RIVO-Noord Zorgviewer Implementation Guide
1.21.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.21.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: MedicationAgreement

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/MedicationRequest | Version: 1.21.0
Active as of 2025-10-28 | Computable Name: MedicationAgreement

Medicatieafspraak

> Dit Profiel is het resultaat van de vergelijking tussen de zib2017 FHIR Profiel en de implementaties in Epic, Chipsoft, Topicus en Nexus. De elementen die in ieder geval in alle output beschikbaar zullen zijn. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

### Zorginformatiebouwsteen

ZIB Medicatieafspraak

### View Definition

ViewDefinition voor MedicationRequest

### UI Wireframe

Medicatie Afspraken

>< | Bron | Start | Eind | Medicatie | Dosering & instructies | Toedieningsweg | Stop type
--- | --- | --- | --- | --- | --- | --- | ---
+ | Chipsoft | 15-8-2016 | 14-9-2016 | METOCLOPRAMIDE ZETPIL 10MG | 1x elke 1 dag, indien nodig (Zo nodig) Aanvullende instructie 1: Pas op met alc... | RECTAAL | Definitief
| Afspraakdatum 30-9-2022 Voorschrijver Peter van Pulver
+ | Epic | 27-11-2020 |  | metoPROLOL 50mg tablet | 1x per dag 50 mg innemen. | Oraal |
| Medicatie vorm tablet Afspraakdatum 27-11-2020 Voorschrijver M Crop
+ | Nexus | 3-10-2023 |  | GLYCEROFOSFORZ. INFCONC 1MMOL/ML(FOSFAAT) AMP 20ML | 1x elke 1 dag om 08:00:00 ⓘ | INTRAVENEUS |
| Afspraakdatum 3-10-2023 Voorschrijver Aalders, JCA (CAR)
+ | Sanday |  |  | PANTOPRAZOL TABLET MSR 40MG | 2 maal per dag 1 tablet;1 TABLET 1 UUR VOOR DE MAALTIJD |  |
| Afspraakdatum 6-8-2025 Voorschrijver Jenneke van der Vecht

### Kolom Definities

Kolom label | FHIR Path Expression | FHIR Type | Zib element | Toelichting of regels
Bron | `meta.extension('http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source').valueUri` | `string` | nvt | Lookup adhv uri (AGB-Z of OID) `<adressering-base>/Organization?identifier=<.meta.tag.code>` en gebruik dan `Organization.name`
Start | `extension('http://nictiz.nl/fhir/StructureDefinition/zib-Medication-PeriodOfUse').valuePeriod.start` | `dateTime` | Gebruiksperiode::TijdsInterval/startDatumTijd |
Eind | `extension('http://nictiz.nl/fhir/StructureDefinition/zib-Medication-PeriodOfUse').valuePeriod.end` | `dateTime` | Gebruiksperiode::TijdsInterval/eindDatumTijd |
Medicatie | `medication.display` | `string` | Afgesprokengeneesmiddel::Product |
Dosering & instructies | `dosageInstruction.text | extension('http://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction').valueString` | `string` | Gebruiksinstructie/Omschrijving, Gebruiksinstructie/AanvullendeInstructie | N.B. Als text niet beschikbaar dan samenstellen uit discrete informatie en markeren met een icoontje ⓘ
Toedieningsweg | `iif(exists(dosageInstruction.route.text), dosageInstruction.route.text, dosageInstruction.route.coding.display)` | `string` | Gebruiksinstructie/Toedieningsweg |
Stop type | `modifierExtension.where(url='http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType').valueCodeableConcept.coding.display` | `string` | StopType |
UITKLAPVELD
+Medicatie vorm | `medication.resolve().form.coding.display` | `string` | Afgesprokengeneesmiddel::FarmaceutischProduct/FarmaceutischeVorm |
+Afspraakdatum | `authoredOn` | `dateTime` | MedicatieafspraakDatumTijd |
+Voorschrijver | `requester.agent.display | requester.display` | `string` | Voorschrijver::Zorgverlener | LET OP: `requester.display` is een FHIR R4 veld

