NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/PROJ-PHILHEALTH-EA-NHDR/nhdr-fhir-ig-review-project-2/ and changes regularly. See the Directory of published versions

## Resource Profile: PH MedicationRequest

Official URL: https://nhdr.gov.ph/fhir/StructureDefinition/PH-MedicationRequest | Version: 0.1.0
Standards status: Draft | Computable Name: PH_MedicationRequest
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

An order or request for both supply of the medication and the instructions for administration of the medication to a patient.

Usages:

- Refer to this Profile: PH Claim

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
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.
Slices for medication[x] | Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Medication to be taken Binding: Drug Codes (required)
medication[x]:medicationReference | Σ | 0..1 | Reference(PH Medication) | Medication to be taken
subject | Σ | 1..1 | Reference(PH Patient | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(PH Encounter) | Encounter created as part of encounter/admission/stay
requester | Σ | 0..1 | Reference(PH Practitioner | PH PractitionerRole | PH Organization | PH Patient | PH RelatedPerson | Device) | Who/What requested the Request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept | Base | required | Drug Codes | 📦0.1.0 | This IG
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
meta |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
lastUpdated |  | 0..1 | instant | When the resource was uploaded to the NHDR.
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
text |  | 0..0 |  | Text summary of the resource, for human interpretation
contained |  | 0..0 |  | Contained, inline Resources
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
statusReason |  | 0..0 |  | Reason for current status
category |  | 0..0 |  | Type of medication usage
priority |  | 0..0 |  | routine | urgent | asap | stat
doNotPerform |  | 0..0 |  | True if request is prohibiting action
reported[x] |  | 0..0 |  | Reported rather than primary record
Slices for medication[x] |  | 1..1 | CodeableConcept, Reference(Medication) | Medication to be taken Slice: Unordered, Open by type:$this
medication[x]:medicationCodeableConcept |  | 0..1 | CodeableConcept | Medication to be taken Binding: Drug Codes (required)
medication[x]:medicationReference |  | 0..1 | Reference(PH Medication) | Medication to be taken
subject |  | 1..1 | Reference(PH Patient | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(PH Encounter) | Encounter created as part of encounter/admission/stay
authoredOn |  | 0..0 |  | When request was initially authored
requester |  | 0..1 | Reference(PH Practitioner | PH PractitionerRole | PH Organization | PH Patient | PH RelatedPerson | Device) | Who/What requested the Request
performer |  | 0..0 |  | Intended performer of administration
performerType |  | 0..0 |  | Desired kind of performer of the medication administration
recorder |  | 0..0 |  | Person who entered the request
reasonCode |  | 0..0 |  | Reason or indication for ordering or not ordering the medication
reasonReference |  | 0..0 |  | Condition or observation that supports why the prescription is being written
instantiatesCanonical |  | 0..0 |  | Instantiates FHIR protocol or definition
instantiatesUri |  | 0..0 |  | Instantiates external protocol or definition
basedOn |  | 0..0 |  | What request fulfills
groupIdentifier |  | 0..0 |  | Composite request this is part of
courseOfTherapyType |  | 0..0 |  | Overall pattern of medication administration
insurance |  | 0..0 |  | Associated insurance coverage
note |  | 0..0 |  | Information about the prescription
dosageInstruction |  |  |  |
id |  | 0..0 |  | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
sequence |  | 0..0 |  | The order of the dosage instructions
text |  | 0..0 |  | Free text dosage instructions e.g. SIG
additionalInstruction |  | 0..0 |  | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
patientInstruction |  | 0..0 |  | Patient or consumer oriented instructions
asNeeded[x] |  | 0..0 |  | Take "as needed" (for x)
site |  | 0..0 |  | Body site to administer to
method |  | 0..0 |  | Technique for administering medication
doseAndRate |  |  |  |
id |  | 0..0 |  | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension
type |  | 0..0 |  | The kind of dose or rate specified
dose[x] |  | 0..1 | SimpleQuantity | Amount of medication per dose
rate[x] |  | 0..1 | SimpleQuantity | Amount of medication per unit of time
maxDosePerPeriod |  | 0..0 |  | Upper limit on medication per unit of time
maxDosePerAdministration |  | 0..0 |  | Upper limit on medication per administration
maxDosePerLifetime |  | 0..0 |  | Upper limit on medication per lifetime of the patient
dispenseRequest |  |  |  |
id |  | 0..0 |  | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
initialFill |  | 0..0 |  | First fill details
dispenseInterval |  | 0..0 |  | Minimum period of time between dispenses
validityPeriod |  | 0..0 |  | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..0 |  | Number of refills authorized
expectedSupplyDuration |  | 0..0 |  | Number of days supply per dispense
performer |  | 0..0 |  | Intended dispenser
substitution |  | 0..0 |  | Any restrictions on medication substitution
priorPrescription |  | 0..0 |  | An order/prescription that is being replaced
detectedIssue |  | 0..0 |  | Clinical Issue with action
eventHistory |  | 0..0 |  | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.medication[x]:medicationCodeableConcept | Base | required | Drug Codes | 📦0.1.0 | This IG

