Da Vinci - Coverage Requirements Discovery
2.1.0-preview - STU 2 United States of America flag

Da Vinci - Coverage Requirements Discovery, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-crd/ and changes regularly. See the Directory of published versions

Resource Profile: CRD Medication Request

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest Version: 2.1.0-preview
Standards status: Trial-use Maturity Level: 2 Computable Name: CRDMedicationRequest

This profile specifies additional constraints on the US Core MedicationRequest profile to support coverage requirements discovery.

Usage


CRD Clients SHALL use this profile to resolve references to MedicationRequest resources passed to CRD Servers (e.g. selections context references) and to populate draftOrders context objects when invoking the when invoking the following CDS Hooks:

Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.

NOTE: This profile is not currently based on US Core because US Core accidentally constrained out PractitionerRole. When a future version of US-Core adds support back in, this profile will be revised to extend the US Core profile

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreMedicationRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest USCoreMedicationRequestProfile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... Coverage-Information S 0..* (Complex) Coverage Info
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... identifier S 0..* Identifier External ids for this request
... reported[x] 0..1 (USCDI) Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(CRD Patient | CRD Practitioner | CRD Organization)
... encounter 0..1 Reference(CRD Encounter - USCDI 1 | CRD Encounter - USCDI 3) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn 1..1 dateTime (USCDI) When request was initially authored
... requester 1..1 Reference(CRD Practitioner) (USCDI) Who/What requested the Request
... performer S 0..1 Reference(CRD Practitioner | HRex PractitionerRole Profile) Intended performer of administration
... reasonCode S 0..* CodeableConcept (USCDI) Reason or indication for ordering or not ordering the medication
... reasonReference S 0..* Reference(Condition | Observation) (USCDI) US Core Condition or Observation that supports the prescription
... basedOn 0..* Reference(CRD Medication Request | CRD Service Request) What request fulfills
... substitution S 0..1 BackboneElement Any restrictions on medication substitution
... priorPrescription S 0..1 Reference(CRD Medication Request) An order/prescription that is being replaced

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile Ordering of medication for patient or group
us-core-21: requester SHALL be present if intent is "order"
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... Coverage-Information SC 0..* (Complex) Coverage Info
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... identifier S 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... reported[x] SΣ 0..1 (USCDI) Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(CRD Patient | CRD Practitioner | CRD Organization)
... medication[x] SΣ 1..1 (USCDI) Medication to be taken
Binding: Medication Clinical Drug . (extensible)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile)
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(CRD Encounter - USCDI 1 | CRD Encounter - USCDI 3) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 1..1 Reference(CRD Practitioner) (USCDI) Who/What requested the Request
... performer S 0..1 Reference(CRD Practitioner | HRex PractitionerRole Profile) Intended performer of administration
... reasonCode S 0..* CodeableConcept (USCDI) Reason or indication for ordering or not ordering the medication
Binding: US Core Condition Codes (extensible)
... reasonReference S 0..* Reference(Condition | Observation) (USCDI) US Core Condition or Observation that supports the prescription
... basedOn Σ 0..* Reference(CRD Medication Request | CRD Service Request) What request fulfills
... dosageInstruction S 0..* Dosage (USCDI) How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string (USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (USCDI) When medication should be administered
.... doseAndRate SΣ 0..* Element (USCDI) Amount of medication administered
..... dose[x] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity
... dispenseRequest S 0..1 BackboneElement (USCDI) Medication supply authorization
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... numberOfRepeatsAllowed S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
... substitution S 0..1 BackboneElement Any restrictions on medication substitution
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
... priorPrescription S 0..1 Reference(CRD Medication Request) An order/prescription that is being replaced

