitution-code)
              TypeCodeableConcept, boolean
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              92. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..*
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Pattern Value{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution",
                "code" : "N",
                "display" : "none"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. MedicationRequest.substitution.reason
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


              Indicates the reason for the substitution, or why substitution must or must not be performed.

              Short✕ This element is not supportedWhy should (not) substitution be made
              Control0..1
              BindingFor example codes, see SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason
              (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

              A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

              TypeCodeableConcept
              Is Modifierfalse
              Standard StatusDraft (from Trial Use)
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              96. MedicationRequest.priorPrescription
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


              A link to a resource representing an earlier order related order or prescription.

              Short✕ This element is not supportedAn order/prescription that is being replaced
              Comments

              Use the XDS mechanism to replace a prescription

              Control0..1
              TypeReference(MedicationRequest)
              Is Modifierfalse
              Standard StatusDraft (from Trial Use)
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. MedicationRequest.detectedIssue
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


              Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

              Short✕ This element is not supportedClinical Issue with action
              Comments

              This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

              Control0..*
              TypeReference(DetectedIssue)
              Is Modifierfalse
              Standard StatusDraft (from Trial Use)
              Summaryfalse
              Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. MedicationRequest.eventHistory
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


              Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

              Short✕ This element is not supportedA list of events of interest in the lifecycle
              Comments

              This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

              Control0..*
              TypeReference(Provenance)
              Is Modifierfalse
              Standard StatusDraft (from Trial Use)
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              Guidance on how to interpret the contents of this table can be found here

              0. MedicationRequest
              Definition

              An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

              ShortCH EMED MedicationRequest Changed (PADV)
              Control0..*
              Is Modifierfalse
              Summaryfalse
              Alternate NamesPrescription, Order
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              ch-dosage-medreq: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. ((dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-medicationrequest') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not()))
              split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. ((dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).count() = 1)
              2. MedicationRequest.id
              Definition

              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

              ShortLogical id of this artifact
              Comments

              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

              Control0..1
              Typeid
              Is Modifierfalse
              Summarytrue
              4. MedicationRequest.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. MedicationRequest.meta.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              8. MedicationRequest.meta.extension
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

              Short✕ This element is not supported
              Control0..*
              TypeExtension
              Is Modifierfalse
              Standard StatusDraft (from Trial Use)
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on MedicationRequest.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 10. MedicationRequest.meta.versionId
                Definition

                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                Short✕ This element is not supported
                Comments

                The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                Control0..1
                Typeid
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusDraft (from Trial Use)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                12. MedicationRequest.meta.lastUpdated
                Definition

                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                Short✕ This element is not supported
                Comments

                This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                Control0..1
                Typeinstant
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusDraft (from Trial Use)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                14. MedicationRequest.meta.source
                Definition

                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                Short✕ This element is not supported
                Comments

                In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusDraft (from Trial Use)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                16. MedicationRequest.meta.profile
                Definition

                A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                ShortProfiles this resource claims to conform to
                Comments

                It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                Control0..*
                Typecanonical(StructureDefinition)
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                18. MedicationRequest.meta.security
                Definition

                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                Short✕ This element is not supported
                Comments

                The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                Control0..*
                BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                Security Labels from the Healthcare Privacy and Security Classification System.

                TypeCoding
                Is Modifierfalse
                Standard StatusDraft (from Trial Use)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                20. MedicationRequest.meta.tag
                Definition

                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                Short✕ This element is not supported
                Comments

                The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                Control0..*
                BindingFor example codes, see CommonTags
                (example to http://hl7.org/fhir/ValueSet/common-tags)

                Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                TypeCoding
                Is Modifierfalse
                Standard StatusDraft (from Trial Use)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                22. MedicationRequest.implicitRules
                Definition

                A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                ShortA set of rules under which this content was created
                Comments

                Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. All modifiers SHALL be documented in the profile, in order to be usable.

                Control0..0
                Typeuri
                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. MedicationRequest.language
                Definition

                The base language in which the resource is written.

