HL7 Electronic Health Record System Functional Model, Release 2.1.1
2.1.1 - Normative

HL7 Electronic Health Record System Functional Model, Release 2.1.1, published by HL7 International / Electronic Health Records. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ehrsfm-ig/ and changes regularly. See the Directory of published versions

## : CPS.4.2 Support for Medication and Immunization Ordering (Function)

Page standards status: Normative

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    <Requirements xmlns="http://hl7.org/fhir">
      <id value="EHRSFMR2-CPS.4.2"/>
      <meta>
        <profile
                 value="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/FMFunction"/>
      </meta>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xml:lang="en" xmlns="http://www.w3.org/1999/xhtml" lang="en">

        <div id="description"><b>Description <a href="https://hl7.org/fhir/versions.html#std-process" title="Informative Content" class="informative-flag">I</a>:</b> <div><p>During medication or immunization ordering it is critical to minimize potential errors that can cause adverse events. This is accomplished by the EHR system through the use of clinical decision support and prompting to validate the order at time of ordering. Whist many of these functions are more commonly associated with medication ordering; they also apply to ordering of immunizations when such ordering occurs. The support includes the checking for drug/drug interactions, checking against documented allergies or previous adverse events, as well as validating patient-specific dosing and providing appropriate warnings. Support for medical ordering efficiencies also ensures that orders are appropriate and contain all required supporting information.</p>
    </div></div>

        <div id="requirements"><b>Criteria <a href="https://hl7.org/fhir/versions.html#std-process" title="Normative Content" class="normative-flag">N</a>:</b></div>

        <table id="statements" class="grid dict">

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#01
                </td>
                <td style="padding-left: 4px;">
                SHALL

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHALL provide the ability to maintain a discrete list of orderable medications and immunizations (i.e., formulary).</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#02
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to render a paper copy of medication and immunization prescriptions for the patient to take to a pharmacy for fulfillment.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#03
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to render electronic medication and immunization prescriptions to a pharmacy.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#04
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                    <span style="border-radius: 999px;margin: 2px 2px;font-size: 10px;display: inline-block;padding: 3px 5px;letter-spacing: 0.5px;line-height: 1;white-space: nowrap;background-color: #e5f5e5;color: #388e3c;border: 1px solid #a2d1a2;">dependent</span>

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to render an alert or notification that a non-formulary medication or immunization was ordered according to scope of practice, organizational policy, and/or jurisdictional law.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#05
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to exchange medication and immunization orders with an external medication management system.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#06
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD update a patient's medication list to show that the medication is discontinued when a prescribed medication or standing medication order is discontinued.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#07
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                    <span style="border-radius: 999px;margin: 2px 2px;font-size: 10px;display: inline-block;padding: 3px 5px;letter-spacing: 0.5px;line-height: 1;white-space: nowrap;background-color: #e5f5e5;color: #388e3c;border: 1px solid #a2d1a2;">dependent</span>

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to manage specific formularies according to scope of practice, organizational policy, and/or jurisdictional law.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#08
                </td>
                <td style="padding-left: 4px;">
                SHALL

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHALL provide the ability to maintain directly or by reference a list (i.e. formulary) of medications and immunizations which includes a unique identifier for each medication / immunization.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#09
                </td>
                <td style="padding-left: 4px;">
                MAY

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system MAY provide the ability to capture the duration of a drug interaction warning after the prescription has run-out.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#10
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to capture and maintain the severity level at which warnings are displayed.</p>
    </div>

                </td>
            </tr>

            <tr>
                <td style="padding-left: 4px;">
                CPS.4.2#11
                </td>
                <td style="padding-left: 4px;">
                SHOULD

                </td>
                <td style="padding-left: 4px;" class="requirement">
                    <div><p>The system SHOULD provide the ability to capture, maintain and render appropriate responses to severity levels at which warnings are displayed.</p>
    </div>

                </td>
            </tr>

        </table>
    </div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="ehr"/>
      </extension>
      <url value="http://hl7.org/ehrs/uv/ehrsfmr2/Requirements/EHRSFMR2-CPS.4.2"/>
      <version value="2.1.1"/>
      <name value="CPS_4_2_Support_for_Medication_and_Immunization_Ordering"/>
      <title
             value="CPS.4.2 Support for Medication and Immunization Ordering (Function)"/>
      <status value="active"/>
      <date value="2025-12-13T09:06:06+00:00"/>
      <publisher value="HL7 International / Electronic Health Records"/>
      <contact>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/ehr"/>
        </telecom>
      </contact>
      <description
                   value="Provide functionality to alert providers to potential medication and immunization ordering errors (such as wrong patient, wrong drug, wrong dose, wrong route and wrong time)."/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="001"/>
          <display value="World"/>
        </coding>
      </jurisdiction>
      <purpose
               value="During medication or immunization ordering it is critical to minimize potential errors that can cause adverse events. This is accomplished by the EHR system through the use of clinical decision support and prompting to validate the order at time of ordering. Whist many of these functions are more commonly associated with medication ordering; they also apply to ordering of immunizations when such ordering occurs. The support includes the checking for drug/drug interactions, checking against documented allergies or previous adverse events, as well as validating patient-specific dosing and providing appropriate warnings. Support for medical ordering efficiencies also ensures that orders are appropriate and contain all required supporting information."/>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-01"/>
        <label value="CPS.4.2#01"/>
        <conformance value="SHALL"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHALL provide the ability to maintain a discrete list of orderable medications and immunizations (i.e., formulary)."/>
        <derivedFrom value="EHR-S_FM_R1.1 DC.1.7.1#5"/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-02"/>
        <label value="CPS.4.2#02"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to render a paper copy of medication and immunization prescriptions for the patient to take to a pharmacy for fulfillment."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-03"/>
        <label value="CPS.4.2#03"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to render electronic medication and immunization prescriptions to a pharmacy."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="true"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-04"/>
        <label value="CPS.4.2#04"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to render an alert or notification that a non-formulary medication or immunization was ordered according to scope of practice, organizational policy, and/or jurisdictional law."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-05"/>
        <label value="CPS.4.2#05"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to exchange medication and immunization orders with an external medication management system."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-06"/>
        <label value="CPS.4.2#06"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD update a patient's medication list to show that the medication is discontinued when a prescribed medication or standing medication order is discontinued."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="true"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-07"/>
        <label value="CPS.4.2#07"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to manage specific formularies according to scope of practice, organizational policy, and/or jurisdictional law."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-08"/>
        <label value="CPS.4.2#08"/>
        <conformance value="SHALL"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHALL provide the ability to maintain directly or by reference a list (i.e. formulary) of medications and immunizations which includes a unique identifier for each medication / immunization."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-09"/>
        <label value="CPS.4.2#09"/>
        <conformance value="MAY"/>
        <conditionality value="false"/>
        <requirement
                     value="The system MAY provide the ability to capture the duration of a drug interaction warning after the prescription has run-out."/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-10"/>
        <label value="CPS.4.2#10"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to capture and maintain the severity level at which warnings are displayed."/>
        <derivedFrom value="EHR-S_FM_R1.1 DC.2.3.1.1#11"/>
      </statement>
      <statement>
        <extension
                   url="http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent">
          <valueBoolean value="false"/>
        </extension>
        <key value="EHRSFMR2-CPS.4.2-11"/>
        <label value="CPS.4.2#11"/>
        <conformance value="SHOULD"/>
        <conditionality value="false"/>
        <requirement
                     value="The system SHOULD provide the ability to capture, maintain and render appropriate responses to severity levels at which warnings are displayed."/>
      </statement>
    </Requirements>