### Request

1. Opvragen (search) definities

   `GET <ontsluiten-bronsysteem-base>/MedicationRequest?category=http://snomed.info/sct|16076005&_include=MedicationRequest:medication&patient=<fhir_patient_id>`

### Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

    "meta": {
        "extension": [ {
            "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
            "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
        } ]
    }

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (`<resource>.subject|patient`). Elke patient heeft een `Patient.managingOrganization` en in de gerefereerde `Organization.identifier` staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

Usages:

- Use this Profile: Medicatiegegevens
- CapabilityStatements using this Profile: Ontsluiten Bronsysteem

You can also check for usages in the FHIR IG Statistics

Changes since version 1.20.0:

- New Content

### 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..* | Zib MedicationAgreement(2.2.9) | MedicationAgreement
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfUse | S | 0..1 | Period | UsagePeriod URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-PeriodOfUse Constraints: ext-1
extension:usageDuration |  | 0..1 | Duration | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
extension:additionalInformation |  | 0..* | (Complex) | MedicationAgreementAdditionalInformation URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: MedicatieafspraakAanvullendeInformatieCodelijst (extensible): MedicatieafspraakAanvullendeInformatieCodelijst Example Example of MedicationAgreementAdditionalInformation: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.2.3.2050","code":"1","display":"Bewust hoge dosering"}]}
extension:medicationTreatment |  | 0..1 | Identifier | Medication Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:nl-core-episodeofcare |  | 0..* | ?gen-e1? [CanonicalType[http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare]] | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare Constraints: ext-1
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:stopType | ?!S | 0..1 | (Complex) | StopType URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: Stoptype (required): StopType
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
status | ?!Σ | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (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 | instance-order Binding: MedicationRequestIntent (required): The kind of medication order Fixed Value: order
category |  | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred): A coded concept identifying where the medication ordered is expected to be consumed or administered
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationAgreementCode | Σ | 0..* | Coding | MedicationAgreementCode
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 16076005
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | AgreedMedicine
display | S Σ | 0..1 | string | Text alternative for the resource
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5) | Group) | Who or group medication request is for
authoredOn | S Σ | 1..1 | dateTime | MedicationAgreementDateTime
requester | Σ C | 0..1 | BackboneElement | Prescriber Constraints: mps-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
agent | Σ | 1..1 | Reference(nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-relatedperson(2.0.5) | Device) | Who ordered the initial medication(s)
Slices for extension |  |  |  | Content/Rules for all slices
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
display | S Σ | 0..1 | string | Text alternative for the resource
dosageInstruction |  | 0..* | Zib InstructionsForUse | InstructionsForUse
text | S Σ | 0..1 | string | Description
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.extension:additionalInformation.​value[x]:valueCodeableConcept | Base | extensible | MedicatieafspraakAanvullendeInformatieCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.modifierExtension:stopType.​value[x]:valueCodeableConcept | Base | required | Stoptype | 📦2016-06-17T10:13:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.status | Base | required | MedicationRequestStatus | 📦3.0.2 | FHIR Std.
MedicationRequest.intent | Base | required | MedicationRequestIntent | 📦3.0.2 | FHIR Std.
MedicationRequest.category | Base | preferred | MedicationRequestCategory | 📦3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
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 | `contained.where(('#'+id in %resource.descendants().reference).not()).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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationRequest.extension:periodOfUse, MedicationRequest.extension:usageDuration, MedicationRequest.extension:additionalInformation, MedicationRequest.extension:medicationTreatment, MedicationRequest.extension:nl-core-episodeofcare, MedicationRequest.modifierExtension:stopType, MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule, MedicationRequest.requester.agent.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mps-1 | error | MedicationRequest.requester | onBehalfOf can only be specified if agent is practitioner or device | `(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()`

