Medication Scheme Implementation Guide
1.0.0 - draft Estonia flag

Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions

Resource Profile: EETISPrescription - Detailed Descriptions

Draft as of 2024-02-21

Definitions for the ee-tis-prescription resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MedicationRequest
2. MedicationRequest.meta
4. MedicationRequest.meta.lastUpdated
Example<br/><b>ajanäidis</b>:2023-09-25T12:12:12+00:01
6. MedicationRequest.extension
Control1..?
SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. MedicationRequest.extension:dispensationAuthorization
    Slice NamedispensationAuthorization
    Control1..1
    TypeExtension(ExtensionEETISDispensationAuthorization) (Extension Type: CodeableConcept)
    10. MedicationRequest.extension:lockStatus
    Slice NamelockStatus
    Definition

    Broneeritud müügiloata ravimi taotluse jaoks. Kasutatakse AINULT müügiloata ravimi taotluse retsepti broneerimise puhul.

    ShortUsed only when requesting unauthorized medication.
    Control0..1
    TypeExtension(ExtensionEETISLockStatus) (Complex Extension)
    12. MedicationRequest.extension:extensionEETISUnauthorizedProductRequest
    Slice NameextensionEETISUnauthorizedProductRequest
    Definition

    Müügiloata ravimi taotluse tarvis.

    ShortUsed for requesting marketing permit for unauthorized medication.
    Control0..*
    TypeExtension(ExtensionEETISUnauthorizedProductRequest) (Complex Extension)
    14. MedicationRequest.extension:extensionEETISTotalPrescribedAmount
    Slice NameextensionEETISTotalPrescribedAmount
    Control0..*
    TypeExtension(ExtensionEETISTotalPrescribedAmount) (Extension Type: Quantity(SimpleQuantity))
    16. MedicationRequest.extension:extensionEETISReimbursementRate
    Slice NameextensionEETISReimbursementRate
    Control0..*
    TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
    18. MedicationRequest.extension:extensionEETISPrescriptionChange
    Slice NameextensionEETISPrescriptionChange
    Control0..*
    TypeExtension(ExtensionEETISPrescriptionChange) (Complex Extension)
    20. MedicationRequest.identifier
    Definition

    Retsepti unikaalne identifikaator. Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

    ShortIdentifier for the prescription.
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    22. MedicationRequest.identifier.system
    ShortIdentifier system uri for Estonian Prescription Centre prescriptions
    Pattern Valuehttps://fhir.ee/CodeSystem/tis-fhir-identifikaatorid/retseptikeskus-retsept
    24. MedicationRequest.identifier.value
    ShortPrescription number
    26. MedicationRequest.identifier.assigner
    TypeReference(EETISOrganization)
    28. MedicationRequest.basedOn
    Control0..1
    30. MedicationRequest.priorPrescription
    Control0..0
    32. MedicationRequest.status
    Definition

    Kui tegemist on müügiloata ravimi taotlusega, on status siiski "active" , sest retsept on aktiivne ning kui müügiloa otsus on positiivne ja "intent" muutunud "proposal"-st "order"-ks extension lockStatus alt täpsustus, milline apteek retesepti broneeris ja retsept staatusesse "on-hold.

    A code specifying the current state of the order. Generally, this will be active or completed state.

    34. MedicationRequest.statusReason
    Definition

    ANNULLEERIMISE PÕHJUS. LOEND. Kui retsept annulleeritakse, kasutatakse statust "cancelled" ning valitakse põhjus loendist "Annulleerimise põhjuse".

    Captures the reason for the current state of the MedicationRequest.

    ShortReason for current status. Used only when prescription is "cancelled".
    BindingThe codes SHALL be taken from ER_Annulleerimise põhjendused
    (required to https://fhir.ee/ValueSet/retsepti-annulleerimise-pohjus)

    Annulleerimise põhjus loend

    36. MedicationRequest.intent
    Definition

    Tavaline retsept on "order", müügiloata ravimi retsept on alguses "proposal".

    ShortBy default all requests are "order", unauthorized medication requests are initially "proposal" and when positively solved change to "order"
    38. MedicationRequest.category
    Definition

    RETSEPTI LIIK/DOK TYYP.

    SlicingThis element introduces a set of slices on MedicationRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ coding.system
    • 40. MedicationRequest.category:prescriptionCategory
      Slice NameprescriptionCategory
      Definition

      RETSEPTI LIIK.

      Shorttavaretsept | narkootilise ravimi retsept | meditsiiniseadme retsept
      Control0..1
      BindingThe codes SHALL be taken from ER_Retsepti liik
      (required to https://fhir.ee/ValueSet/retsepti-liik)

      RETSEPTI LIIK. LOEND.

      42. MedicationRequest.category:prescriptionCategory.coding
      44. MedicationRequest.category:prescriptionCategory.coding.system
      Control1..?
      Pattern Valuehttps://fhir.ee/CodeSystem/retsepti-liik
      46. MedicationRequest.category:repeatCategory
      Slice NamerepeatCategory
      Definition

      KORDSUS. LOEND.

      Short1-kordne | 2-kordne | 3-kordne| 6-kordne
      Control0..1
      BindingThe codes SHALL be taken from ER_Retsepti kordsus
      (required to https://fhir.ee/ValueSet/retsepti-kordsus)

      Retsepti kordsuse loend

      48. MedicationRequest.category:repeatCategory.coding
      50. MedicationRequest.category:repeatCategory.coding.system
      Control1..?
      Pattern Valuehttps://fhir.ee/CodeSystem/retsepti-kordsus
      52. MedicationRequest.priority
      Control0..0
      54. MedicationRequest.doNotPerform
      Control0..0
      56. MedicationRequest.medication
      TypeCodeableReference(EETISMedicationEPC, EETISMedicationExtemporal)referenced
      58. MedicationRequest.subject
      Definition

      Patsient, kellele retsept on välja kirjutatud.

      ShortPatient for who is the request made for.
      TypeReference(EE MPI Patient Verified)referenced
      60. MedicationRequest.informationSource
      Definition

      Juhul kui retsept on annulleeritud kellegi teise poolt kui algne väljakirjutaja, tuleb annulleerija info siia tuua.

      ShortIf prescription is cancelled by someone else than original prescriber it must be filled here. Original prescriber remains in requester field.
      TypeReference(EETISPractitionerRole, EETISPractitioner)
      62. MedicationRequest.encounter
      Control0..0
      64. MedicationRequest.authoredOn
      Definition

      Koostamise aeg

      ShortWhen the prescription was made.
      Control1..?
      66. MedicationRequest.requester
      Definition

      Kes tegi retsepti. Retsepti algne koostaja.

      ShortWho/What requested the Request. Initial author of the request. NB! See also the differenece between informationSource
      TypeReference(EETISPractitionerRole, EETISPractitioner)contained
      68. MedicationRequest.reported
      Control0..0
      70. MedicationRequest.performerType
      Control0..0
      72. MedicationRequest.performer
      Control0..0
      74. MedicationRequest.device
      Control0..0
      76. MedicationRequest.recorder
      Control0..0
      78. MedicationRequest.reason
      Definition

      Diagnoosikood RHK-10 järgi.