                ShortLanguage of the resource content
                Comments

                Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                Control0..1
                BindingThe codes SHOULD be taken from CommonLanguages
                (preferred to http://hl7.org/fhir/ValueSet/languages)

                A human language.

                Additional BindingsPurpose
                AllLanguagesMax Binding
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. MedicationRequest.text
                Definition

                A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                ShortText summary of the resource, for human interpretation
                Comments

                Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                Control0..1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Alternate Namesnarrative, html, xhtml, display
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. MedicationRequest.contained
                Definition

                These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                ShortContained, inline Resources
                Comments

                This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                Control1..*
                TypeResource
                Is Modifierfalse
                Summaryfalse
                Alternate Namesinline resources, anonymous resources, contained resources
                30. MedicationRequest.extension
                Definition

                An Extension

                ShortExtension
                Control1..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 32. MedicationRequest.extension:treatmentplan
                  Slice Nametreatmentplan
                  Definition

                  An Extension

                  ShortA reference to the MedicationStatement that introduced this medication
                  Control1..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(CH EMED Extension Treatment Plan) (Complex Extension)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  34. MedicationRequest.modifierExtension
                  Definition

                  An Extension

                  ShortExtension
                  Comments

                  All modifiers SHALL be documented in the profile, in order to be usable.

                  Control0..0
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  36. MedicationRequest.identifier
                  Definition

                  Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                  ShortMedicationRequest Identifier
                  Comments

                  This is a business identifier, not a resource identifier.

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  38. MedicationRequest.identifier.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  40. MedicationRequest.identifier.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MedicationRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 42. MedicationRequest.identifier.use
                    Definition

                    The purpose of this identifier.

                    Shortusual | official | temp | secondary | old (If known)
                    Comments

                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                    Control0..1
                    BindingThe codes SHALL be taken from IdentifierUse
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                    Identifies the purpose for this identifier, if known .

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    44. MedicationRequest.identifier.type
                    Definition

                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                    ShortDescription of identifier
                    Comments

                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows users to make use of identifiers when the identifier system is not known.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. MedicationRequest.identifier.system
                    Definition

                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                    Fixed Valueurn:ietf:rfc:3986
                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. MedicationRequest.identifier.value
                    Definition

                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                    ShortIdentifier value as UUID
                    Comments

                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Example<br/><b>General</b>:123456 <br/><b>CH EMED</b>:urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    50. MedicationRequest.identifier.period
                    Definition

                    Time period during which identifier is/was valid for use.

                    ShortTime period when id is/was valid for use
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    52. MedicationRequest.identifier.assigner
                    Definition

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                    Control0..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    54. MedicationRequest.status
                    Definition

                    A code specifying the current state of the order. Generally, this will be active or completed state.

                    Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
                    Comments

                    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                    Control1..1
                    BindingThe codes SHALL be taken from medicationrequest Status
                    (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

                    A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

                    Typecode
                    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Pattern Valueactive
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    56. MedicationRequest.statusReason
                    Definition

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element is not supported
                    Comments

                    This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

                    Control0..1
                    BindingFor example codes, see medicationRequest Status Reason Codes
                    (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

                    Identifies the reasons for a given status.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Standard StatusDraft (from Trial Use)
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    58. MedicationRequest.intent
                    Definition

                    Whether the request is a proposal, plan, or an original order.

                    Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
                    Comments

                    It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                    An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                    Control1..1
                    BindingThe codes SHALL be taken from medicationRequest Intent
                    (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

                    The kind of medication order.

                    Typecode
                    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Pattern Valueorder
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    60. MedicationRequest.category
                    Definition

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element is not supported
                    Comments

                    The category can be used to include where the medication is expected to be consumed or other types of requests.

                    Control0..*
                    BindingFor example codes, see medicationRequest Category Codes
                    (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

                    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.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Standard StatusDraft (from Trial Use)
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. MedicationRequest.priority
                    Definition

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element is not supported
                    Control0..1
                    BindingThe codes SHALL be taken from RequestPriority
                    (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

                    Identifies the level of importance to be assigned to actioning the request.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Standard StatusDraft (from Trial Use)
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. MedicationRequest.doNotPerform
                    Definition

                    If true indicates that the provider is asking for the medication request not to occur.

