Patient Cost Transparency Implementation Guide
2.0.0 - STU 2 - Draft United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Resource Profile: PCT GFE MedicationRequest

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-medicationrequest Version: 2.0.0
Standards status: Draft Maturity Level: 0 Computable Name: PCTMedicationRequest
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.49

The PCT MedicationRequest including details about a medication for which a GFE is being requested.

The following profile relates to the GFE Coordination workflow and is marked as DRAFT. This content has not yet met the requisite level of testing to be balloted as trail-use. However, this part of the specification has been reviewed by the Da Vinci PCT open community of providers, payers, and health IT vendors and was determined to be at a sufficient level of development to be included in this publication for the purposes of soliciting feedback from, and enabling testing by, the larger implementation community with the intention of bringing the content related to the GFE Coordination workflow to full STU status in a future version. Feedback is welcome and may be submitted through the FHIR change tracker indicating "US Da Vinci Patient Cost Transparency (PCT)(FHIR)" as the specification.

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 1.1.0:

  • New Content

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(7.0.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... Slices for extension Content/Rules for all slices
    .... extension:medicationAdherence 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension
    URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!SΣ 1..1 code 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.
    Required Pattern: active
    ... intent ?!SΣC 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    Required Pattern: proposal
    ... Slices for category S 0..* CodeableConcept 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 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 Reported rather than primary record
    .... reportedBoolean boolean S
    .... reportedReference Reference S(US Core Practitioner Profile(7.0.0) S | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))
    ... medication[x] SΣ 1..1 Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(7.0.0))
    ... subject SΣ 1..1 Reference(US Core Patient Profile(7.0.0)) Who or group medication request is for
    ... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
    ... authoredOn SΣ 0..1 dateTime When request was initially authored
    ... requester SΣC 0..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) Who/What requested the Request
    ... dosageInstruction S 0..* Dosage How the medication should be taken
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... text SΣ 0..1 string Free text dosage instructions e.g. SIG
    .... timing SΣ 0..1 Timing When medication should be administered
    .... doseAndRate SΣ 0..* Element Amount of medication administered
    ..... dose[x] SΣ 0..1 Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S(SimpleQuantity)
    ...... doseRange Range
    ... dispenseRequest S 0..1 BackboneElement Medication supply authorization
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... numberOfRepeatsAllowed S 0..1 unsignedInt Number of refills authorized
    .... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    MedicationRequest.statusrequiredPattern Value: active
    http://hl7.org/fhir/ValueSet/medicationrequest-status
    From the FHIR Standard
    MedicationRequest.intentrequiredPattern Value: proposal
    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|20240606
    MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
    http://hl7.org/fhir/ValueSet/ucum-common
    From the FHIR Standard
    Additional Bindings Purpose
    UCUMCodes Max Binding

    Constraints

    IdGradePath(s)DetailsRequirements
    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()

    This structure is derived from USCoreMedicationRequestProfile

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest USCoreMedicationRequestProfile(7.0.0)
    ... status 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Required Pattern: active
    ... intent 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Required Pattern: proposal
    ... doNotPerform 0..0
    ... subject 1..1 Reference(US Core Patient Profile(7.0.0)) Who or group medication request is for

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(7.0.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... 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
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... extension:medicationAdherence 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension
    URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier External ids for this request
    ... status ?!SΣ 1..1 code 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.
    Required Pattern: active
    ... 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 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    Required Pattern: proposal
    ... Slices for category S 0..* CodeableConcept 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 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 Reported rather than primary record
    .... reportedBoolean boolean S
    .... reportedReference Reference S(US Core Practitioner Profile(7.0.0) S | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))
    ... medication[x] SΣ 1..1 Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(7.0.0))
    ... subject SΣ 1..1 Reference(US Core Patient Profile(7.0.0)) Who or group medication request is for
    ... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
    ... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    ... authoredOn SΣ 0..1 dateTime When request was initially authored
    ... requester SΣC 0..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) Who/What requested the Request
    ... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
    ... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
    Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
    ... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
    ... reasonCode 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication
    Binding: USCoreConditionCodes (7.0.0) (extensible)
    ... reasonReference 0..* Reference(Condition | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 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(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
    ... groupIdentifier Σ 0..1 Identifier Composite request this is part of
    ... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
    ... note 0..* Annotation Information about the prescription
    ... dosageInstruction S 0..* Dosage 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 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 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 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 Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S(SimpleQuantity)
    ...... 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 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 Number of refills authorized
    .... quantity S 0..1 SimpleQuantity 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 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 (3.0.0) (example): Identifies the type of substitution allowed.
    ..... allowedBoolean boolean
    ..... allowedCodeableConcept CodeableConcept
    .... reason 0..1 CodeableConcept Why should (not) substitution be made
    Binding: SubstanceAdminSubstitutionReason (3.0.0) (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
    ... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
    ... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
    ... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    MedicationRequest.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    From the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    MedicationRequest.statusrequiredPattern Value: active
    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.intentrequiredPattern Value: proposal
    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|20240606
    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|7.0.0
    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
    http://hl7.org/fhir/ValueSet/ucum-common
    From the FHIR Standard
    Additional Bindings Purpose
    UCUMCodes Max Binding
    MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
    http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode|3.0.0
    MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
    http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason|3.0.0