      ShortDiagnosis according to ICD-10. Reason or indication for ordering or not ordering the medication
      Control1..1
      BindingThe codes SHOULD be taken from https://fhir.ee/ValueSet/rhk-10
      (preferred to https://fhir.ee/ValueSet/rhk-10)

      RHK-10

      80. MedicationRequest.courseOfTherapyType
      Shortpidev | fikseeritud | vajadusel | muutuv | ühekordne
      BindingThe codes SHALL be taken from ER_Ravikuuritüüp
      (required to https://fhir.ee/ValueSet/ravikuuri-tyyp)

      RAVIKUURI TÜÜP. Loend

      82. MedicationRequest.courseOfTherapyType.coding
      Shortpidev | fikseeritud | vajadusel | muutuv | ühekordne
      84. MedicationRequest.insurance
      Control0..0
      86. MedicationRequest.note
      Definition

      Kommentaari saab lisada ainult sama inimene, kes koostas retsepti.

      Extra information about the prescription that could not be conveyed by the other attributes.

      ShortComment from the request author only.
      Control0..1
      88. MedicationRequest.note.author[x]
      Control0..0
      90. MedicationRequest.note.time
      Control0..0
      92. MedicationRequest.renderedDosageInstruction
      Control0..0
      94. MedicationRequest.effectiveDosePeriod
      Control0..0
      96. MedicationRequest.dosageInstruction
      Definition

      ANNUSTAMINE. Täpne annustamisjuhis, kuidas määratud ravimit tuleb võtta.

      Control1..?
      TypeDosage(EETISDosage)
      98. MedicationRequest.dosageInstruction.sequence
      Control0..0
      100. MedicationRequest.dosageInstruction.additionalInstruction
      Control0..0
      102. MedicationRequest.dosageInstruction.timing
      104. MedicationRequest.dosageInstruction.timing.event
      Control0..0
      106. MedicationRequest.dosageInstruction.timing.repeat
      108. MedicationRequest.dosageInstruction.timing.repeat.countMax
      Control0..0
      110. MedicationRequest.dosageInstruction.timing.repeat.duration
      Control0..0
      112. MedicationRequest.dosageInstruction.timing.repeat.durationMax
      Control0..0
      114. MedicationRequest.dosageInstruction.timing.repeat.frequency
      Definition

      Indicates the number of repetitions that should occur within a period. I.e. Event occurs frequency times per period.

      ShortMitu korda (ajaühikus).
      116. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
      Control0..0
      118. MedicationRequest.dosageInstruction.timing.repeat.period
      Definition

      (mitu korda) aja(ühikus).

      120. MedicationRequest.dosageInstruction.timing.repeat.periodMax
      Control0..0
      122. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
      Definition

      T(mitu korda aja)ühikus. Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

      ShortThe units of time for the period in UCUM units
      124. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
      Control0..0
      126. MedicationRequest.dosageInstruction.timing.repeat.when
      Control0..0
      128. MedicationRequest.dosageInstruction.timing.repeat.offset
      Control0..0
      130. MedicationRequest.dosageInstruction.timing.code
      Control0..0
      132. MedicationRequest.dosageInstruction.asNeeded
      Control0..0
      134. MedicationRequest.dosageInstruction.site
      Control0..0
      136. MedicationRequest.dosageInstruction.route
      Control0..0
      138. MedicationRequest.dosageInstruction.method
      Control0..0
      140. MedicationRequest.dosageInstruction.doseAndRate
      Control1..1
      142. MedicationRequest.dosageInstruction.doseAndRate.type
      Control0..0
      144. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
      Definition

      RAVIMI KOGUS ÜHE KASUTUSKORRA AJAL.

      TypeQuantity(SimpleQuantity)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      146. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
      Control0..0
      148. MedicationRequest.dosageInstruction.maxDosePerPeriod
      Control0..0
      150. MedicationRequest.dosageInstruction.maxDosePerAdministration
      Control0..0
      152. MedicationRequest.dosageInstruction.maxDosePerLifetime
      Control0..0
      154. MedicationRequest.dispenseRequest
      Definition

      Täpne info ravimi väljamüügi kohta.

      ShortIndicates the specific details for the dispense or medication supply part of a medication request.
      156. MedicationRequest.dispenseRequest.id
      Control0..0
      158. MedicationRequest.dispenseRequest.initialFill
      Control0..0
      160. MedicationRequest.dispenseRequest.dispenseInterval
      Control0..0
      162. MedicationRequest.dispenseRequest.validityPeriod
      Definition

      RETSEPTI KEHTIVUS AEG. Periood väljakirjutamise hetkest alates, mil on võimalik ravimit välja osta.

      Control1..?
      164. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
      Control0..0
      166. MedicationRequest.dispenseRequest.quantity
      Control0..0
      168. MedicationRequest.dispenseRequest.expectedSupplyDuration
      Control0..0
      170. MedicationRequest.dispenseRequest.dispenser
      Definition

      KASUTATAKSE AINULT MÜÜGILOATA RAVIMI APTEEGI BRONEERIMISE PUHUL. Indicates the intended performing Organization that will dispense the medication as specified by the prescriber.

      TypeReference(EETISOrganization)referenced
      172. MedicationRequest.dispenseRequest.dispenserInstruction
      Control0..0
      174. MedicationRequest.dispenseRequest.doseAdministrationAid
      Control0..0
      176. MedicationRequest.substitution
      ShortAsendamine. Any restrictions on medication substitution
      178. MedicationRequest.substitution.allowed[x]
      Definition

      Kas asendamine on keelatud.

      ShortTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
      Typeboolean, CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      180. MedicationRequest.substitution.reason
      Definition

      Asendamatuse põhjus (loend).

      Indicates the reason for the substitution, or why substitution must not be performed.

      BindingThe codes SHOULD be taken from ER_Asendamatuse põhjus
      (preferred to https://fhir.ee/ValueSet/ravimi-asendamatuse-pohjus)

      Asendamatuse põhjus. Loend

      182. MedicationRequest.substitution.reason.coding
      BindingThe codes SHOULD be taken from ER_Asendamatuse põhjus
      (preferred to https://fhir.ee/ValueSet/ravimi-asendamatuse-pohjus)

      Asendamise keelamise loend

      184. MedicationRequest.eventHistory
      Control0..0

      Guidance on how to interpret the contents of this table can be found here

      0. MedicationRequest
      Definition

      An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

      ShortOrdering of medication for patient or group
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamesPrescription, Order
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationRequest.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. MedicationRequest.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      6. MedicationRequest.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control10..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 8. MedicationRequest.extension:dispensationAuthorization
        Slice NamedispensationAuthorization
        Definition

        Volituse liik. Digiretsepti koostamisel on patsiendil võimalik piirata ravimi väljaostu õiguseid. Vaikimisi on küll kõik retseptid avalikud, kuid seda staatust saab muuta arst retsepti koostamisel või patsient terviseportaalis.

        ShortDefines the authorization of the prescription.
        Control1..1
        TypeExtension(ExtensionEETISDispensationAuthorization) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. MedicationRequest.extension:lockStatus
        Slice NamelockStatus
        Definition

        Broneeritud müügiloata ravimi taotluse jaoks. Kasutatakse AINULT müügiloata ravimi taotluse retsepti broneerimise puhul.

        ShortUsed only when requesting unauthorized medication.
        Control0..1
        TypeExtension(ExtensionEETISLockStatus) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. MedicationRequest.extension:extensionEETISUnauthorizedProductRequest
        Slice NameextensionEETISUnauthorizedProductRequest
        Definition

        Müügiloata ravimi taotluse tarvis.