This structure is derived from Zib MedicationAgreement

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | Zib MedicationAgreement(2.2.9) |
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfUse | S | 0..1 | Zib Medication Period Of Use | UsagePeriod
Slices for modifierExtension |  |  |  | Content/Rules for all slices
modifierExtension:stopType | S | 0..1 | Zib Medication StopType | StopType
category |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
​ medicationReference | S | 1..1 | Reference(Medication) | AgreedMedicine
​ display | S | 0..1 | string | Text alternative for the resource
authoredOn | S | 1..1 | dateTime | MedicationAgreementDateTime
requester |  |  |  |
agent |  |  |  |
display | S | 0..1 | string | Text alternative for the resource
dosageInstruction |  |  |  |
text | S | 0..1 | string | Description
route |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | Zib MedicationAgreement(2.2.9) | MedicationAgreement
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: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | 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
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:periodOfUse | S | 0..1 | Period | UsagePeriod URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-PeriodOfUse Constraints: ext-1
extension:usageDuration |  | 0..1 | Duration | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
extension:additionalInformation |  | 0..* | (Complex) | MedicationAgreementAdditionalInformation URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: MedicatieafspraakAanvullendeInformatieCodelijst (extensible): MedicatieafspraakAanvullendeInformatieCodelijst Example Example of MedicationAgreementAdditionalInformation: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.2.3.2050","code":"1","display":"Bewust hoge dosering"}]}
extension:medicationTreatment |  | 0..1 | Identifier | Medication Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:nl-core-episodeofcare |  | 0..* | ?gen-e1? [CanonicalType[http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare]] | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare Constraints: ext-1
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:stopType | ?!S | 0..1 | (Complex) | StopType URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: Stoptype (required): StopType
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
identifier |  | 0..* | Identifier | External ids for this request
definition | Σ | 0..* | Reference(ActivityDefinition | PlanDefinition) | Protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
status | ?!Σ | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (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 | instance-order Binding: MedicationRequestIntent (required): The kind of medication order Fixed Value: order
category |  | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred): A coded concept identifying where the medication ordered is expected to be consumed or administered
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationAgreementCode | Σ | 0..* | Coding | MedicationAgreementCode
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 16076005
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
priority | Σ | 0..1 | code | routine | urgent | stat | asap Binding: MedicationRequestPriority (required): Identifies the level of importance to be assigned to actioning the request
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | AgreedMedicine
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 0..1 | string | Text alternative for the resource
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5) | Group) | Who or group medication request is for
context |  | 0..1 | Reference(HCIM Encounter(2.1.6) | nl-core-episodeofcare(1.1.4)) | Created during encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | MedicationAgreementDateTime
requester | Σ C | 0..1 | BackboneElement | Prescriber Constraints: mps-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
agent | Σ | 1..1 | Reference(nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-relatedperson(2.0.5) | Device) | Who ordered the initial medication(s)
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 0..1 | string | Text alternative for the resource
onBehalfOf | Σ C | 0..1 | Reference(nl-core-organization(2.0.6)) | Organization agent is acting for
recorder |  | 0..1 | Reference(nl-core-practitioner(2.0.7)) | Person who entered the request
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
reasonCode |  | 0..* | CodeableConcept | ReasonMedicationAgreement Binding: RedenMedicatieafspraakCodelijst (extensible): RedenWijzigenOfStakenCodelijst
reasonReference |  | 0..* | Reference(Observation | HCIM Problem(3.0.7)) | PrescriptionReason
note |  | 0..* | Annotation | Comment
dosageInstruction |  | 0..* | Zib InstructionsForUse | InstructionsForUse
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
sequence | Σ | 0..1 | integer | SequenceNumber
text | S Σ | 0..1 | string | Description
additionalInstruction | Σ | 0..* | CodeableConcept | AdditionalInstructions Binding: Aanvullende gebruiksinstructie (extensible)
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Zib AdministrationSchedule | When medication should be administered
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
low | Σ C | 0..1 | SimpleQuantity | Low limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
high | Σ C | 0..1 | SimpleQuantity | High limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
maxDosePerPeriod | Σ | 0..1 | Ratio | MaximumDose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
numerator | Σ | 0..1 | Quantity | Numerator value Binding: G-Standaard Eenhedentabel (required): GstdTabel902
denominator | Σ | 0..1 | Quantity | Denominator value
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
rate[x] | Σ | 0..1 |  | AdministeringSpeed
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | positiveInt | 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 | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
allowed | ?! | 1..1 | boolean | Whether substitution is allowed or not
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

