International Patient Summary Implementation Guide
2.0.0 -

International Patient Summary Implementation Guide, published by HL7 International / Patient Care. 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/fhir-ips/ and changes regularly. See the Directory of published versions

## Resource Profile: MedicationRequest (IPS)

Official URL: http://hl7.org/fhir/uv/ips/StructureDefinition/MedicationRequest-uv-ips | Version: 2.0.0
Standards status: Trial-use Active as of 2021-05-14 | Maturity Level: 3 | Computable Name: MedicationRequestIPS

This profile represents the constraints applied to the MedicationRequest resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication request is represented in the patient summary as an instance of a MedicationRequest resource constrained by this profile.

> medicationCodeableConcept vs. medicationReference

> In the previously balloted versions, medicationCodeableConcept was not allowed to represent medications. To better support implementations, both options (medicationCodeableConcept and medicationReference) are now allowed, recognizing that different jurisdictions may provide different guidance worldwide and that future FHIR releases introduce CodeableReference

> STU implementers are encouraged to provide their feedback about this design choice.

Usages:

- Use this Profile: Bundle (IPS)
- Refer to this Profile: Composition (IPS)
- Examples for this Profile: MedicationRequest/eumfh-39-07-1-request
- CapabilityStatements using this Profile: IPS Server Capability Statement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Obligations
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 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.
intent | ?!Σ | 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 Required Pattern: false
medication[x] | SO Σ | 1..1 |  | Medication to be taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (IPS)) |
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
dosageInstruction | SO | 0..* | Dosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | SO Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (preferred): SNOMED Route Terms
Additional Bindings | Purpose
Medicine EDQM Route of Administration - IPS | candidate
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
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 | preferred | Medications - IPS | 📦2.0.0 | This IG
MedicationRequest.dosageInstruction.​route | Base | preferred | SNOMED CT Route 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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | MedicationRequest |
status |  | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
doNotPerform |  | 0..1 | boolean | True if request is prohibiting action Required Pattern: false
medication[x] | SO | 1..1 |  | Medication to be taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (IPS)) |
subject | SO | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
dosageInstruction | SO | 0..* | Dosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
text | SO | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | SO | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route |  | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (preferred): SNOMED Route Terms
Additional Bindings | Purpose
Medicine EDQM Route of Administration - IPS | candidate
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.medication[x] | Base | preferred | Medications - IPS | 📦2.0.0 | This IG
MedicationRequest.dosageInstruction.​route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
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 Bindings | Purpose
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
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 | ?!Σ | 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 | ?!Σ | 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 Required Pattern: false
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | SO Σ | 1..1 |  | Medication to be taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (IPS)) |
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
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
display | Σ | 0..1 | string | Text alternative for the resource
encounter |  | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 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 | SO | 0..* | Dosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 (preferred): SNOMED Route Terms
Additional Bindings | Purpose
Medicine EDQM Route of Administration - IPS | candidate
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 | Σ | 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] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
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(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
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
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
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 | preferred | Medications - IPS | 📦2.0.0 | This IG
MedicationRequest.subject.​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.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v6.5
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v6.5

#### 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()`

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
Documentation for this format

Summary

Mandatory: 1 element
Must-Support: 6 elements

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Medication (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Medication-uv-ips)
- Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Maturity: 3

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 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.
intent | ?!Σ | 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 Required Pattern: false
medication[x] | SO Σ | 1..1 |  | Medication to be taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (IPS)) |
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
dosageInstruction | SO | 0..* | Dosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | SO Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (preferred): SNOMED Route Terms
Additional Bindings | Purpose
Medicine EDQM Route of Administration - IPS | candidate
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
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 | preferred | Medications - IPS | 📦2.0.0 | This IG
MedicationRequest.dosageInstruction.​route | Base | preferred | SNOMED CT Route 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | MedicationRequest |
status |  | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
doNotPerform |  | 0..1 | boolean | True if request is prohibiting action Required Pattern: false
medication[x] | SO | 1..1 |  | Medication to be taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (IPS)) |
subject | SO | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | SO | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
dosageInstruction | SO | 0..* | Dosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
text | SO | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | SO | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route |  | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (preferred): SNOMED Route Terms
Additional Bindings | Purpose
Medicine EDQM Route of Administration - IPS | candidate
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.medication[x] | Base | preferred | Medications - IPS | 📦2.0.0 | This IG
MedicationRequest.dosageInstruction.​route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
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 Bindings | Purpose
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
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 | ?!Σ | 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 | ?!Σ | 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 Required Pattern: false
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | SO Σ | 1..1 |  | Medication to be taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (IPS)) |
subject | SO Σ | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
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
display | Σ | 0..1 | string | Text alternative for the resource
encounter |  | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 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 | SO | 0..* | Dosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 | SO Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
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 (preferred): SNOMED Route Terms
Additional Bindings | Purpose
Medicine EDQM Route of Administration - IPS | candidate
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 | Σ | 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] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
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(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
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
Documentation for this format

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
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 | preferred | Medications - IPS | 📦2.0.0 | This IG
MedicationRequest.subject.​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.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v6.5
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v6.5

#### 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()`

Name | Creator (IPS) | Consumer (IPS)
--- | --- | ---
MedicationRequest |  |
medication[x] | SHALL:populate-if-known | SHALL:handle SHOULD:display
subject | SHALL:populate-if-known | SHALL:handle SHOULD:display
reference | SHALL:populate-if-known | SHALL:handle
dosageInstruction | SHALL:populate-if-known | SHALL:handle SHOULD:display
text | SHALL:populate-if-known | SHALL:handle SHOULD:display
timing | SHALL:populate-if-known | SHALL:handle SHOULD:display
Documentation for this format

Summary

Mandatory: 1 element
Must-Support: 6 elements

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Medication (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Medication-uv-ips)
- Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Maturity: 3

Other representations of profile: CSV, Excel, Schematron