    Constraints

    IdGradePath(s)DetailsRequirements
    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()

    This structure is derived from USCoreMedicationRequestProfile

    Summary

    Prohibited: 1 element

    Structures

    This structure refers to these other structures:

    Maturity: 0

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(7.0.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... Slices for extension Content/Rules for all slices
    .... extension:medicationAdherence 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension
    URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!SΣ 1..1 code 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.
    Required Pattern: active
    ... intent ?!SΣC 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    Required Pattern: proposal
    ... Slices for category S 0..* CodeableConcept 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 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 Reported rather than primary record
    .... reportedBoolean boolean S
    .... reportedReference Reference S(US Core Practitioner Profile(7.0.0) S | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))
    ... medication[x] SΣ 1..1 Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(7.0.0))
    ... subject SΣ 1..1 Reference(US Core Patient Profile(7.0.0)) Who or group medication request is for
    ... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
    ... authoredOn SΣ 0..1 dateTime When request was initially authored
    ... requester SΣC 0..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) Who/What requested the Request
    ... dosageInstruction S 0..* Dosage How the medication should be taken
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... text SΣ 0..1 string Free text dosage instructions e.g. SIG
    .... timing SΣ 0..1 Timing When medication should be administered
    .... doseAndRate SΣ 0..* Element Amount of medication administered
    ..... dose[x] SΣ 0..1 Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S(SimpleQuantity)
    ...... doseRange Range
    ... dispenseRequest S 0..1 BackboneElement Medication supply authorization
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... numberOfRepeatsAllowed S 0..1 unsignedInt Number of refills authorized
    .... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    MedicationRequest.statusrequiredPattern Value: active
    http://hl7.org/fhir/ValueSet/medicationrequest-status
    From the FHIR Standard
    MedicationRequest.intentrequiredPattern Value: proposal
    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|20240606
    MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
    http://hl7.org/fhir/ValueSet/ucum-common
    From the FHIR Standard
    Additional Bindings Purpose
    UCUMCodes Max Binding

    Constraints

    IdGradePath(s)DetailsRequirements
    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 & Constraints    Filter: Filtersdoco
    .. MedicationRequest USCoreMedicationRequestProfile(7.0.0)
    ... status 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Required Pattern: active
    ... intent 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Required Pattern: proposal
    ... doNotPerform 0..0
    ... subject 1..1 Reference(US Core Patient Profile(7.0.0)) Who or group medication request is for

    doco Documentation for this format

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(7.0.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... 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
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... extension:medicationAdherence 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension
    URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier External ids for this request
    ... status ?!SΣ 1..1 code 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.
    Required Pattern: active
    ... 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 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    Required Pattern: proposal
    ... Slices for category S 0..* CodeableConcept 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 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 Reported rather than primary record
    .... reportedBoolean boolean S
    .... reportedReference Reference S(US Core Practitioner Profile(7.0.0) S | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))
    ... medication[x] SΣ 1..1 Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(7.0.0))
    ... subject SΣ 1..1 Reference(US Core Patient Profile(7.0.0)) Who or group medication request is for
    ... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
    ... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    ... authoredOn SΣ 0..1 dateTime When request was initially authored
    ... requester SΣC 0..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) Who/What requested the Request
    ... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
    ... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
    Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
    ... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
    ... reasonCode 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication
    Binding: USCoreConditionCodes (7.0.0) (extensible)
    ... reasonReference 0..* Reference(Condition | Observation) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 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(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
    ... groupIdentifier Σ 0..1 Identifier Composite request this is part of
    ... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
    ... note 0..* Annotation Information about the prescription
    ... dosageInstruction S 0..* Dosage 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 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 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 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 Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S(SimpleQuantity)
    ...... 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 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 Number of refills authorized
    .... quantity S 0..1 SimpleQuantity 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 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 (3.0.0) (example): Identifies the type of substitution allowed.
    ..... allowedBoolean boolean
    ..... allowedCodeableConcept CodeableConcept
    .... reason 0..1 CodeableConcept Why should (not) substitution be made
    Binding: SubstanceAdminSubstitutionReason (3.0.0) (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
    ... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
    ... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
    ... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    MedicationRequest.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    From the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    MedicationRequest.statusrequiredPattern Value: active
    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.intentrequiredPattern Value: proposal
    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|20240606
    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|7.0.0
    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
    http://hl7.org/fhir/ValueSet/ucum-common
    From the FHIR Standard
    Additional Bindings Purpose
    UCUMCodes Max Binding
    MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
    http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode|3.0.0
    MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
    http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason|3.0.0

    Constraints

    IdGradePath(s)DetailsRequirements
    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()

    This structure is derived from USCoreMedicationRequestProfile

    Summary

    Prohibited: 1 element

    Structures

    This structure refers to these other structures:

    Maturity: 0

     

    Other representations of profile: CSV, Excel, Schematron