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode

Constraints

IdGradePath(s)DetailsRequirements
crd-ci-q1errorMedicationRequest.extension:Coverage-InformationQuestionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
: extension.where(url='questionnaire' or url='response').exists() implies (extension.where(url = 'doc-needed').exists() and extension.where(url = 'doc-needed').all(value != 'no-doc'))
crd-ci-q2errorMedicationRequest.extension:Coverage-InformationIf covered is set to 'not-covered', then 'pa-needed' should not exist.
: extension.where(url = 'covered' and value != 'not-covered') implies extension.where(url = 'pa-needed').exists()
crd-ci-q3errorMedicationRequest.extension:Coverage-InformationIf 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
: extension.where(url = 'info-needed').exists() implies extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1
crd-ci-q4errorMedicationRequest.extension:Coverage-InformationIf 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
: extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'PA')
crd-ci-q5errorMedicationRequest.extension:Coverage-Information'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
: extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-21errorMedicationRequestrequester SHALL be present if intent is "order"
: (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile Ordering of medication for patient or group
us-core-21: requester SHALL be present if intent is "order"
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... Coverage-Information SC 0..* (Complex) Coverage Info
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (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: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... reported[x] SΣ 0..1 (USCDI) Reported rather than primary record
.... reportedBoolean boolean S
.... reportedReference Reference S(CRD Patient | CRD Practitioner | CRD Organization)
... medication[x] SΣ 1..1 (USCDI) Medication to be taken
Binding: Medication Clinical Drug . (extensible)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile)
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(CRD Encounter - USCDI 1 | CRD Encounter - USCDI 3) (USCDI) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 1..1 Reference(CRD Practitioner) (USCDI) Who/What requested the Request
... performer S 0..1 Reference(CRD Practitioner | HRex PractitionerRole Profile) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode S 0..* CodeableConcept (USCDI) Reason or indication for ordering or not ordering the medication
Binding: US Core Condition Codes (extensible)
... reasonReference S 0..* Reference(Condition | Observation) (USCDI) US Core Condition or Observation that supports the prescription
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CRD Medication Request | CRD Service Request) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.

... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage (USCDI) How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string (USCDI) 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: SNOMEDCTAdditionalDosageInstructions (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
.... timing SΣ 0..1 Timing (USCDI) When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ 0..* Element (USCDI) Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest S 0..1 BackboneElement (USCDI) Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution S 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

... priorPrescription S 0..1 Reference(CRD Medication Request) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
crd-ci-q1errorMedicationRequest.extension:Coverage-InformationQuestionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
: extension.where(url='questionnaire' or url='response').exists() implies (extension.where(url = 'doc-needed').exists() and extension.where(url = 'doc-needed').all(value != 'no-doc'))
crd-ci-q2errorMedicationRequest.extension:Coverage-InformationIf covered is set to 'not-covered', then 'pa-needed' should not exist.
: extension.where(url = 'covered' and value != 'not-covered') implies extension.where(url = 'pa-needed').exists()
crd-ci-q3errorMedicationRequest.extension:Coverage-InformationIf 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
: extension.where(url = 'info-needed').exists() implies extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1
crd-ci-q4errorMedicationRequest.extension:Coverage-InformationIf 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
: extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'PA')
crd-ci-q5errorMedicationRequest.extension:Coverage-Information'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
: extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-21errorMedicationRequestrequester SHALL be present if intent is "order"
: (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Differential View

This structure is derived from USCoreMedicationRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest USCoreMedicationRequestProfile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... Coverage-Information S 0..* (Complex) Coverage Info
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... identifier S 0..* Identifier External ids for this request
... reported[x] 0..1 (USCDI) Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(CRD Patient | CRD Practitioner | CRD Organization)
... encounter 0..1 Reference(CRD Encounter - USCDI 1 | CRD Encounter - USCDI 3) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn 1..1 dateTime (USCDI) When request was initially authored
... requester 1..1 Reference(CRD Practitioner) (USCDI) Who/What requested the Request
... performer S 0..1 Reference(CRD Practitioner | HRex PractitionerRole Profile) Intended performer of administration
... reasonCode S 0..* CodeableConcept (USCDI) Reason or indication for ordering or not ordering the medication
... reasonReference S 0..* Reference(Condition | Observation) (USCDI) US Core Condition or Observation that supports the prescription
... basedOn 0..* Reference(CRD Medication Request | CRD Service Request) What request fulfills
... substitution S 0..1 BackboneElement Any restrictions on medication substitution
... priorPrescription S 0..1 Reference(CRD Medication Request) An order/prescription that is being replaced