        ShortUsed for requesting marketing permit for unauthorized medication.
        Control0..*
        TypeExtension(ExtensionEETISUnauthorizedProductRequest) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. MedicationRequest.extension:extensionEETISTotalPrescribedAmount
        Slice NameextensionEETISTotalPrescribedAmount
        Definition

        Kui palju on ravimit koguseliselt välja kirutatud - näiteks 120 tabletti. Selle pealt saab arvutada JÄÄKI.
        Väljakirjutatud kogus.

        ShortHow much in total there is medication prescribed on one Medication Request. Used for calculating the current status of how much medication is left on one Medication Statement row.
        Control0..*
        TypeExtension(ExtensionEETISTotalPrescribedAmount) (Extension Type: Quantity(SimpleQuantity))
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. MedicationRequest.extension:extensionEETISReimbursementRate
        Slice NameextensionEETISReimbursementRate
        Definition

        Ravimi soodustuse määr protsentides Retseptikeskuse loendist "Soodustuste määrad" ning tingimused "Vajalikud tingimused" -loendist soodustuse saamiseks.

        ShortReimbursement rate and reason of prescription medicine.
        Control0..*
        TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. MedicationRequest.extension:extensionEETISPrescriptionChange
        Slice NameextensionEETISPrescriptionChange
        Definition

        Retsepti muutmine, kes muutis, millal ja põhjus loendist.

        ShortChanges on prescription - who changed, when and reason.
        Control0..*
        TypeExtension(ExtensionEETISPrescriptionChange) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. MedicationRequest.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Must Supportfalse
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. MedicationRequest.identifier
        Definition

        Retsepti unikaalne identifikaator. Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.


        Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

        ShortIdentifier for the prescription.External ids for this request
        Comments

        This is a business identifier, not a resource identifier.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationRequest.identifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|5.0.0
        (required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MedicationRequest.identifier.system
        Definition

        Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.

        ShortIdentifier system uri for Estonian Prescription Centre prescriptionsThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Pattern Valuehttps://fhir.ee/CodeSystem/tis-fhir-identifikaatorid/retseptikeskus-retsept
        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. MedicationRequest.identifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortPrescription numberThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control0..1
        This element is affected by the following invariants: ident-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. MedicationRequest.identifier.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control0..1
        TypeReference(EETISOrganization, Organization)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. MedicationRequest.basedOn
        Definition

        A plan or request that is fulfilled in whole or in part by this medication request.

        ShortA plan or request that is fulfilled in whole or in part by this medication request
        Control0..1*
        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MedicationRequest.priorPrescription
        Definition

        Reference to an order/prescription that is being replaced by this MedicationRequest.

        ShortReference to an order/prescription that is being replaced by this MedicationRequest
        Control0..01
        TypeReference(MedicationRequest)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. MedicationRequest.status
        Definition

        Kui tegemist on müügiloata ravimi taotlusega, on status siiski "active" , sest retsept on aktiivne ning kui müügiloa otsus on positiivne ja "intent" muutunud "proposal"-st "order"-ks extension lockStatus alt täpsustus, milline apteek retesepti broneeris ja retsept staatusesse "on-hold.

        A code specifying the current state of the order. Generally, this will be active or completed state.


        A code specifying the current state of the order. Generally, this will be active or completed state.

        Shortactive | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
        Comments

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

        Control1..1
        BindingThe codes SHALL be taken from MedicationrequestStatushttp://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0
        (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0)

        A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. MedicationRequest.statusReason
        Definition

        ANNULLEERIMISE PÕHJUS. LOEND. Kui retsept annulleeritakse, kasutatakse statust "cancelled" ning valitakse põhjus loendist "Annulleerimise põhjuse".

        Captures the reason for the current state of the MedicationRequest.


        Captures the reason for the current state of the MedicationRequest.

        ShortReason for current status. Used only when prescription is "cancelled".
        Comments

        This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

        Control0..1
        BindingThe codes SHALL be taken from For example codes, see ER_Annulleerimise põhjendusedhttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason
        (required to https://fhir.ee/ValueSet/retsepti-annulleerimise-pohjus)

        Annulleerimise põhjus loend


        Identifies the reasons for a given status.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. MedicationRequest.intent
        Definition

        Tavaline retsept on "order", müügiloata ravimi retsept on alguses "proposal".


        Whether the request is a proposal, plan, or an original order.

        ShortBy default all requests are "order", unauthorized medication requests are initially "proposal" and when positively solved change to "order"proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
        Comments

        It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

        An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

        This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

        Control1..1
        BindingThe codes SHALL be taken from MedicationRequestIntenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0
        (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0)

        The kind of medication order.

        Typecode
        Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationRequest.category
        Definition

        RETSEPTI LIIK/DOK TYYP.


        An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication.

        ShortGrouping or category of medication request
        Comments

        The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

        Control0..*
        BindingFor example codes, see MedicationRequestAdministrationLocationCodeshttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
        (example to http://hl7.org/fhir/ValueSet/medicationrequest-admin-location)

        A coded concept identifying where the medication is to be consumed or administered.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on MedicationRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ coding.system
        • 44. MedicationRequest.category:prescriptionCategory
          Slice NameprescriptionCategory
          Definition

          RETSEPTI LIIK.


          An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication.

          Shorttavaretsept | narkootilise ravimi retsept | meditsiiniseadme retseptGrouping or category of medication request
          Comments

          The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

          Control0..1*
          BindingThe codes SHALL be taken from For example codes, see ER_Retsepti liikhttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
          (required to https://fhir.ee/ValueSet/retsepti-liik)

          RETSEPTI LIIK. LOEND.


          A coded concept identifying where the medication is to be consumed or administered.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. MedicationRequest.category:repeatCategory
          Slice NamerepeatCategory
          Definition

          KORDSUS. LOEND.


          An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication.

          Short1-kordne | 2-kordne | 3-kordne| 6-kordneGrouping or category of medication request
          Comments

          The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

          Control0..1*
          BindingThe codes SHALL be taken from For example codes, see ER_Retsepti kordsushttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
          (required to https://fhir.ee/ValueSet/retsepti-kordsus)

          Retsepti kordsuse loend


          A coded concept identifying where the medication is to be consumed or administered.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. MedicationRequest.priority
          Definition

          Indicates how quickly the Medication Request should be addressed with respect to other requests.

          Shortroutine | urgent | asap | stat
          Control0..01
          BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|5.0.0
          (required to http://hl7.org/fhir/ValueSet/request-priority|5.0.0)

          Identifies the level of importance to be assigned to actioning the request.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. MedicationRequest.doNotPerform
          Definition

          If true, indicates that the provider is asking for the patient to either stop taking or to not start taking the specified medication. For example, the patient is taking an existing medication and the provider is changing their medication. They want to create two seperate requests: one to stop using the current medication and another to start the new medication.

          ShortTrue if patient is to stop taking or not to start taking the medication
          Comments

          If do not perform is not specified, the request is a positive request e.g. "do perform".

          Control0..01
          Typeboolean
          Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc.)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationRequest.medication
          Definition

          Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

          ShortMedication to be taken
          Comments

          If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

          Control1..1
          BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
          (example to http://hl7.org/fhir/ValueSet/medication-codes)

          A coded concept identifying substance or product that can be ordered.

          TypeCodeableReference(EETISMedicationEPC, EETISMedicationExtemporal, Medication)referenced
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. MedicationRequest.subject
          Definition

          Patsient, kellele retsept on välja kirjutatud.


