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

Messages

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		Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date	2023-10-17	2020-05-23T00:00:00-05:00	Values Differ
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)](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.	This profile constrains the MedicationRequest resource to convey a subset of prescription information required in the consumer real-time pharmacy benefit check (RTPBC) process. The content specifies the prescribed product and quantity, and references the prescribing practitioner and the patient's preferred pharmacy. This profile differs from the US Core MedicationRequest in that it doesn't set the encounter or dosageInstruction elements as Must Support, because clients in the exchange will typically be mobile consumer applications that do not posess this information, and because that information is not pertinent to this use case.	Values Differ
experimental	false
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	USCoreMedicationRequestProfile	RtpbcMedicationRequest	Values Differ
publisher	HL7 International / Cross-Group Projects	HL7 International / Pharmacy	Values Differ
purpose
status	active
title	US Core MedicationRequest Profile	RTPBC Medication Request	Values Differ
type	MedicationRequest
url	http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest	http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest	Values Differ
version	8.0.0	2.0.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group Constraints: us-core-21		0..*	MedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Additional content defined by implementations
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	?!SΣ	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.	?!SΣ	1..1	code	Request Status Binding: ?? (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Fixed Value: draft
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	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order.	?!SΣ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. Fixed Value: proposal
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by value:$this Binding: ?? (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.		0..*	CodeableConcept	Type of medication usage 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.	Elements differ in definition for mustSupport: 'true' vs 'false'
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]	SΣ	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	SΣ	1..1	boolean	Reported rather than primary record	Element minimum cardinalities differ: '0' vs '1'
medication[x]	SΣ	1..1	CodeableConcept, Reference(US Core Medication Profile)	Medication to be taken Binding: ?? (extensible)	SΣ	1..1	CodeableConcept	Prescribed Product Binding: ?? (extensible): RTPBC prescribable product codes (NDC11 and RxNorm)	Unable to resolve left value set http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 at MedicationRequest.medication[x]
subject	SΣ	1..1	Reference(US Core Patient Profile S | Group)	Who or group medication request is for	SΣ	1..1	Reference(RTPBC Patient)	Patient
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay	Elements differ in definition for mustSupport: 'true' vs 'false'
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	When request was initially authored	SΣ	1..1	dateTime	When request was initially authored	Element minimum cardinalities differ: '0' vs '1'
requester	SΣC	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	SΣ	1..1	Reference(US Core Practitioner Profile)	Prescriber	Element minimum cardinalities differ: '0' vs '1'
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	Reason or indication for ordering or not ordering the medication Binding: ?? (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
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					Removed this element
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url					Removed this element
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized					Removed this element
sequence	Σ	0..1	integer	The order of the dosage instructions					Removed this element
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG					Removed this element
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".					Removed this element
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions					Removed this element
timing	SΣ	0..1	Timing	When medication should be administered					Removed this element
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.					Removed this element
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.					Removed this element
route	SΣ	0..1	CodeableConcept	How drug should enter body Binding: ?? (extensible): SNOMED CT and NCI Thesaurus SPL route of administration codes					Removed this element
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered.					Removed this element
doseAndRate	SΣ	0..*	Element	Amount of medication administered					Removed this element
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time					Removed this element
maxDosePerAdministration	Σ	0..1	??	Upper limit on medication per administration					Removed this element
maxDosePerLifetime	Σ	0..1	??	Upper limit on medication per lifetime of the patient					Removed this element
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization	S	1..1	BackboneElement	Medication supply authorization	Element minimum cardinalities differ: '0' vs '1'
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		0..1	unsignedInt	Number of refills authorized	Elements differ in definition for mustSupport: 'true' vs 'false'
quantity	S	0..1	??	Amount of medication to supply per dispense	S	1..1	??	Prescribed Quantity	Element minimum cardinalities differ: '0' vs '1'
id						0..1	string	Unique id for inter-element referencing	Added this element
Slices for extension						0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url	Added this element
value					SΣ	1..1	decimal	Quantity in Billing Units	Added this element
comparator					?!Σ	0..0			Added this element
unit					SΣ	1..1	string	Billing unit of measure Binding: ?? (extensible): Billing quantity unity of measure	Added this element
system					ΣC	0..1	uri	System that defines coded unit form	Added this element
code					Σ	0..1	code	Coded form of the unit	Added this element
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense	S	0..1	Duration	Days Supply	Elements differ in definition for mustSupport: 'false' vs 'true'
id						0..1	string	Unique id for inter-element referencing	Added this element
Slices for extension						0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url	Added this element
value					SΣ	0..1	decimal	Days Supply Value	Added this element
comparator					?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: ?? (required): How the Quantity should be understood and represented.	Added this element
unit					Σ	0..1	string	Unit representation	Added this element
system					ΣC	0..1	uri	System that defines coded unit form	Added this element
code					Σ	0..1	code	Coded form of the unit	Added this element
performer		0..1	Reference(Organization)	Intended dispenser	S	1..1	Reference(RTPBC Pharmacy Organization)	Pharmacy	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
substitution		0..1	BackboneElement	Any restrictions on medication substitution	S	1..1	BackboneElement	Substitution	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
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.	S	1..1	boolean	Substitution Allowed	Elements differ in definition for mustSupport: 'false' vs 'true'
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