De-Identification, Anonymization, Redaction Toolkit Services
0.1.0 - STU1 Release 1 - Standard for Trial-Use United States of America flag

De-Identification, Anonymization, Redaction Toolkit Services, published by HL7 International / Cross Group Projects. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-darts/ and changes regularly. See the Directory of published versions

Resource Profile: De-Identified UDS Plus MedicationRequest

Official URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-medicationrequest Version: 0.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: UDSPlusMedicationRequest

The UDS+ profile is based on the MedicationRequest resource and establishes the core elements, extensions, vocabularies and value sets for representing MedicationRequest for UDS+ program.

All canonical (Official) URLs will be changed in the future and are not available currently on the web.

Introduction

This profile is used to represent de-identified MedicationRequest information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes MedicationRequest.authoredOn.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a MedicationRequest resource text element may contain information such as the MedicationRequest date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original MedicationRequest resource id should not be included in the De-identified MedicationRequest instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original MedicationRequest. All resource references to the MedicationRequest submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

  • subject
  • encounter

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

  • authoredOn

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id SΣ 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... medication[x] SΣ 1..1 Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... dosageInstruction S 0..* Dosage How the medication should be taken

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If 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-4 error MedicationRequest If 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-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from MedicationRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id S 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... text 0..0 Cannot include any text in the resource as part of the de-identified data.
... contained 0..0 Cannot include any contained resources in the resource as part of the de-identified data.
... intent S 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
... medication[x] S 1..1 CodeableConcept, Reference(Medication) Medication to be taken
... subject S 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
.... display 0..0 Text alternative for the resource
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
.... display 0..0 Text alternative for the resource
... authoredOn S 0..1 dateTime When request was initially authored
... requester S 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... dosageInstruction S 0..* Dosage How the medication should be taken

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id SΣ 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... 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
... extension 0..* Extension Additional content defined by implementations
... 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 coded concept 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 ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... category 0..* CodeableConcept Type of medication usage
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.
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ 1..1 Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | 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 Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... 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
... dispenseRequest 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(4.0.1) 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 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity(4.0.1) 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 (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 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

Path Status Usage ValueSet Version Source
MedicationRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.statusReason Base example Medication request status reason codes 📍4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📍4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
MedicationRequest.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
MedicationRequest.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
MedicationRequest.performerType Base example Procedure Performer Role Codes 📍4.0.1 FHIR Std.
MedicationRequest.reasonCode Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📍4.0.1 FHIR Std.
MedicationRequest.substitution.​allowed[x] Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v7.1
MedicationRequest.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v7.1

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If 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-4 error MedicationRequest If 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-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from MedicationRequest

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id SΣ 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... medication[x] SΣ 1..1 Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... dosageInstruction S 0..* Dosage How the medication should be taken

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If 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-4 error MedicationRequest If 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-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from MedicationRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id S 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... text 0..0 Cannot include any text in the resource as part of the de-identified data.
... contained 0..0 Cannot include any contained resources in the resource as part of the de-identified data.
... intent S 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
... medication[x] S 1..1 CodeableConcept, Reference(Medication) Medication to be taken
... subject S 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
.... display 0..0 Text alternative for the resource
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
.... display 0..0 Text alternative for the resource
... authoredOn S 0..1 dateTime When request was initially authored
... requester S 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... dosageInstruction S 0..* Dosage How the medication should be taken

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* MedicationRequest De-Identified UDS Plus MedicationRequest
... id SΣ 0..1 id The de-identified MedicationRequest identifier created by the health center to send data to UDS+ Data Receiver
... 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
... extension 0..* Extension Additional content defined by implementations
... 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 coded concept 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 ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... category 0..* CodeableConcept Type of medication usage
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.
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ 1..1 Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(De-Identified UDS Plus Patient) Who or group medication request is for
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
... encounter S 0..1 Reference(De-Identified UDS Plus Encounter) Encounter created as part of encounter/admission/stay
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | 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 Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... 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
... dispenseRequest 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(4.0.1) 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 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity(4.0.1) 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 (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 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

Path Status Usage ValueSet Version Source
MedicationRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.statusReason Base example Medication request status reason codes 📍4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📍4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
MedicationRequest.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
MedicationRequest.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
MedicationRequest.performerType Base example Procedure Performer Role Codes 📍4.0.1 FHIR Std.
MedicationRequest.reasonCode Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📍4.0.1 FHIR Std.
MedicationRequest.substitution.​allowed[x] Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v7.1
MedicationRequest.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v7.1

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If 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-4 error MedicationRequest If 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-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from MedicationRequest

 

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