          The individual or group for whom the medication has been requested.

          ShortPatient for who is the request made for.Individual or group for whom the medication has been requested
          Comments

          The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

          Control1..1
          TypeReference(EE MPI Patient Verified, Patient, Group)referenced
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. MedicationRequest.informationSource
          Definition

          Juhul kui retsept on annulleeritud kellegi teise poolt kui algne väljakirjutaja, tuleb annulleerija info siia tuua.


          The person or organization who provided the information about this request, if the source is someone other than the requestor. This is often used when the MedicationRequest is reported by another person.

          ShortIf prescription is cancelled by someone else than original prescriber it must be filled here. Original prescriber remains in requester field.The person or organization who provided the information about this request, if the source is someone other than the requestor
          Control0..*
          TypeReference(EETISPractitionerRole, EETISPractitioner, Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. MedicationRequest.encounter
          Definition

          The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

          ShortEncounter created as part of encounter/admission/stay
          Comments

          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

          Control0..01
          TypeReference(Encounter)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. MedicationRequest.authoredOn
          Definition

          Koostamise aeg


          The date (and perhaps time) when the prescription was initially written or authored on.

          ShortWhen the prescription was made.When request was initially authored
          Control10..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. MedicationRequest.requester
          Definition

          Kes tegi retsepti. Retsepti algne koostaja.


          The individual, organization, or device that initiated the request and has responsibility for its activation.

          ShortWho/What requested the Request. Initial author of the request. NB! See also the differenece between informationSource
          Control0..1
          TypeReference(EETISPractitionerRole, EETISPractitioner, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)contained
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. MedicationRequest.reported
          Definition

          Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

          ShortReported rather than primary record
          Comments

          If not populated, then assume that this is the original record and not reported

          Control0..01
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationRequest.performerType
          Definition

          Indicates the type of performer of the administration of the medication.

          ShortDesired kind of performer of the medication administration
          Comments

          If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

          Control0..01
          BindingUnless not suitable, these codes SHALL be taken from MedicationIntendedPerformerRolehttp://hl7.org/fhir/ValueSet/medication-intended-performer-role
          (extensible to http://hl7.org/fhir/ValueSet/medication-intended-performer-role)

          Identifies the type of individual that is desired to administer the medication.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. MedicationRequest.performer
          Definition

          The specified desired performer of the medication treatment (e.g. the performer of the medication administration). For devices, this is the device that is intended to perform the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers.

          ShortIntended performer of administration
          Control0..0*
          TypeReference(Practitioner, PractitionerRole, Organization, Patient, DeviceDefinition, RelatedPerson, CareTeam, HealthcareService)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. MedicationRequest.device
          Definition

          The intended type of device that is to be used for the administration of the medication (for example, PCA Pump).

          ShortIntended type of device for the administration
          Control0..0*
          TypeCodeableReference(DeviceDefinition)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. MedicationRequest.recorder
          Definition

          The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

          ShortPerson who entered the request
          Control0..01
          TypeReference(Practitioner, PractitionerRole)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. MedicationRequest.reason
          Definition

          Diagnoosikood RHK-10 järgi.


          The reason or the indication for ordering or not ordering the medication.

          ShortDiagnosis according to ICD-10. Reason or indication for ordering or not ordering the medicationReason or indication for ordering or not ordering the medication
          Comments

          This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

          Control10..1*
          BindingThe codes SHOULD be taken from For example codes, see https://fhir.ee/ValueSet/rhk-10http://hl7.org/fhir/ValueSet/condition-code
          (preferred to https://fhir.ee/ValueSet/rhk-10)

          RHK-10


          A coded concept indicating why the medication was ordered.

          TypeCodeableReference(Condition, Observation)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. MedicationRequest.courseOfTherapyType
          Definition

          The description of the overall pattern of the administration of the medication to the patient.

          Shortpidev | fikseeritud | vajadusel | muutuv | ühekordneOverall pattern of medication administration
          Comments

          This attribute should not be confused with the protocol of the medication.

          Control0..1
          BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from ER_Ravikuuritüüphttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
          (required to https://fhir.ee/ValueSet/ravikuuri-tyyp)

          RAVIKUURI TÜÜP. Loend


          Identifies the overall pattern of medication administratio.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. MedicationRequest.courseOfTherapyType.coding
          Definition

          A reference to a code defined by a terminology system.

          Shortpidev | fikseeritud | vajadusel | muutuv | ühekordneCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..*
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. MedicationRequest.insurance
          Definition

          Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

          ShortAssociated insurance coverage
          Control0..0*
          TypeReference(Coverage, ClaimResponse)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. MedicationRequest.note
          Definition

          Kommentaari saab lisada ainult sama inimene, kes koostas retsepti.

          Extra information about the prescription that could not be conveyed by the other attributes.


          Extra information about the prescription that could not be conveyed by the other attributes.

          ShortComment from the request author only.Information about the prescription
          Control0..1*
          TypeAnnotation
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. MedicationRequest.note.author[x]
          Definition

          The individual responsible for making the annotation.

          ShortIndividual responsible for the annotation
          Comments

          Organization is used when there's no need for specific attribution as to who made the comment.

          Control0..01
          TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. MedicationRequest.note.time
          Definition

          Indicates when this particular annotation was made.

          ShortWhen the annotation was made
          Control0..01
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. MedicationRequest.note.text
          Definition

          The text of the annotation in markdown format.

          ShortThe annotation - text content (as markdown)
          Control1..1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. MedicationRequest.renderedDosageInstruction
          Definition

          The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

          ShortFull representation of the dosage instructions
          Control0..01
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Requirements

          The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. MedicationRequest.effectiveDosePeriod
          Definition

          The period over which the medication is to be taken. Where there are multiple dosageInstruction lines (for example, tapering doses), this is the earliest date and the latest end date of the dosageInstructions.

          ShortPeriod over which the medication is to be taken
          Control0..01
          TypePeriod
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. MedicationRequest.dosageInstruction
          Definition

          ANNUSTAMINE. Täpne annustamisjuhis, kuidas määratud ravimit tuleb võtta.


          Specific instructions for how the medication is to be used by the patient.

          ShortDosageSpecific instructions for how the medication should be taken
          Comments

          There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. In general, each prescribed drug will be a separate Medication Request.

          When drug orders are grouped together at the time of order entry, but each of the drugs can be manipulated independently e.g. changing the status of one order to "completed" or "cancelled", changing another order status to "on-hold", the method to "group" all of the medication requests together is to use MedicationRequest.groupIdentifier element. All of the orders grouped together in this manner will have the same groupIdentifier, and separately, each order in the group may have a unique identifier.

          There are cases that require grouping of Medication orders together when it is necessary to specify optionality e.g. order two drugs at one time, but stating either of these drugs may be used to treat the patient. The use of a RequestOrchestration should be used as a parent for the Medication orders that require this type of grouping. An example when it may be necessary to group medication orders together is when you specify timing relationships e.g. order drug "xyz" with dose 123, then taper the same drug to a different dose after some interval of time precedence: e.g. give drug "abc" followed by drug "def" e.g. give drug 30 minutes before some procedure was performed more generically this supports - hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group. Note that one should NOT use the List or Composition resource to accomplish the above requirements. You may use List or Composition for other business requirements, but not to address the specific requirements of grouping medication orders.