                    ShortTrue if request is prohibiting action
                    Comments

                    Use a PADV CANCEL/SUSPEND/REFUSE instead

                    Control0..0
                    Typeboolean
                    Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. MedicationRequest.reported[x]
                    Definition

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element is not supported
                    Control0..1
                    TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Standard StatusDraft (from Trial Use)
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. MedicationRequest.medication[x]
                    Definition

                    Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                    ShortMedication to be taken
                    Comments

                    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                    Control1..1
                    TypeReference(CH Core Medication)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on MedicationRequest.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 70. MedicationRequest.medication[x]:medicationReference
                      Slice NamemedicationReference
                      Definition

                      Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                      ShortReference to the contained medication
                      Comments

                      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                      Control0..1
                      TypeReference(CH EMED EPR Medication)contained
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      72. MedicationRequest.subject
                      Definition

                      A link to a resource representing the person or set of individuals to whom the medication will be given.

                      ShortPatient
                      Comments

                      The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                      Control1..1
                      TypeReference(CH EMED EPR Patient)referenced, bundled
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      74. MedicationRequest.subject.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      76. MedicationRequest.subject.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MedicationRequest.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 78. MedicationRequest.subject.reference
                        Definition

                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                        ShortLiteral reference, Relative, internal or absolute URL
                        Comments

                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                        Control1..1
                        This element is affected by the following invariants: ref-1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        80. MedicationRequest.subject.type
                        Definition

                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                        ShortType the reference refers to (e.g. "Patient")
                        Comments

                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                        Aa resource (or, for logical models, the URI of the logical model).

                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        82. MedicationRequest.subject.identifier
                        Definition

                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                        ShortLogical reference, when literal reference is not known
                        Comments

                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1
                        TypeIdentifier
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        84. MedicationRequest.subject.display
                        Definition

                        Plain text narrative that identifies the resource in addition to the resource reference.

                        ShortText alternative for the resource
                        Comments

                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        86. MedicationRequest.encounter
                        Definition

                        Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                        Short✕ This element is not supported
                        Comments

                        This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

                        Control0..1
                        TypeReference(Encounter)
                        Is Modifierfalse
                        Standard StatusDraft (from Trial Use)
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        88. MedicationRequest.supportingInformation
                        Definition

                        Include additional information (for example, patient height and weight) that supports the ordering of the medication.

                        ShortInformation to support ordering of the medication
                        Control1..*
                        TypeReference(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on MedicationRequest.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 90. MedicationRequest.supportingInformation:partOf
                          Slice NamepartOf
                          Definition

                          Include additional information (for example, patient height and weight) that supports the ordering of the medication.

                          ShortReference to the Observation from type 'CHANGE'
                          Control1..1
                          TypeReference(PADV Observation)referenced, bundled
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          92. MedicationRequest.authoredOn
                          Definition

                          The date (and perhaps time) when the prescription was initially written or authored on.

                          ShortWhen request was initially authored
                          Control1..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          94. MedicationRequest.requester
                          Definition

                          The individual, organization, or device that initiated the request and has responsibility for its activation.

                          ShortThe author of the medical decision, see also 'Guidance - Authorship'
                          Control1..1
                          TypeReference(CH EMED EPR PractitionerRole)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          96. MedicationRequest.requester.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          98. MedicationRequest.requester.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MedicationRequest.requester.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 100. MedicationRequest.requester.reference
                            Definition

                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                            ShortLiteral reference, Relative, internal or absolute URL
                            Comments

                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                            Control1..1
                            This element is affected by the following invariants: ref-1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. MedicationRequest.requester.type
                            Definition

                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                            ShortType the reference refers to (e.g. "Patient")
                            Comments

                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                            Aa resource (or, for logical models, the URI of the logical model).