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
MedicationRequest.extension:additionalInformation.​value[x]:valueCodeableConcept | Base | extensible | MedicatieafspraakAanvullendeInformatieCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.modifierExtension:stopType.​value[x]:valueCodeableConcept | Base | required | Stoptype | 📦2016-06-17T10:13:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.status | Base | required | MedicationRequestStatus | 📦3.0.2 | FHIR Std.
MedicationRequest.intent | Base | required | MedicationRequestIntent | 📦3.0.2 | FHIR Std.
MedicationRequest.category | Base | preferred | MedicationRequestCategory | 📦3.0.2 | FHIR Std.
MedicationRequest.priority | Base | required | MedicationRequestPriority | 📦3.0.2 | FHIR Std.
MedicationRequest.reasonCode | Base | extensible | RedenMedicatieafspraakCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​additionalInstruction | Base | extensible | Aanvullende gebruiksinstructie | 📦2016-04-07T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​dose[x]:doseRange.low | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​dose[x]:doseRange.high | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​maxDosePerPeriod.numerator | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦2014-03-26 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
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 | `contained.where(('#'+id in %resource.descendants().reference).not()).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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationRequest.extension:periodOfUse, MedicationRequest.extension:usageDuration, MedicationRequest.extension:additionalInformation, MedicationRequest.extension:medicationTreatment, MedicationRequest.extension:nl-core-episodeofcare, MedicationRequest.modifierExtension:stopType, MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule, MedicationRequest.requester.agent.extension:practitionerRole, MedicationRequest.recorder.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mps-1 | error | MedicationRequest.requester | onBehalfOf can only be specified if agent is practitioner or device | `(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()`

This structure is derived from Zib MedicationAgreement

Summary

Must-Support: 9 elements

Structures

This structure refers to these other structures:

- Medication (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Medication)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | Zib MedicationAgreement(2.2.9) | MedicationAgreement
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfUse | S | 0..1 | Period | UsagePeriod URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-PeriodOfUse Constraints: ext-1
extension:usageDuration |  | 0..1 | Duration | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
extension:additionalInformation |  | 0..* | (Complex) | MedicationAgreementAdditionalInformation URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: MedicatieafspraakAanvullendeInformatieCodelijst (extensible): MedicatieafspraakAanvullendeInformatieCodelijst Example Example of MedicationAgreementAdditionalInformation: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.2.3.2050","code":"1","display":"Bewust hoge dosering"}]}
extension:medicationTreatment |  | 0..1 | Identifier | Medication Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:nl-core-episodeofcare |  | 0..* | ?gen-e1? [CanonicalType[http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare]] | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare Constraints: ext-1
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:stopType | ?!S | 0..1 | (Complex) | StopType URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: Stoptype (required): StopType
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
status | ?!Σ | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (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 | instance-order Binding: MedicationRequestIntent (required): The kind of medication order Fixed Value: order
category |  | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred): A coded concept identifying where the medication ordered is expected to be consumed or administered
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationAgreementCode | Σ | 0..* | Coding | MedicationAgreementCode
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 16076005
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | AgreedMedicine
display | S Σ | 0..1 | string | Text alternative for the resource
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5) | Group) | Who or group medication request is for
authoredOn | S Σ | 1..1 | dateTime | MedicationAgreementDateTime
requester | Σ C | 0..1 | BackboneElement | Prescriber Constraints: mps-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
agent | Σ | 1..1 | Reference(nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-relatedperson(2.0.5) | Device) | Who ordered the initial medication(s)
Slices for extension |  |  |  | Content/Rules for all slices
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
display | S Σ | 0..1 | string | Text alternative for the resource
dosageInstruction |  | 0..* | Zib InstructionsForUse | InstructionsForUse
text | S Σ | 0..1 | string | Description
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.extension:additionalInformation.​value[x]:valueCodeableConcept | Base | extensible | MedicatieafspraakAanvullendeInformatieCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.modifierExtension:stopType.​value[x]:valueCodeableConcept | Base | required | Stoptype | 📦2016-06-17T10:13:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.status | Base | required | MedicationRequestStatus | 📦3.0.2 | FHIR Std.
MedicationRequest.intent | Base | required | MedicationRequestIntent | 📦3.0.2 | FHIR Std.
MedicationRequest.category | Base | preferred | MedicationRequestCategory | 📦3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
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 | `contained.where(('#'+id in %resource.descendants().reference).not()).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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationRequest.extension:periodOfUse, MedicationRequest.extension:usageDuration, MedicationRequest.extension:additionalInformation, MedicationRequest.extension:medicationTreatment, MedicationRequest.extension:nl-core-episodeofcare, MedicationRequest.modifierExtension:stopType, MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule, MedicationRequest.requester.agent.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mps-1 | error | MedicationRequest.requester | onBehalfOf can only be specified if agent is practitioner or device | `(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()`