          Control10..*
          TypeDosage(EETISDosage)
          Is Modifierfalse
          Must Supportfalse
          Invariantsdos-1: AsNeededFor can only be set if AsNeeded is empty or true (asNeededFor.empty() or asNeeded.empty() or asNeeded)
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. MedicationRequest.dosageInstruction.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          98. MedicationRequest.dosageInstruction.sequence
          Definition

          JÄRJEKORD.


          Indicates the order in which the dosage instructions should be applied or interpreted.

          ShortThe order of the dosage instructions
          Control0..01
          Typeinteger
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. MedicationRequest.dosageInstruction.additionalInstruction
          Definition

          LISAJUHIS.


          Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

          ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
          Comments

          Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or take "immediately following drug x") should be populated in dosage.text.

          Control0..0*
          BindingFor example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes
          (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

          A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. MedicationRequest.dosageInstruction.asNeeded
          Definition

          VAJADUSEL


          Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option).

          ShortTake "as needed"
          Comments

          Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated.

          Control0..01
          This element is affected by the following invariants: dos-1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. MedicationRequest.dosageInstruction.asNeededFor
          Definition

          Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept).

          ShortTake "as needed" (for x)
          Comments

          Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed".

          Control0..1*
          This element is affected by the following invariants: dos-1
          BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
          (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

          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.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. MedicationRequest.dosageInstruction.site
          Definition

          KEHAPIIRKOND.


          Body site to administer to.

          ShortBody site to administer to
          Comments

          If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

          Control0..01
          BindingFor example codes, see SNOMEDCTAnatomicalStructureAdministrationSiteshttp://hl7.org/fhir/ValueSet/approach-site-codes
          (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

          A coded concept describing the site location the medicine enters into or onto the body.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          A coded specification of the anatomic site where the medication first enters the body.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. MedicationRequest.dosageInstruction.route
          Definition

          MANUSTAMISVIIS.


          How drug should enter body.

          ShortHow drug should enter body
          Control0..01
          BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes
          (example to http://hl7.org/fhir/ValueSet/route-codes)

          A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. MedicationRequest.dosageInstruction.method
          Definition

          MANUSTAMISMEETOD. Näiteks subkutaanne


          Technique for administering medication.

          ShortTechnique for administering medication
          Comments

          Terminologies used often pre-coordinate this term with the route and or form of administration.

          Control0..01
          BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes
          (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

          A coded concept describing the technique by which the medicine is administered.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          112. MedicationRequest.dosageInstruction.doseAndRate
          Definition

          ANNUS JA KIIRUS.


          Depending on the resource,this is the amount of medication administered, to be administered or typical amount to be administered.

          ShortAmount of medication administered, to be administered or typical amount to be administered
          Control10..1*
          TypeElement
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          114. MedicationRequest.dosageInstruction.doseAndRate.type
          Definition

          The kind of dose or rate specified, for example, ordered or calculated.

          ShortThe kind of dose or rate specified
          Control0..01
          BindingFor example codes, see DoseAndRateTypehttp://terminology.hl7.org/ValueSet/dose-rate-type
          (example to http://terminology.hl7.org/ValueSet/dose-rate-type)

          The kind of dose or rate specified.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          If the type is not populated, assume to be "ordered".

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
          Definition

          RAVIMI KOGUS ÜHE KASUTUSKORRA AJAL.


          Amount of medication per dose.

          ShortA fixed quantity (no comparator)Amount of medication per dose
          Comments

          The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.


          Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

          Control0..1
          TypeQuantity(SimpleQuantity), Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Requirements

          The amount of therapeutic or other substance given at one administration event.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
          sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
          118. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
          Definition

          MANUSTAMISE KIIRUS. Amount of medication per unit of time.


          Amount of medication per unit of time.

          ShortAmount of medication per unit of time
          Comments

          It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

          It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammar where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

          Control0..01
          TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
          Is Modifierfalse
          Summarytrue
          Requirements

          Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. MedicationRequest.dosageInstruction.maxDosePerPeriod
          Definition

          MAKSIMAALNE ANNUS PERIOODIS. Upper limit on medication per unit of time.


          Upper limit on medication per unit of time.

          ShortUpper limit on medication per unit of time
          Comments

          This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

          Control0..0*
          TypeRatio
          Is Modifierfalse
          Summarytrue
          Requirements

          The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. MedicationRequest.dosageInstruction.maxDosePerAdministration
          Definition

          MAKSIMAALNE ANNUS ÜHE ANNUSTAMISE KOHTA. Upper limit on medication per administration.


          Upper limit on medication per administration.

          ShortUpper limit on medication per administration
          Comments

          This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

          Control0..01
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summarytrue
          Requirements

          The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. MedicationRequest.dosageInstruction.maxDosePerLifetime
          Definition

          MAKSIMAALNE ANNUS ELUS. Upper limit on medication per lifetime of the patient.


          Upper limit on medication per lifetime of the patient.

          ShortUpper limit on medication per lifetime of the patient
          Control0..01
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summarytrue
          Requirements

          The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. MedicationRequest.dispenseRequest
          Definition

          Täpne info ravimi väljamüügi kohta.


          Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

          ShortIndicates the specific details for the dispense or medication supply part of a medication request.Medication supply authorization
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. MedicationRequest.dispenseRequest.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..01
          This element is affected by the following invariants: ele-1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          130. MedicationRequest.dispenseRequest.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          132. MedicationRequest.dispenseRequest.initialFill
          Definition

          Indicates the quantity or duration for the first dispense of the medication.

          ShortFirst fill details
          Comments

          If populating this element, either the quantity or the duration must be included.

          Control0..01
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          135. MedicationRequest.dispenseRequest.dispenseInterval
          Definition

          The minimum period of time that must occur between dispenses of the medication.

          ShortMinimum period of time between dispenses
          Control0..01
          TypeDuration
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          137. MedicationRequest.dispenseRequest.validityPeriod
          Definition

          RETSEPTI KEHTIVUS AEG. Periood väljakirjutamise hetkest alates, mil on võimalik ravimit välja osta.


          This indicates the validity period of a prescription (stale dating the Prescription).

          ShortTime period supply is authorized for
          Comments

          It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

          Control10..1
          TypePeriod
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          139. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
          Definition

          An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

          ShortNumber of refills authorized
          Comments

          If displaying "number of authorized fills", add 1 to this number.

          Control0..01
          TypeunsignedInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          141. MedicationRequest.dispenseRequest.quantity
          Definition

          The amount that is to be dispensed for one fill.

          ShortAmount of medication to supply per dispense
          Control0..01
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          143. MedicationRequest.dispenseRequest.expectedSupplyDuration
          Definition

          Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

          ShortNumber of days supply per dispense
          Comments

          In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

          Control0..01
          TypeDuration
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          145. MedicationRequest.dispenseRequest.dispenser
          Definition

          KASUTATAKSE AINULT MÜÜGILOATA RAVIMI APTEEGI BRONEERIMISE PUHUL. Indicates the intended performing Organization that will dispense the medication as specified by the prescriber.


          Indicates the intended performing Organization that will dispense the medication as specified by the prescriber.

          ShortIntended performer of dispense
          Control0..1
          TypeReference(EETISOrganization, Organization)referenced
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          147. MedicationRequest.dispenseRequest.dispenserInstruction
          Definition

          Provides additional information to the dispenser, for example, counselling to be provided to the patient.

          ShortAdditional information for the dispenser
          Control0..0*
          TypeAnnotation
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          149. MedicationRequest.dispenseRequest.doseAdministrationAid
          Definition

          Provides information about the type of adherence packaging to be supplied for the medication dispense.