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
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
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource was uploaded to the NHDR.
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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.
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.
Slices for medication[x] | Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Medication to be taken Binding: Drug Codes (required)
medication[x]:medicationReference | Σ | 0..1 | Reference(PH Medication) | Medication to be taken
subject | Σ | 1..1 | Reference(PH Patient | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(PH Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
requester | Σ | 0..1 | Reference(PH Practitioner | PH PractitionerRole | PH Organization | PH Patient | PH RelatedPerson | Device) | Who/What requested the Request
dosageInstruction |  | 0..* | Dosage | How the medication should be taken
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
timing | Σ | 0..1 | Timing | When medication should be administered
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
dose[x] | Σ | 0..1 | SimpleQuantity | Amount of medication per dose
rate[x] | Σ | 0..1 | SimpleQuantity | Amount of medication per unit of time
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.meta.​security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
MedicationRequest.meta.​tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept | Base | required | Drug Codes | 📦0.1.0 | This IG
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequest

Summary

Prohibited: 53 elements

Structures

This structure refers to these other structures:

- PH Medication (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Medication)
- PH Patient (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient)
- PH Encounter (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter)
- PH Practitioner (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Practitioner)
- PH PractitionerRole (https://nhdr.gov.ph/fhir/StructureDefinition/PH-PractitionerRole)
- PH Organization (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization)
- PH RelatedPerson (https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson)
- SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Extensions

This structure refers to these extensions:

- https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
- https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
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.
Slices for medication[x] | Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Medication to be taken Binding: Drug Codes (required)
medication[x]:medicationReference | Σ | 0..1 | Reference(PH Medication) | Medication to be taken
subject | Σ | 1..1 | Reference(PH Patient | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(PH Encounter) | Encounter created as part of encounter/admission/stay
requester | Σ | 0..1 | Reference(PH Practitioner | PH PractitionerRole | PH Organization | PH Patient | PH RelatedPerson | Device) | Who/What requested the Request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept | Base | required | Drug Codes | 📦0.1.0 | This IG
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
meta |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
lastUpdated |  | 0..1 | instant | When the resource was uploaded to the NHDR.
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
text |  | 0..0 |  | Text summary of the resource, for human interpretation
contained |  | 0..0 |  | Contained, inline Resources
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
statusReason |  | 0..0 |  | Reason for current status
category |  | 0..0 |  | Type of medication usage
priority |  | 0..0 |  | routine | urgent | asap | stat
doNotPerform |  | 0..0 |  | True if request is prohibiting action
reported[x] |  | 0..0 |  | Reported rather than primary record
Slices for medication[x] |  | 1..1 | CodeableConcept, Reference(Medication) | Medication to be taken Slice: Unordered, Open by type:$this
medication[x]:medicationCodeableConcept |  | 0..1 | CodeableConcept | Medication to be taken Binding: Drug Codes (required)
medication[x]:medicationReference |  | 0..1 | Reference(PH Medication) | Medication to be taken
subject |  | 1..1 | Reference(PH Patient | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(PH Encounter) | Encounter created as part of encounter/admission/stay
authoredOn |  | 0..0 |  | When request was initially authored
requester |  | 0..1 | Reference(PH Practitioner | PH PractitionerRole | PH Organization | PH Patient | PH RelatedPerson | Device) | Who/What requested the Request
performer |  | 0..0 |  | Intended performer of administration
performerType |  | 0..0 |  | Desired kind of performer of the medication administration
recorder |  | 0..0 |  | Person who entered the request
reasonCode |  | 0..0 |  | Reason or indication for ordering or not ordering the medication
reasonReference |  | 0..0 |  | Condition or observation that supports why the prescription is being written
instantiatesCanonical |  | 0..0 |  | Instantiates FHIR protocol or definition
instantiatesUri |  | 0..0 |  | Instantiates external protocol or definition
basedOn |  | 0..0 |  | What request fulfills
groupIdentifier |  | 0..0 |  | Composite request this is part of
courseOfTherapyType |  | 0..0 |  | Overall pattern of medication administration
insurance |  | 0..0 |  | Associated insurance coverage
note |  | 0..0 |  | Information about the prescription
dosageInstruction |  |  |  |
id |  | 0..0 |  | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
sequence |  | 0..0 |  | The order of the dosage instructions
text |  | 0..0 |  | Free text dosage instructions e.g. SIG
additionalInstruction |  | 0..0 |  | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
patientInstruction |  | 0..0 |  | Patient or consumer oriented instructions
asNeeded[x] |  | 0..0 |  | Take "as needed" (for x)
site |  | 0..0 |  | Body site to administer to
method |  | 0..0 |  | Technique for administering medication
doseAndRate |  |  |  |
id |  | 0..0 |  | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension
type |  | 0..0 |  | The kind of dose or rate specified
dose[x] |  | 0..1 | SimpleQuantity | Amount of medication per dose
rate[x] |  | 0..1 | SimpleQuantity | Amount of medication per unit of time
maxDosePerPeriod |  | 0..0 |  | Upper limit on medication per unit of time
maxDosePerAdministration |  | 0..0 |  | Upper limit on medication per administration
maxDosePerLifetime |  | 0..0 |  | Upper limit on medication per lifetime of the patient
dispenseRequest |  |  |  |
id |  | 0..0 |  | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension
modifierExtension |  | 0..0 |  | Extension
initialFill |  | 0..0 |  | First fill details
dispenseInterval |  | 0..0 |  | Minimum period of time between dispenses
validityPeriod |  | 0..0 |  | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..0 |  | Number of refills authorized
expectedSupplyDuration |  | 0..0 |  | Number of days supply per dispense
performer |  | 0..0 |  | Intended dispenser
substitution |  | 0..0 |  | Any restrictions on medication substitution
priorPrescription |  | 0..0 |  | An order/prescription that is being replaced
detectedIssue |  | 0..0 |  | Clinical Issue with action
eventHistory |  | 0..0 |  | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.medication[x]:medicationCodeableConcept | Base | required | Drug Codes | 📦0.1.0 | This IG

Snapshot View

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
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
extension:hfRecordedDate |  | 0..1 | dateTime | The recorded date indicating when the record was uploaded by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
extension:hfLastUpdated |  | 0..* | dateTime | The date indicating when the record was last updated by the health facility. URL: https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource was uploaded to the NHDR.
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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.
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.
Slices for medication[x] | Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Medication to be taken Binding: Drug Codes (required)
medication[x]:medicationReference | Σ | 0..1 | Reference(PH Medication) | Medication to be taken
subject | Σ | 1..1 | Reference(PH Patient | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(PH Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
requester | Σ | 0..1 | Reference(PH Practitioner | PH PractitionerRole | PH Organization | PH Patient | PH RelatedPerson | Device) | Who/What requested the Request
dosageInstruction |  | 0..* | Dosage | How the medication should be taken
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
timing | Σ | 0..1 | Timing | When medication should be administered
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
dose[x] | Σ | 0..1 | SimpleQuantity | Amount of medication per dose
rate[x] | Σ | 0..1 | SimpleQuantity | Amount of medication per unit of time
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.meta.​security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
MedicationRequest.meta.​tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept | Base | required | Drug Codes | 📦0.1.0 | This IG
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequest

Summary

Prohibited: 53 elements

Structures

This structure refers to these other structures:

- PH Medication (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Medication)
- PH Patient (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient)
- PH Encounter (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter)
- PH Practitioner (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Practitioner)
- PH PractitionerRole (https://nhdr.gov.ph/fhir/StructureDefinition/PH-PractitionerRole)
- PH Organization (https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization)
- PH RelatedPerson (https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson)
- SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Extensions

This structure refers to these extensions:

- https://nhdr.gov.ph/fhir/StructureDefinition/HFRecordedDate
- https://nhdr.gov.ph/fhir/StructureDefinition/HFLastUpdated

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Other representations of profile: CSV, Excel, Schematron