Common CQL Artifacts for FHIR (US-Based), published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/us-cql-ig/ and changes regularly. See the Directory of published versions

Medication Patterns

Page standards status: Informative

US Core defines US Core MedicationRequest to record a patient's medication prescription or order, as well as self-reported medications.

MedicationRequest can either use a code which will be RXNORM plus an optional NDC (https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1010.4/expansion), or use a reference to a more detailed Medication resource (which also uses RXNORM plus optional NDC).

Modifier Elements

The MedicationRequest resource defines the following modifier elements:

• status
• intent
• doNotPerform

In addition to being modifiers, the status and intent elements are required with a required binding. The USCoreCommon library defines several functions for determining status and intent.

However, doNotPerform is not required, so care must be taken to ensure that if specified, the doNotPerform element is respected.

Search Parameters

USCore defines the following mandatory search parameters:

• patient, intent
• patient, intent, status

In addition, the following optional parameters are defined:

• patient, intent, encounter
• patient, intent, authoredOn

NOTE: For discussion on how to manage search parameters with terminology, see the Terminology Considerations discussion in the Architectural Guidance topic.

NOTE: For discussion on how to manage optional search parameters, see the Performant Data Access discussion in the Architectural Guidance topic.

Cross-Version Considerations

Although newer versions of USCore introduce additional capability through new elements, there are no significant backwards compatibility issues associated with using the 3.1.1 version.

Common Elements and Functions

Active Medications

NOTE: In the prior auth use case, the workflow is generally being conducted in the context of 1 or more order, so you'll want to start by working off that context before searching the FHIR server for medication requests.

To get all medications, UCE."All Medication Requests" can be used. To filter it down to active medications, UCE."Active Medication Orders" can be used.

NOTE: Content for this page was adapted from the QICore Authoring Patterns - Medications topic.