                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            104. MedicationRequest.requester.identifier
                            Definition

                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                            ShortLogical reference, when literal reference is not known
                            Comments

                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            106. MedicationRequest.requester.display
                            Definition

                            Plain text narrative that identifies the resource in addition to the resource reference.

                            ShortText alternative for the resource
                            Comments

                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            108. MedicationRequest.performer
                            Definition

                            Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                            Short✕ This element is not supported
                            Control0..1
                            TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                            Is Modifierfalse
                            Standard StatusDraft (from Trial Use)
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            110. MedicationRequest.performerType
                            Definition

                            Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                            Short✕ This element is not supported
                            Comments

                            If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

                            Control0..1
                            BindingFor example codes, see ProcedurePerformerRoleCodes
                            (example to http://hl7.org/fhir/ValueSet/performer-role)

                            Identifies the type of individual that is desired to administer the medication.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Standard StatusDraft (from Trial Use)
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            112. MedicationRequest.recorder
                            Definition

                            The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

                            ShortPerson who entered the request
                            Control0..1
                            TypeReference(Practitioner, PractitionerRole)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            114. MedicationRequest.reasonCode
                            Definition

                            The reason or the indication for ordering or not ordering the medication. Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').

                            ShortThe treatment reason(s) as text, and optionally coded
                            Comments

                            This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

                            Control0..*
                            BindingFor example codes, see Condition/Problem/DiagnosisCodes
                            (example to http://hl7.org/fhir/ValueSet/condition-code)

                            A coded concept indicating why the medication was ordered.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. MedicationRequest.reasonCode.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            118. MedicationRequest.reasonCode.extension
                            Definition

                            Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                            Short✕ This element is not supported
                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Standard StatusDraft (from Trial Use)
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MedicationRequest.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 120. MedicationRequest.reasonCode.coding
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              Comments

                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                              Control0..*
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              122. MedicationRequest.reasonCode.text
                              Definition

                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                              ShortPlain text representation of the treatment reason(s)
                              Comments

                              Very often the text is the same as a displayName of one of the codings.

                              Control1..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              124. MedicationRequest.reasonReference
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Comments

                              This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

                              Control0..*
                              TypeReference(Condition, Observation)
                              Is Modifierfalse
                              Standard StatusDraft (from Trial Use)
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              126. MedicationRequest.instantiatesCanonical
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..*
                              Typecanonical
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Standard StatusDraft (from Trial Use)
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              128. MedicationRequest.instantiatesUri
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..*
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Standard StatusDraft (from Trial Use)
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              130. MedicationRequest.basedOn
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..*
                              TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                              Is Modifierfalse
                              Standard StatusDraft (from Trial Use)
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              132. MedicationRequest.groupIdentifier
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..1
                              TypeIdentifier
                              Is Modifierfalse
                              Standard StatusDraft (from Trial Use)
                              Summarytrue
                              Requirements

                              Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              134. MedicationRequest.courseOfTherapyType
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Comments

                              This attribute should not be confused with the protocol of the medication.

                              Control0..1
                              BindingFor example codes, see medicationRequest Course of Therapy Codes
                              (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                              Identifies the overall pattern of medication administratio.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Standard StatusDraft (from Trial Use)
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. MedicationRequest.insurance
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..*
                              TypeReference(Coverage, ClaimResponse)
                              Is Modifierfalse
                              Standard StatusDraft (from Trial Use)
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              138. MedicationRequest.note
                              Definition

                              Extra information about the prescription that could not be conveyed by the other attributes.

                              ShortInformation about the prescription
                              Control0..*
                              TypeAnnotation
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              140. MedicationRequest.note.id
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Standard StatusDraft (from Trial Use)
                              Summaryfalse
                              142. MedicationRequest.note.extension
                              Definition

                              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                              Short✕ This element is not supported
                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Standard StatusDraft (from Trial Use)
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on MedicationRequest.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 144. MedicationRequest.note.author[x]
                                Definition

                                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                Short✕ The note author is ignored, as it cannot be different than the document and/or entry's author
                                Comments

                                Organization is used when there's no need for specific attribution as to who made the comment.