          ShortType of adherence packaging to use for the dispense
          Control0..01
          BindingFor example codes, see MedicationDoseAidshttp://hl7.org/fhir/ValueSet/medication-dose-aid
          (example to http://hl7.org/fhir/ValueSet/medication-dose-aid)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          151. MedicationRequest.substitution
          Definition

          Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

          ShortAsendamine. Any restrictions on medication substitutionAny restrictions on medication substitution
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          153. MedicationRequest.substitution.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          155. MedicationRequest.substitution.allowed[x]
          Definition

          Kas asendamine on keelatud.


          True if the prescriber allows a different drug to be dispensed from what was prescribed.

          ShortTrue if the prescriber allows a different drug to be dispensed from what was prescribed.Whether substitution is allowed or not
          Comments

          This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

          Control1..1
          Typeboolean, CodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          157. MedicationRequest.substitution.reason
          Definition

          Asendamatuse põhjus (loend).

          Indicates the reason for the substitution, or why substitution must not be performed.


          Indicates the reason for the substitution, or why substitution must or must not be performed.

          ShortWhy should (not) substitution be made
          Control0..1
          BindingThe codes SHOULD be taken from For example codes, see ER_Asendamatuse põhjushttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason
          (preferred to https://fhir.ee/ValueSet/ravimi-asendamatuse-pohjus)

          Asendamatuse põhjus. Loend


          SubstanceAdminSubstitutionReason

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          159. MedicationRequest.substitution.reason.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..*
          BindingThe codes SHOULD be taken from For codes, see ER_Asendamatuse põhjus
          (preferred to https://fhir.ee/ValueSet/ravimi-asendamatuse-pohjus)

          Asendamise keelamise loend

          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          161. MedicationRequest.eventHistory
          Definition

          Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

          ShortA list of events of interest in the lifecycle
          Comments

          This might not include provenances for all versions of the request – only those deemed "relevant" or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

          Control0..0*
          TypeReference(Provenance)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be found here

          0. MedicationRequest
          Definition

          An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

          ShortOrdering of medication for patient or group
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate NamesPrescription, Order
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. MedicationRequest.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          4. MedicationRequest.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. MedicationRequest.meta.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          This element is affected by the following invariants: ele-1
          Typeid
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          8. MedicationRequest.meta.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MedicationRequest.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 10. MedicationRequest.meta.versionId
            Definition

            The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

            ShortVersion specific identifier
            Comments

            The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

            Control0..1
            Typeid
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. MedicationRequest.meta.lastUpdated
            Definition

            When the resource last changed - e.g. when the version changed.

            ShortWhen the resource version last changed
            Comments

            This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

            Control0..1
            Typeinstant
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Example<br/><b>ajanäidis</b>:2023-09-25T12:12:12+00:01
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            14. MedicationRequest.meta.source
            Definition

            A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

            ShortIdentifies where the resource comes from
            Comments

            The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference.

            This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

            Control0..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            16. MedicationRequest.meta.profile
            Definition

            A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

            ShortProfiles this resource claims to conform to
            Comments

            It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

            Control0..*
            Typecanonical(StructureDefinition)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. MedicationRequest.meta.security
            Definition

            Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

            ShortSecurity Labels applied to this resource
            Comments

            The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from AllSecurityLabels
            (extensible to http://hl7.org/fhir/ValueSet/security-labels)

            Security Labels from the Healthcare Privacy and Security Classification System.

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. MedicationRequest.meta.tag
            Definition

            Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

            ShortTags applied to this resource
            Comments

            The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingFor example codes, see CommonTags
            (example to http://hl7.org/fhir/ValueSet/common-tags)

            Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. MedicationRequest.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

            ShortA set of rules under which this content was created
            Comments

            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

            Control0..1
            Typeuri
            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. MedicationRequest.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

            Control0..1
            BindingThe codes SHALL be taken from AllLanguages
            (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

            IETF language tag for a human language

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. MedicationRequest.text
            Definition

            A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

            ShortText summary of the resource, for human interpretation
            Comments

            Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

            Control0..1
            This element is affected by the following invariants: dom-6
            TypeNarrative
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. MedicationRequest.contained
            Definition

            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

            ShortContained, inline Resources
            Comments

            This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

            Control0..*
            This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
            TypeResource
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            30. MedicationRequest.extension
            Definition

            An Extension

            ShortExtension
            Control1..*
            TypeExtension
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. MedicationRequest.extension:dispensationAuthorization
              Slice NamedispensationAuthorization
              Definition

              Volituse liik. Digiretsepti koostamisel on patsiendil võimalik piirata ravimi väljaostu õiguseid. Vaikimisi on küll kõik retseptid avalikud, kuid seda staatust saab muuta arst retsepti koostamisel või patsient terviseportaalis.

              ShortDefines the authorization of the prescription.
              Control1..1
              TypeExtension(ExtensionEETISDispensationAuthorization) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Must Supportfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              34. MedicationRequest.extension:lockStatus
              Slice NamelockStatus
              Definition

              Broneeritud müügiloata ravimi taotluse jaoks. Kasutatakse AINULT müügiloata ravimi taotluse retsepti broneerimise puhul.

              ShortUsed only when requesting unauthorized medication.
              Control0..1
              TypeExtension(ExtensionEETISLockStatus) (Complex Extension)
              Is Modifierfalse
              Must Supportfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              36. MedicationRequest.extension:extensionEETISUnauthorizedProductRequest
              Slice NameextensionEETISUnauthorizedProductRequest
              Definition

              Müügiloata ravimi taotluse tarvis.

              ShortUsed for requesting marketing permit for unauthorized medication.
              Control0..*
              TypeExtension(ExtensionEETISUnauthorizedProductRequest) (Complex Extension)
              Is Modifierfalse
              Must Supportfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              38. MedicationRequest.extension:extensionEETISTotalPrescribedAmount
              Slice NameextensionEETISTotalPrescribedAmount
              Definition

              Kui palju on ravimit koguseliselt välja kirutatud - näiteks 120 tabletti. Selle pealt saab arvutada JÄÄKI.
              Väljakirjutatud kogus.

              ShortHow much in total there is medication prescribed on one Medication Request. Used for calculating the current status of how much medication is left on one Medication Statement row.
              Control0..*
              TypeExtension(ExtensionEETISTotalPrescribedAmount) (Extension Type: Quantity(SimpleQuantity))
              Is Modifierfalse
              Must Supportfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              40. MedicationRequest.extension:extensionEETISReimbursementRate
              Slice NameextensionEETISReimbursementRate
              Definition

              Ravimi soodustuse määr protsentides Retseptikeskuse loendist "Soodustuste määrad" ning tingimused "Vajalikud tingimused" -loendist soodustuse saamiseks.

              ShortReimbursement rate and reason of prescription medicine.
              Control0..*
              TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
              Is Modifierfalse
              Must Supportfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              42. MedicationRequest.extension:extensionEETISPrescriptionChange
              Slice NameextensionEETISPrescriptionChange
              Definition

              Retsepti muutmine, kes muutis, millal ja põhjus loendist.

              ShortChanges on prescription - who changed, when and reason.
              Control0..*
              TypeExtension(ExtensionEETISPrescriptionChange) (Complex Extension)
              Is Modifierfalse
              Must Supportfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              44. MedicationRequest.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Must Supportfalse
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              46. MedicationRequest.identifier
              Definition

              Retsepti unikaalne identifikaator. Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

              ShortIdentifier for the prescription.
              Comments

              This is a business identifier, not a resource identifier.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. MedicationRequest.identifier.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              50. MedicationRequest.identifier.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on MedicationRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 52. MedicationRequest.identifier.use
                Definition

                The purpose of this identifier.

