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

Left: | US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest)
Right: | US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest)

### Messages

Information | MedicationRequest.language | Example/preferred bindings differ at MedicationRequest.language using binding from USCoreMedicationRequestProfile
Warning | MedicationRequest.dosageInstruction.route | Elements differ in definition for mustSupport: 'false' vs 'true'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/MedicationRequest |
copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |
description | The US Core MedicationRequest Profile inherits from the FHIR [MedicationRequest](https://hl7.org/fhir/R4/medicationrequest.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) *Medications* Data Class. This profile sets minimum expectations for the MedicationRequest resource to record, search, and fetch a patient's medication prescriptions or orders. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | The US Core MedicationRequest Profile inherits from the FHIR [MedicationRequest](https://hl7.org/fhir/R4/medicationrequest.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the [U.S. Core Data for Interoperability (USCDI)](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi) *Medications* Data Class. This profile sets minimum expectations for the MedicationRequest resource to record, search, and fetch a patient's medication prescriptions or orders. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | Values Differ
experimental | false |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreMedicationRequestProfile |
publisher | HL7 International / Cross-Group Projects |
purpose |  |
status | active |
title | US Core MedicationRequest Profile |
type | MedicationRequest |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest |

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
MedicationRequest | C | 0..* | MedicationRequest | Ordering of medication for patient or group Constraints: us-core-21 | C | 0..* | MedicationRequest | Ordering of medication for patient or group Constraints: us-core-21 |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
| Example/preferred bindings differ at MedicationRequest.language using binding from USCoreMedicationRequestProfile
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..* | Resource | Contained, inline Resources |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier |  | 0..* | Identifier | External ids for this request |  | 0..* | Identifier | External ids for this request |
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. |
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: ?? (example): Identifies the reasons for a given status. |  | 0..1 | CodeableConcept | Reason for current status Binding: ?? (example): Identifies the reasons for a given status. |
intent | ?!S Σ C | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. | ?!S Σ C | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. |
Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: ?? (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by value:$this Binding: ?? (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. |
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. |
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action | ?!Σ | 0..1 | boolean | True if request is prohibiting action |
reported[x] | S Σ | 0..1 | boolean S, Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | Reported rather than primary record | S Σ | 0..1 | boolean S, Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | Reported rather than primary record |
medication[x] | S Σ | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | Medication to be taken Binding: ?? (extensible) | S Σ | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | Medication to be taken Binding: ?? (extensible) |
subject | S Σ | 1..1 | Reference(US Core Patient Profile S | Group) | Who or group medication request is for | S Σ | 1..1 | Reference(US Core Patient Profile S | Group) | Who or group medication request is for |
encounter | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of encounter/admission/stay | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of encounter/admission/stay |
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication |  | 0..* | Reference(Resource) | Information to support ordering of the medication |
authoredOn | S Σ | 0..1 | dateTime | When request was initially authored | S Σ | 0..1 | dateTime | When request was initially authored |
requester | S Σ C | 0..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Who/What requested the Request | S Σ C | 0..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Who/What requested the Request |
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration |
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ?? (example): Identifies the type of individual that is desired to administer the medication. | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ?? (example): Identifies the type of individual that is desired to administer the medication. |
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request |
reasonCode |  | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: ?? (extensible) |  | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: ?? (extensible) |
reasonReference |  | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription |  | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription |
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills |
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | Σ | 0..1 | Identifier | Composite request this is part of |
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio. |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio. |
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage |
note |  | 0..* | Annotation | Information about the prescription |  | 0..* | Annotation | Information about the prescription |
dosageInstruction | S | 0..* | Dosage | How the medication should be taken | S | 0..* | Dosage | How the medication should be taken |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence | Σ | 0..1 | integer | The order of the dosage instructions | Σ | 0..1 | integer | The order of the dosage instructions |
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG |
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions | Σ | 0..1 | string | Patient or consumer oriented instructions |
timing | S Σ | 0..1 | Timing | When medication should be administered | S Σ | 0..1 | Timing | When medication should be administered |
asNeeded[x] | Σ | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) Binding: ?? (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | Σ | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) Binding: ?? (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. |
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | S Σ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (extensible): SNOMED CT and NCI Thesaurus SPL route of administration codes | Elements differ in definition for mustSupport: 'false' vs 'true'
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. |
doseAndRate | S Σ | 0..* | Element | Amount of medication administered | S Σ | 0..* | Element | Amount of medication administered |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified. | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified. |
dose[x] | S Σ | 0..1 | ??, Range | Amount of medication per dose Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
| S Σ | 0..1 | ??, Range | Amount of medication per dose Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
rate[x] | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | Σ | 0..1 | Ratio | Upper limit on medication per unit of time |
maxDosePerAdministration | Σ | 0..1 | ?? | Upper limit on medication per administration | Σ | 0..1 | ?? | Upper limit on medication per administration |
maxDosePerLifetime | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient |
dispenseRequest | S | 0..1 | BackboneElement | Medication supply authorization | S | 0..1 | BackboneElement | Medication supply authorization |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
initialFill |  | 0..1 | BackboneElement | First fill details |  | 0..1 | BackboneElement | First fill details |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
quantity |  | 0..1 | ?? | First fill quantity |  | 0..1 | ?? | First fill quantity |
duration |  | 0..1 | Duration | First fill duration |  | 0..1 | Duration | First fill duration |
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses |  | 0..1 | Duration | Minimum period of time between dispenses |
validityPeriod |  | 0..1 | Period | Time period supply is authorized for |  | 0..1 | Period | Time period supply is authorized for |
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | Number of refills authorized | S | 0..1 | unsignedInt | Number of refills authorized |
quantity | S | 0..1 | ?? | Amount of medication to supply per dispense | S | 0..1 | ?? | Amount of medication to supply per dispense |
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense |  | 0..1 | Duration | Number of days supply per dispense |
performer |  | 0..1 | Reference(Organization) | Intended dispenser |  | 0..1 | Reference(Organization) | Intended dispenser |
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
allowed[x] |  | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed. |  | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed. |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. |
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced |
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action |
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle |
Documentation for this format