                                Control0..1
                                TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Standard StatusDraft (from Trial Use)
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                146. MedicationRequest.note.time
                                Definition

                                Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                Short✕ This element is not supported
                                Control0..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Standard StatusDraft (from Trial Use)
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                148. MedicationRequest.note.text
                                Definition

                                The text of the annotation in markdown format.

                                ShortThe annotation text content (as raw text, no markdown allowed).
                                Control1..1
                                Typemarkdown
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                150. MedicationRequest.dosageInstruction
                                Definition

                                Indicates how the medication is/was taken or should be taken by the patient.

                                ShortHow the medication should be taken
                                Comments

                                There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                                Control1..*
                                TypeDosage(CH Core Dosage)
                                Is Modifierfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                • profile @ $this
                                • 152. MedicationRequest.dosageInstruction:baseEntry
                                  Slice NamebaseEntry
                                  Definition

                                  Indicates how the medication is/was taken or should be taken by the patient.

                                  ShortCH EMED Dosage (MedicationRequest)
                                  Comments

                                  There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                                  Control1..1
                                  TypeDosage(Dosage (MedicationRequest))
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ch-dosage-4: For split dosage timing event and dose/rate are required (sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists()))
                                  ch-dosage-3: Patient instruction/free text dosage instruction, or timing and dose/rate has to be specified (patientInstruction.exists() or (timing.exists() and doseAndRate.exists()))
                                  base-dosage-text: It is a strong recommendation that the base dosage should contain the whole dosage information as narrative, including the information from split dosage elements. (text.exists() and text.trim().length() > 0)
                                  154. MedicationRequest.dosageInstruction:additionalEntry
                                  Slice NameadditionalEntry
                                  Definition

                                  Indicates how the medication is/was taken or should be taken by the patient.

                                  ShortCH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
                                  Comments

                                  There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                                  Control0..*
                                  TypeDosage(Dosage Split)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  156. MedicationRequest.dispenseRequest
                                  Definition

                                  Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

                                  ShortMedication supply authorization
                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  158. MedicationRequest.dispenseRequest.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  160. MedicationRequest.dispenseRequest.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  162. MedicationRequest.dispenseRequest.modifierExtension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Comments

                                  All modifiers SHALL be documented in the profile, in order to be usable.

                                  Control0..0
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  164. MedicationRequest.dispenseRequest.initialFill
                                  Definition

                                  Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                  Short✕ This element is not supported
                                  Comments

                                  If populating this element, either the quantity or the duration must be included.

                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Standard StatusDraft (from Trial Use)
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  166. MedicationRequest.dispenseRequest.initialFill.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  168. MedicationRequest.dispenseRequest.initialFill.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  170. MedicationRequest.dispenseRequest.initialFill.modifierExtension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Comments

                                  All modifiers SHALL be documented in the profile, in order to be usable.

                                  Control0..0
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  172. MedicationRequest.dispenseRequest.initialFill.quantity
                                  Definition

                                  The comparator is not used on a SimpleQuantity

                                  ShortA fixed quantity (no comparator)
                                  Comments

                                  The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeQuantity(Amount Quantity)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                  174. MedicationRequest.dispenseRequest.initialFill.duration
                                  Definition

                                  The length of time that the first dispense is expected to last.

                                  ShortFirst fill duration
                                  Control0..1
                                  TypeDuration
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  176. MedicationRequest.dispenseRequest.dispenseInterval
                                  Definition

                                  Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                  Short✕ This element is not supported
                                  Control0..1
                                  TypeDuration
                                  Is Modifierfalse
                                  Standard StatusDraft (from Trial Use)
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  178. MedicationRequest.dispenseRequest.validityPeriod
                                  Definition

                                  This indicates the validity period of a prescription (stale dating the Prescription).

                                  ShortPeriod of validity of the prescription
                                  Comments

                                  It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

                                  Control0..1
                                  TypePeriod
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  180. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                  Definition

                                  An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

                                  ShortRepeated supply per medication (without initial dispense)
                                  Comments

                                  If displaying "number of authorized fills", add 1 to this number.