                Shortusual | official | temp | secondary | old (If known)
                Comments

                Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                Control0..1
                BindingThe codes SHALL be taken from IdentifierUse
                (required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

                Identifies the purpose for this identifier, if known .

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. MedicationRequest.identifier.type
                Definition

                A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                ShortDescription of identifier
                Comments

                This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from IdentifierTypeCodes
                (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows users to make use of identifiers when the identifier system is not known.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. MedicationRequest.identifier.system
                Definition

                Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.

                ShortIdentifier system uri for Estonian Prescription Centre prescriptions
                Comments

                Identifier.system is always case sensitive.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                Pattern Valuehttps://fhir.ee/CodeSystem/tis-fhir-identifikaatorid/retseptikeskus-retsept
                Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. MedicationRequest.identifier.value
                Definition

                The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                ShortPrescription number
                Comments

                If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                Control0..1
                This element is affected by the following invariants: ident-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Example<br/><b>General</b>:123456
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. MedicationRequest.identifier.period
                Definition

                Time period during which identifier is/was valid for use.

                ShortTime period when id is/was valid for use
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. MedicationRequest.identifier.assigner
                Definition

                Organization that issued/manages the identifier.

                ShortOrganization that issued id (may be just text)
                Comments

                The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                Control0..1
                TypeReference(EETISOrganization)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. MedicationRequest.basedOn
                Definition

                A plan or request that is fulfilled in whole or in part by this medication request.

                ShortA plan or request that is fulfilled in whole or in part by this medication request
                Control0..1
                TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. MedicationRequest.priorPrescription
                Definition

                Reference to an order/prescription that is being replaced by this MedicationRequest.

                ShortReference to an order/prescription that is being replaced by this MedicationRequest
                Control0..0
                TypeReference(MedicationRequest)
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. MedicationRequest.groupIdentifier
                Definition

                A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time.

                ShortComposite request this is part of
                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Requirements

                Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. MedicationRequest.status
                Definition

                Kui tegemist on müügiloata ravimi taotlusega, on status siiski "active" , sest retsept on aktiivne ning kui müügiloa otsus on positiivne ja "intent" muutunud "proposal"-st "order"-ks extension lockStatus alt täpsustus, milline apteek retesepti broneeris ja retsept staatusesse "on-hold.

                A code specifying the current state of the order. Generally, this will be active or completed state.

                Shortactive | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
                Comments

                This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

                Control1..1
                BindingThe codes SHALL be taken from MedicationrequestStatus
                (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0)

                A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

                Typecode
                Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. MedicationRequest.statusReason
                Definition

                ANNULLEERIMISE PÕHJUS. LOEND. Kui retsept annulleeritakse, kasutatakse statust "cancelled" ning valitakse põhjus loendist "Annulleerimise põhjuse".

                Captures the reason for the current state of the MedicationRequest.

                ShortReason for current status. Used only when prescription is "cancelled".
                Comments

                This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

                Control0..1
                BindingThe codes SHALL be taken from ER_Annulleerimise põhjendused
                (required to https://fhir.ee/ValueSet/retsepti-annulleerimise-pohjus)

                Annulleerimise põhjus loend

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. MedicationRequest.statusChanged
                Definition

                The date (and perhaps time) when the status was changed.

                ShortWhen the status was changed
                Control0..1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. MedicationRequest.intent
                Definition

                Tavaline retsept on "order", müügiloata ravimi retsept on alguses "proposal".

                ShortBy default all requests are "order", unauthorized medication requests are initially "proposal" and when positively solved change to "order"
                Comments

                It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                Control1..1
                BindingThe codes SHALL be taken from MedicationRequestIntent
                (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0)

                The kind of medication order.

                Typecode
                Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. MedicationRequest.category
                Definition

                RETSEPTI LIIK/DOK TYYP.

                ShortGrouping or category of medication request
                Comments

                The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

                Control0..*
                BindingFor example codes, see MedicationRequestAdministrationLocationCodes
                (example to http://hl7.org/fhir/ValueSet/medicationrequest-admin-location)

                A coded concept identifying where the medication is to be consumed or administered.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on MedicationRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ coding.system
                • 80. MedicationRequest.category:prescriptionCategory
                  Slice NameprescriptionCategory
                  Definition

                  RETSEPTI LIIK.

                  Shorttavaretsept | narkootilise ravimi retsept | meditsiiniseadme retsept
                  Comments

                  The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

                  Control0..1
                  BindingThe codes SHALL be taken from ER_Retsepti liik
                  (required to https://fhir.ee/ValueSet/retsepti-liik)

                  RETSEPTI LIIK. LOEND.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  82. MedicationRequest.category:prescriptionCategory.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  84. MedicationRequest.category:prescriptionCategory.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MedicationRequest.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 86. MedicationRequest.category:prescriptionCategory.coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..*
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows for alternative encodings within a code system, and translations to other code systems.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. MedicationRequest.category:prescriptionCategory.coding.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    90. MedicationRequest.category:prescriptionCategory.coding.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on MedicationRequest.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 92. MedicationRequest.category:prescriptionCategory.coding.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Pattern Valuehttps://fhir.ee/CodeSystem/retsepti-liik
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      94. MedicationRequest.category:prescriptionCategory.coding.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business version Id, not a resource version Id (see discussion)
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      96. MedicationRequest.category:prescriptionCategory.coding.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control0..1
                      This element is affected by the following invariants: cod-1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      98. MedicationRequest.category:prescriptionCategory.coding.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

                      ShortRepresentation defined by the system
                      Control0..1
                      This element is affected by the following invariants: cod-1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      100. MedicationRequest.category:prescriptionCategory.coding.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                      Control0..1
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      102. MedicationRequest.category:prescriptionCategory.text
                      Definition

                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                      ShortPlain text representation of the concept
                      Comments

                      Very often the text is the same as a displayName of one of the codings.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      104. MedicationRequest.category:repeatCategory
                      Slice NamerepeatCategory
                      Definition

                      KORDSUS. LOEND.

                      Short1-kordne | 2-kordne | 3-kordne| 6-kordne
                      Comments

                      The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

                      Control0..1
                      BindingThe codes SHALL be taken from ER_Retsepti kordsus
                      (required to https://fhir.ee/ValueSet/retsepti-kordsus)

                      Retsepti kordsuse loend

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      106. MedicationRequest.category:repeatCategory.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typeid
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      108. MedicationRequest.category:repeatCategory.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MedicationRequest.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 110. MedicationRequest.category:repeatCategory.coding
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        Comments

                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                        Control0..*
                        TypeCoding
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        112. MedicationRequest.category:repeatCategory.coding.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeid
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        114. MedicationRequest.category:repeatCategory.coding.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on MedicationRequest.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 116. MedicationRequest.category:repeatCategory.coding.system
                          Definition

                          The identification of the code system that defines the meaning of the symbol in the code.

                          ShortIdentity of the terminology system
                          Comments

                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.

                          Control1..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be unambiguous about the source of the definition of the symbol.

