International Patient Summary Implementation Guide
1.1.0 - CI Build
International Patient Summary Implementation Guide
1.1.0 - CI Build
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 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ips/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/uv/ips/StructureDefinition/MedicationRequest-uv-ips | Version: 1.1.0 | |||
| Standards status: Trial-use | Maturity Level: 2 | 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.
This profile constrains the representation of a medication request related to the patient, in the context of the international patient summary as specified by the IPS project of HL7 International.
medicationCodeableConcept vs. medicationReferenceIn the previously balloted versions the medicationCodeableConcept was used only to provide information about the known absent/unknown medications; using the medicationReference to describe the actual medication. To better support local implementations of patient summaries and align with the US Core appoach, both options (medicationCodeableConcept and medicationReference) have been made possible; recognizing however that there are jurisdictions that impose that the medicationReference is always used.
Implementers are encouraged "to improve global interoperability (...)" by using the medicationReference, limiting the usage of the medicationCodeableConcept only to the cases in which no other information than a simple code is available.
It also should be noted that in an anticipated future version of the IG based on R5, these two slices on medication[x] will be replaced by the 'medication' element in the MedicationUsage resource (which replaces MedicationStatement), as it uses the new CodeableReference data type.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from MedicationRequest
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  MedicationRequest |
0..* | MedicationRequest | Ordering of medication for patient or group | |
  status |
1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown | |
  medication[x] |
S | 1..1 | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication | |
  medicationCodeableConcept |
CodeableConcept | |||
  medicationReference |
Reference(Medication (IPS)) | |||
| subject |
S | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for |
| reference |
S | 1..1 | string | Literal reference, Relative, internal or absolute URL |
| dosageInstruction |
S | 0..* | Dosage | How the medication should be taken |
| text |
S | 0..1 | string | Free text dosage instructions e.g. SIG |
| timing |
S | 0..1 | Timing | When medication should be administered |
| route |
0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms | |
 dispenseRequest |
||||
 validityPeriod |
||||
 Slices for extension |
Content/Rules for all slices | |||
  data-absent-reason |
0..1 | code | validityPeriod absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknownhttp://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ipsfrom this IG | |
| MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIpshttp://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administrationfrom this IG |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| 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 |
| medication[x] |
SΣ | 1..1 | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication | |
| medicationCodeableConcept |
CodeableConcept | |||
| medicationReference |
Reference(Medication (IPS)) | |||
| subject |
SΣ | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for |
| reference |
SΣC | 1..1 | string | Literal reference, Relative, internal or absolute URL |
| dosageInstruction |
S | 0..* | Dosage | How the medication should be taken |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| text |
SΣ | 0..1 | string | Free text dosage instructions e.g. SIG |
| timing |
SΣ | 0..1 | Timing | When medication should be administered |
| route |
0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1from the FHIR Standard | |
| MedicationRequest.intent | required | medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1from the FHIR Standard | |
| MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknownhttp://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ipsfrom this IG | |
| MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIpshttp://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administrationfrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| 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 | ||||
|---|---|---|---|---|---|---|---|---|
| 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.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| 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 | ||||
| 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: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication | |||||
| medicationCodeableConcept |
CodeableConcept | |||||||
| medicationReference |
Reference(Medication (IPS)) | |||||||
| subject |
SΣ | 1..1 | Reference(Patient (IPS)) | 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 |
SΣC | 1..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 | ||||
| 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 |
S | 0..* | Dosage | How the medication should be taken | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| sequence |
Σ | 0..1 | integer | The order of the dosage instructions | ||||
| text |
SΣ | 0..1 | string | Free text dosage instructions e.g. SIG | ||||
| additionalInstruction |
Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
| patientInstruction |
Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
| timing |
SΣ | 0..1 | Timing | When medication should be administered | ||||
| asNeeded[x] |
Σ | 0..1 | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | |||||
| asNeededBoolean |
boolean | |||||||
| asNeededCodeableConcept |
CodeableConcept | |||||||
| site |
Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | ||||
| route |
0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms | |||||
| 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 | Upper limit on medication per administration | ||||
| maxDosePerLifetime |
Σ | 0..1 | SimpleQuantity | 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 | 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 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| data-absent-reason |
0..1 | code | validityPeriod absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) | |||||
| start |
ΣC | 0..1 | dateTime | Starting time with inclusive boundary | ||||
| end |
ΣC | 0..1 | dateTime | End time with inclusive boundary, if not ongoing | ||||
| numberOfRepeatsAllowed |
0..1 | unsignedInt | Number of refills authorized | |||||
| quantity |
0..1 | SimpleQuantity | Amount of medication to supply per dispense | |||||
| expectedSupplyDuration |
0..1 | Duration | Number of days supply per dispense | |||||
| performer |
0..1 | Reference(Organization) | Intended dispenser | |||||
| substitution |
0..1 | BackboneElement | Any restrictions on medication substitution | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| allowed[x] |
1..1 | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (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 | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MedicationRequest.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1from the FHIR Standard | ||||
| MedicationRequest.statusReason | example | medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reasonfrom the FHIR Standard | ||||
| MedicationRequest.intent | required | medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1from the FHIR Standard | ||||
| MedicationRequest.category | example | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryfrom the FHIR Standard | ||||
| MedicationRequest.priority | required | RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1from the FHIR Standard | ||||
| MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknownhttp://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ipsfrom this IG | ||||
| MedicationRequest.subject.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-rolefrom the FHIR Standard | ||||
| MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-codefrom the FHIR Standard | ||||
| MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapyfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codesfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIpshttp://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administrationfrom this IG | ||||
| MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-typefrom the FHIR Standard | ||||
| MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode | ||||
| MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| 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
Summary
Mandatory: 1 element
Must-Support: 6 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 2
Differential View
This structure is derived from MedicationRequest
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationRequest |
0..* | MedicationRequest | Ordering of medication for patient or group | |
| status |
1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown | |
| medication[x] |
S | 1..1 | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication | |
| medicationCodeableConcept |
CodeableConcept | |||
| medicationReference |
Reference(Medication (IPS)) | |||
| subject |
S | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for |
| reference |
S | 1..1 | string | Literal reference, Relative, internal or absolute URL |
| dosageInstruction |
S | 0..* | Dosage | How the medication should be taken |
| text |
S | 0..1 | string | Free text dosage instructions e.g. SIG |
| timing |
S | 0..1 | Timing | When medication should be administered |
| route |
0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms | |
| dispenseRequest |
||||
| validityPeriod |
||||
| Slices for extension |
Content/Rules for all slices | |||
| data-absent-reason |
0..1 | code | validityPeriod absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknownhttp://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ipsfrom this IG | |
| MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIpshttp://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administrationfrom this IG |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| 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 |
| medication[x] |
SΣ | 1..1 | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication | |
| medicationCodeableConcept |
CodeableConcept | |||
| medicationReference |
Reference(Medication (IPS)) | |||
| subject |
SΣ | 1..1 | Reference(Patient (IPS)) | Who or group medication request is for |
| reference |
SΣC | 1..1 | string | Literal reference, Relative, internal or absolute URL |
| dosageInstruction |
S | 0..* | Dosage | How the medication should be taken |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| text |
SΣ | 0..1 | string | Free text dosage instructions e.g. SIG |
| timing |
SΣ | 0..1 | Timing | When medication should be administered |
| route |
0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1from the FHIR Standard | |
| MedicationRequest.intent | required | medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1from the FHIR Standard | |
| MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknownhttp://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ipsfrom this IG | |
| MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIpshttp://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administrationfrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| 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() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| 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.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| 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 | ||||
| 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: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication | |||||
| medicationCodeableConcept |
CodeableConcept | |||||||
| medicationReference |
Reference(Medication (IPS)) | |||||||
| subject |
SΣ | 1..1 | Reference(Patient (IPS)) | 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 |
SΣC | 1..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 | ||||
| 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 |
S | 0..* | Dosage | How the medication should be taken | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| sequence |
Σ | 0..1 | integer | The order of the dosage instructions | ||||
| text |
SΣ | 0..1 | string | Free text dosage instructions e.g. SIG | ||||
| additionalInstruction |
Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
| patientInstruction |
Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
| timing |
SΣ | 0..1 | Timing | When medication should be administered | ||||
| asNeeded[x] |
Σ | 0..1 | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | |||||
| asNeededBoolean |
boolean | |||||||
| asNeededCodeableConcept |
CodeableConcept | |||||||
| site |
Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | ||||
| route |
0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms | |||||
| 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 | Upper limit on medication per administration | ||||
| maxDosePerLifetime |
Σ | 0..1 | SimpleQuantity | 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 | 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 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| data-absent-reason |
0..1 | code | validityPeriod absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) | |||||
| start |
ΣC | 0..1 | dateTime | Starting time with inclusive boundary | ||||
| end |
ΣC | 0..1 | dateTime | End time with inclusive boundary, if not ongoing | ||||
| numberOfRepeatsAllowed |
0..1 | unsignedInt | Number of refills authorized | |||||
| quantity |
0..1 | SimpleQuantity | Amount of medication to supply per dispense | |||||
| expectedSupplyDuration |
0..1 | Duration | Number of days supply per dispense | |||||
| performer |
0..1 | Reference(Organization) | Intended dispenser | |||||
| substitution |
0..1 | BackboneElement | Any restrictions on medication substitution | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| allowed[x] |
1..1 | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (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 | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MedicationRequest.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1from the FHIR Standard | ||||
| MedicationRequest.statusReason | example | medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reasonfrom the FHIR Standard | ||||
| MedicationRequest.intent | required | medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1from the FHIR Standard | ||||
| MedicationRequest.category | example | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryfrom the FHIR Standard | ||||
| MedicationRequest.priority | required | RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1from the FHIR Standard | ||||
| MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknownhttp://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ipsfrom this IG | ||||
| MedicationRequest.subject.type | extensible | ResourceTypehttp://hl7.org/fhir/ValueSet/resource-typesfrom the FHIR Standard | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-rolefrom the FHIR Standard | ||||
| MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-codefrom the FHIR Standard | ||||
| MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapyfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codesfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIpshttp://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administrationfrom this IG | ||||
| MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-typefrom the FHIR Standard | ||||
| MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode | ||||
| MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| 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
Summary
Mandatory: 1 element
Must-Support: 6 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 2
Other representations of profile: CSV, Excel, Schematron
IG © 2020+ HL7 International / Patient Care. Package hl7.fhir.uv.ips#1.1.0 based on FHIR 4.0.1. Generated 2024-05-19
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