Differential View

This structure is derived from Zib MedicationAgreement

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | Zib MedicationAgreement(2.2.9) |
Slices for extension |  |  |  | Content/Rules for all slices
extension:periodOfUse | S | 0..1 | Zib Medication Period Of Use | UsagePeriod
Slices for modifierExtension |  |  |  | Content/Rules for all slices
modifierExtension:stopType | S | 0..1 | Zib Medication StopType | StopType
category |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
​ medicationReference | S | 1..1 | Reference(Medication) | AgreedMedicine
​ display | S | 0..1 | string | Text alternative for the resource
authoredOn | S | 1..1 | dateTime | MedicationAgreementDateTime
requester |  |  |  |
agent |  |  |  |
display | S | 0..1 | string | Text alternative for the resource
dosageInstruction |  |  |  |
text | S | 0..1 | string | Description
route |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | Zib MedicationAgreement(2.2.9) | MedicationAgreement
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: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | 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
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:periodOfUse | S | 0..1 | Period | UsagePeriod URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-PeriodOfUse Constraints: ext-1
extension:usageDuration |  | 0..1 | Duration | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
extension:additionalInformation |  | 0..* | (Complex) | MedicationAgreementAdditionalInformation URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-AdditionalInformation"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: MedicatieafspraakAanvullendeInformatieCodelijst (extensible): MedicatieafspraakAanvullendeInformatieCodelijst Example Example of MedicationAgreementAdditionalInformation: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.2.3.2050","code":"1","display":"Bewust hoge dosering"}]}
extension:medicationTreatment |  | 0..1 | Identifier | Medication Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:nl-core-episodeofcare |  | 0..* | ?gen-e1? [CanonicalType[http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare]] | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/extension-context-nl-core-episodeofcare Constraints: ext-1
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:stopType | ?!S | 0..1 | (Complex) | StopType URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-StopType"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: Stoptype (required): StopType
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
identifier |  | 0..* | Identifier | External ids for this request
definition | Σ | 0..* | Reference(ActivityDefinition | PlanDefinition) | Protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
status | ?!Σ | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (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 | instance-order Binding: MedicationRequestIntent (required): The kind of medication order Fixed Value: order
category |  | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred): A coded concept identifying where the medication ordered is expected to be consumed or administered
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationAgreementCode | Σ | 0..* | Coding | MedicationAgreementCode
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 16076005
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
priority | Σ | 0..1 | code | routine | urgent | stat | asap Binding: MedicationRequestPriority (required): Identifies the level of importance to be assigned to actioning the request
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | AgreedMedicine
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 0..1 | string | Text alternative for the resource
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5) | Group) | Who or group medication request is for
context |  | 0..1 | Reference(HCIM Encounter(2.1.6) | nl-core-episodeofcare(1.1.4)) | Created during encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | MedicationAgreementDateTime
requester | Σ C | 0..1 | BackboneElement | Prescriber Constraints: mps-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
agent | Σ | 1..1 | Reference(nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-relatedperson(2.0.5) | Device) | Who ordered the initial medication(s)
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 0..1 | string | Text alternative for the resource
onBehalfOf | Σ C | 0..1 | Reference(nl-core-organization(2.0.6)) | Organization agent is acting for
recorder |  | 0..1 | Reference(nl-core-practitioner(2.0.7)) | Person who entered the request
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
reasonCode |  | 0..* | CodeableConcept | ReasonMedicationAgreement Binding: RedenMedicatieafspraakCodelijst (extensible): RedenWijzigenOfStakenCodelijst
reasonReference |  | 0..* | Reference(Observation | HCIM Problem(3.0.7)) | PrescriptionReason
note |  | 0..* | Annotation | Comment
dosageInstruction |  | 0..* | Zib InstructionsForUse | InstructionsForUse
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
sequence | Σ | 0..1 | integer | SequenceNumber
text | S Σ | 0..1 | string | Description
additionalInstruction | Σ | 0..* | CodeableConcept | AdditionalInstructions Binding: Aanvullende gebruiksinstructie (extensible)
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Zib AdministrationSchedule | When medication should be administered
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
low | Σ C | 0..1 | SimpleQuantity | Low limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
high | Σ C | 0..1 | SimpleQuantity | High limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
maxDosePerPeriod | Σ | 0..1 | Ratio | MaximumDose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
numerator | Σ | 0..1 | Quantity | Numerator value Binding: G-Standaard Eenhedentabel (required): GstdTabel902
denominator | Σ | 0..1 | Quantity | Denominator value
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
rate[x] | Σ | 0..1 |  | AdministeringSpeed
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | positiveInt | 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 | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
allowed | ?! | 1..1 | boolean | Whether substitution is allowed or not
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