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile Ordering of medication for patient or group
us-core-21: requester SHALL be present if intent is "order"
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... Coverage-Information SC 0..* (Complex) Coverage Info
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... identifier S 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... reported[x] SΣ 0..1 (USCDI) Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(CRD Patient | CRD Practitioner | CRD Organization)
... medication[x] SΣ 1..1 (USCDI) Medication to be taken
Binding: Medication Clinical Drug . (extensible)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile)
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(CRD Encounter - USCDI 1 | CRD Encounter - USCDI 3) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 1..1 Reference(CRD Practitioner) (USCDI) Who/What requested the Request
... performer S 0..1 Reference(CRD Practitioner | HRex PractitionerRole Profile) Intended performer of administration
... reasonCode S 0..* CodeableConcept (USCDI) Reason or indication for ordering or not ordering the medication
Binding: US Core Condition Codes (extensible)
... reasonReference S 0..* Reference(Condition | Observation) (USCDI) US Core Condition or Observation that supports the prescription
... basedOn Σ 0..* Reference(CRD Medication Request | CRD Service Request) What request fulfills
... dosageInstruction S 0..* Dosage (USCDI) How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string (USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (USCDI) When medication should be administered
.... doseAndRate SΣ 0..* Element (USCDI) Amount of medication administered
..... dose[x] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity
... dispenseRequest S 0..1 BackboneElement (USCDI) Medication supply authorization
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... numberOfRepeatsAllowed S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
... substitution S 0..1 BackboneElement Any restrictions on medication substitution
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
... priorPrescription S 0..1 Reference(CRD Medication Request) An order/prescription that is being replaced

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode

Constraints

IdGradePath(s)DetailsRequirements
crd-ci-q1errorMedicationRequest.extension:Coverage-InformationQuestionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
: extension.where(url='questionnaire' or url='response').exists() implies (extension.where(url = 'doc-needed').exists() and extension.where(url = 'doc-needed').all(value != 'no-doc'))
crd-ci-q2errorMedicationRequest.extension:Coverage-InformationIf covered is set to 'not-covered', then 'pa-needed' should not exist.
: extension.where(url = 'covered' and value != 'not-covered') implies extension.where(url = 'pa-needed').exists()
crd-ci-q3errorMedicationRequest.extension:Coverage-InformationIf 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
: extension.where(url = 'info-needed').exists() implies extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1
crd-ci-q4errorMedicationRequest.extension:Coverage-InformationIf 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
: extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'PA')
crd-ci-q5errorMedicationRequest.extension:Coverage-Information'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
: extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-21errorMedicationRequestrequester SHALL be present if intent is "order"
: (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile Ordering of medication for patient or group
us-core-21: requester SHALL be present if intent is "order"
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... Coverage-Information SC 0..* (Complex) Coverage Info
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (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: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... reported[x] SΣ 0..1 (USCDI) Reported rather than primary record
.... reportedBoolean boolean S
.... reportedReference Reference S(CRD Patient | CRD Practitioner | CRD Organization)
... medication[x] SΣ 1..1 (USCDI) Medication to be taken
Binding: Medication Clinical Drug . (extensible)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile)
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(CRD Encounter - USCDI 1 | CRD Encounter - USCDI 3) (USCDI) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 1..1 Reference(CRD Practitioner) (USCDI) Who/What requested the Request
... performer S 0..1 Reference(CRD Practitioner | HRex PractitionerRole Profile) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode S 0..* CodeableConcept (USCDI) Reason or indication for ordering or not ordering the medication
Binding: US Core Condition Codes (extensible)
... reasonReference S 0..* Reference(Condition | Observation) (USCDI) US Core Condition or Observation that supports the prescription
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CRD Medication Request | CRD Service Request) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.

... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage (USCDI) How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string (USCDI) 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: SNOMEDCTAdditionalDosageInstructions (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
.... timing SΣ 0..1 Timing (USCDI) When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ 0..* Element (USCDI) Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest S 0..1 BackboneElement (USCDI) Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution S 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

... priorPrescription S 0..1 Reference(CRD Medication Request) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
crd-ci-q1errorMedicationRequest.extension:Coverage-InformationQuestionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
: extension.where(url='questionnaire' or url='response').exists() implies (extension.where(url = 'doc-needed').exists() and extension.where(url = 'doc-needed').all(value != 'no-doc'))
crd-ci-q2errorMedicationRequest.extension:Coverage-InformationIf covered is set to 'not-covered', then 'pa-needed' should not exist.
: extension.where(url = 'covered' and value != 'not-covered') implies extension.where(url = 'pa-needed').exists()
crd-ci-q3errorMedicationRequest.extension:Coverage-InformationIf 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
: extension.where(url = 'info-needed').exists() implies extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1
crd-ci-q4errorMedicationRequest.extension:Coverage-InformationIf 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
: extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'PA')
crd-ci-q5errorMedicationRequest.extension:Coverage-Information'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
: extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-21errorMedicationRequestrequester SHALL be present if intent is "order"
: (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Notes

While the codes for the medication are expected to be drawn from RxNorm, EHRs MAY send additional coding repetions to communicate other code systems (e.g. HCPCS J codes). This may be necessary for the payer to appropriately respond to coverage information regarding medications associated with medical and DME benefits.