                                  Control0..1
                                  TypeunsignedInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  182. MedicationRequest.dispenseRequest.quantity
                                  Definition

                                  The comparator is not used on a SimpleQuantity

                                  ShortA fixed quantity (no comparator)
                                  Comments

                                  The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeQuantity(Amount Quantity)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                  184. MedicationRequest.dispenseRequest.expectedSupplyDuration
                                  Definition

                                  Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                  Short✕ This element is not supported
                                  Comments

                                  In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

                                  Control0..1
                                  TypeDuration
                                  Is Modifierfalse
                                  Standard StatusDraft (from Trial Use)
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  186. MedicationRequest.dispenseRequest.performer
                                  Definition

                                  Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                  Short✕ This element is not supported
                                  Control0..1
                                  TypeReference(Organization)
                                  Is Modifierfalse
                                  Standard StatusDraft (from Trial Use)
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  188. MedicationRequest.substitution
                                  Definition

                                  Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

                                  ShortIf absent, substitution is assumed allowed. If present, the value is fixed to none (not allowed).
                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  190. MedicationRequest.substitution.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  192. MedicationRequest.substitution.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  194. MedicationRequest.substitution.modifierExtension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Comments

                                  All modifiers SHALL be documented in the profile, in order to be usable.

                                  Control0..0
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  196. MedicationRequest.substitution.allowed[x]
                                  Definition

                                  True if the prescriber allows a different drug to be dispensed from what was prescribed.

                                  ShortWhether substitution is allowed or not
                                  Comments

                                  This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                  Control1..1
                                  BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                  (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                  Identifies the type of substitution allowed.

                                  TypeCodeableConcept
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on MedicationRequest.substitution.allowed[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 198. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
                                    Slice NameallowedCodeableConcept
                                    Definition

                                    True if the prescriber allows a different drug to be dispensed from what was prescribed.

                                    ShortWhether substitution is allowed or not
                                    Comments

                                    This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                    Control0..1
                                    BindingThe codes SHALL be taken from Substance Administration Substitution Codes
                                    (required to http://fhir.ch/ig/ch-emed-epr/ValueSet/ch-emed-epr-substance-admin-substitution-code)
                                    TypeCodeableConcept
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    200. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    202. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on MedicationRequest.substitution.allowed[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 204. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept.coding
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control0..*
                                      TypeCoding
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Pattern Value{
                                        "system" : "http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution",
                                        "code" : "N",
                                        "display" : "none"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      206. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept.text
                                      Definition

                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                      ShortPlain text representation of the concept
                                      Comments

                                      Very often the text is the same as a displayName of one of the codings.

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      208. MedicationRequest.substitution.reason
                                      Definition

                                      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                      Short✕ This element is not supported
                                      Control0..1
                                      BindingFor example codes, see SubstanceAdminSubstitutionReason
                                      (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                                      A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Standard StatusDraft (from Trial Use)
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      210. MedicationRequest.priorPrescription
                                      Definition

                                      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                      Short✕ This element is not supported
                                      Comments

                                      Use the XDS mechanism to replace a prescription

                                      Control0..1
                                      TypeReference(MedicationRequest)
                                      Is Modifierfalse
                                      Standard StatusDraft (from Trial Use)
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      212. MedicationRequest.detectedIssue
                                      Definition

                                      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                      Short✕ This element is not supported
                                      Comments

                                      This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                                      Control0..*
                                      TypeReference(DetectedIssue)
                                      Is Modifierfalse
                                      Standard StatusDraft (from Trial Use)
                                      Summaryfalse
                                      Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      214. MedicationRequest.eventHistory
                                      Definition

                                      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                                      Short✕ This element is not supported
                                      Comments

                                      This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                      Control0..*
                                      TypeReference(Provenance)
                                      Is Modifierfalse
                                      Standard StatusDraft (from Trial Use)
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))