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
MedicationRequest.extension:additionalInformation.​value[x]:valueCodeableConcept | Base | extensible | MedicatieafspraakAanvullendeInformatieCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.modifierExtension:stopType.​value[x]:valueCodeableConcept | Base | required | Stoptype | 📦2016-06-17T10:13:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.status | Base | required | MedicationRequestStatus | 📦3.0.2 | FHIR Std.
MedicationRequest.intent | Base | required | MedicationRequestIntent | 📦3.0.2 | FHIR Std.
MedicationRequest.category | Base | preferred | MedicationRequestCategory | 📦3.0.2 | FHIR Std.
MedicationRequest.priority | Base | required | MedicationRequestPriority | 📦3.0.2 | FHIR Std.
MedicationRequest.reasonCode | Base | extensible | RedenMedicatieafspraakCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​additionalInstruction | Base | extensible | Aanvullende gebruiksinstructie | 📦2016-04-07T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍3.0.2 | FHIR Std.
MedicationRequest.dosageInstruction.​dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​dose[x]:doseRange.low | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​dose[x]:doseRange.high | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.dosageInstruction.​maxDosePerPeriod.numerator | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦2014-03-26 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
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 | `contained.where(('#'+id in %resource.descendants().reference).not()).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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationRequest.extension:periodOfUse, MedicationRequest.extension:usageDuration, MedicationRequest.extension:additionalInformation, MedicationRequest.extension:medicationTreatment, MedicationRequest.extension:nl-core-episodeofcare, MedicationRequest.modifierExtension:stopType, MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule, MedicationRequest.requester.agent.extension:practitionerRole, MedicationRequest.recorder.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mps-1 | error | MedicationRequest.requester | onBehalfOf can only be specified if agent is practitioner or device | `(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()`

This structure is derived from Zib MedicationAgreement

Summary

Must-Support: 9 elements

Structures

This structure refers to these other structures:

- Medication (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Medication)

Other representations of profile: CSV, Excel, Schematron