                          Pattern Valuehttps://fhir.ee/CodeSystem/retsepti-kordsus
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. MedicationRequest.category:repeatCategory.coding.version
                          Definition

                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                          ShortVersion of the system - if relevant
                          Comments

                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                          NoteThis is a business version Id, not a resource version Id (see discussion)
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          120. MedicationRequest.category:repeatCategory.coding.code
                          Definition

                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                          ShortSymbol in syntax defined by the system
                          Control0..1
                          This element is affected by the following invariants: cod-1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to refer to a particular code in the system.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          122. MedicationRequest.category:repeatCategory.coding.display
                          Definition

                          A representation of the meaning of the code in the system, following the rules of the system.

                          ShortRepresentation defined by the system
                          Control0..1
                          This element is affected by the following invariants: cod-1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          124. MedicationRequest.category:repeatCategory.coding.userSelected
                          Definition

                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                          ShortIf this coding was chosen directly by the user
                          Comments

                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                          Control0..1
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          126. MedicationRequest.category:repeatCategory.text
                          Definition

                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                          ShortPlain text representation of the concept
                          Comments

                          Very often the text is the same as a displayName of one of the codings.

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          128. MedicationRequest.priority
                          Definition

                          Indicates how quickly the Medication Request should be addressed with respect to other requests.

                          Shortroutine | urgent | asap | stat
                          Control0..0
                          BindingThe codes SHALL be taken from RequestPriority
                          (required to http://hl7.org/fhir/ValueSet/request-priority|5.0.0)

                          Identifies the level of importance to be assigned to actioning the request.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          130. MedicationRequest.doNotPerform
                          Definition

                          If true, indicates that the provider is asking for the patient to either stop taking or to not start taking the specified medication. For example, the patient is taking an existing medication and the provider is changing their medication. They want to create two seperate requests: one to stop using the current medication and another to start the new medication.

                          ShortTrue if patient is to stop taking or not to start taking the medication
                          Comments

                          If do not perform is not specified, the request is a positive request e.g. "do perform".

                          Control0..0
                          Typeboolean
                          Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc.)
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          132. MedicationRequest.medication
                          Definition

                          Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                          ShortMedication to be taken
                          Comments

                          If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                          Control1..1
                          BindingFor example codes, see SNOMEDCTMedicationCodes
                          (example to http://hl7.org/fhir/ValueSet/medication-codes)

                          A coded concept identifying substance or product that can be ordered.

                          TypeCodeableReference(EETISMedicationEPC, EETISMedicationExtemporal)referenced
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          134. MedicationRequest.subject
                          Definition

                          Patsient, kellele retsept on välja kirjutatud.

                          ShortPatient for who is the request made for.
                          Comments

                          The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                          Control1..1
                          TypeReference(EE MPI Patient Verified)referenced
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          136. MedicationRequest.informationSource
                          Definition

                          Juhul kui retsept on annulleeritud kellegi teise poolt kui algne väljakirjutaja, tuleb annulleerija info siia tuua.

                          ShortIf prescription is cancelled by someone else than original prescriber it must be filled here. Original prescriber remains in requester field.
                          Control0..*
                          TypeReference(EETISPractitionerRole, EETISPractitioner)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          138. MedicationRequest.encounter
                          Definition

                          The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

                          ShortEncounter created as part of encounter/admission/stay
                          Comments

                          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

                          Control0..0
                          TypeReference(Encounter)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          140. MedicationRequest.supportingInformation
                          Definition

                          Information to support fulfilling (i.e. dispensing or administering) of the medication, for example, patient height and weight, a MedicationStatement for the patient).

                          ShortInformation to support fulfilling of the medication
                          Comments

                          This attribute can be used to reference a MedicationStatement about the patients' medication use.

                          Control0..*
                          TypeReference(Resource)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          142. MedicationRequest.authoredOn
                          Definition

                          Koostamise aeg

                          ShortWhen the prescription was made.
                          Control1..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          144. MedicationRequest.requester
                          Definition

                          Kes tegi retsepti. Retsepti algne koostaja.

                          ShortWho/What requested the Request. Initial author of the request. NB! See also the differenece between informationSource
                          Control0..1
                          TypeReference(EETISPractitionerRole, EETISPractitioner)contained
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          146. MedicationRequest.reported
                          Definition

                          Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

                          ShortReported rather than primary record
                          Comments

                          If not populated, then assume that this is the original record and not reported

                          Control0..0
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          148. MedicationRequest.performerType
                          Definition

                          Indicates the type of performer of the administration of the medication.

                          ShortDesired kind of performer of the medication administration
                          Comments

                          If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

                          Control0..0
                          BindingUnless not suitable, these codes SHALL be taken from MedicationIntendedPerformerRole
                          (extensible to http://hl7.org/fhir/ValueSet/medication-intended-performer-role)

                          Identifies the type of individual that is desired to administer the medication.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          150. MedicationRequest.performer
                          Definition

                          The specified desired performer of the medication treatment (e.g. the performer of the medication administration). For devices, this is the device that is intended to perform the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers.

                          ShortIntended performer of administration
                          Control0..0
                          TypeReference(Practitioner, PractitionerRole, Organization, Patient, DeviceDefinition, RelatedPerson, CareTeam, HealthcareService)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          152. MedicationRequest.device
                          Definition

                          The intended type of device that is to be used for the administration of the medication (for example, PCA Pump).

                          ShortIntended type of device for the administration
                          Control0..0
                          TypeCodeableReference(DeviceDefinition)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          154. MedicationRequest.recorder
                          Definition

                          The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

                          ShortPerson who entered the request
                          Control0..0
                          TypeReference(Practitioner, PractitionerRole)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          156. MedicationRequest.reason
                          Definition

                          Diagnoosikood RHK-10 järgi.

                          ShortDiagnosis according to ICD-10. Reason or indication for ordering or not ordering the medication
                          Comments

                          This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

                          Control1..1
                          BindingThe codes SHOULD be taken from https://fhir.ee/ValueSet/rhk-10
                          (preferred to https://fhir.ee/ValueSet/rhk-10)

                          RHK-10

                          TypeCodeableReference(Condition, Observation)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          158. MedicationRequest.courseOfTherapyType
                          Definition

                          The description of the overall pattern of the administration of the medication to the patient.

                          Shortpidev | fikseeritud | vajadusel | muutuv | ühekordne
                          Comments

                          This attribute should not be confused with the protocol of the medication.

                          Control0..1
                          BindingThe codes SHALL be taken from ER_Ravikuuritüüp
                          (required to https://fhir.ee/ValueSet/ravikuuri-tyyp)

                          RAVIKUURI TÜÜP. Loend

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          160. MedicationRequest.courseOfTherapyType.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typeid
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          162. MedicationRequest.courseOfTherapyType.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MedicationRequest.courseOfTherapyType.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 164. MedicationRequest.courseOfTherapyType.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            Shortpidev | fikseeritud | vajadusel | muutuv | ühekordne
                            Comments

                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                            Control0..*
                            TypeCoding
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Allows for alternative encodings within a code system, and translations to other code systems.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            166. MedicationRequest.courseOfTherapyType.text
                            Definition

                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                            ShortPlain text representation of the concept
                            Comments

                            Very often the text is the same as a displayName of one of the codings.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            168. MedicationRequest.insurance
                            Definition

                            Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

                            ShortAssociated insurance coverage
                            Control0..0
                            TypeReference(Coverage, ClaimResponse)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            170. MedicationRequest.note
                            Definition

                            Kommentaari saab lisada ainult sama inimene, kes koostas retsepti.

                            Extra information about the prescription that could not be conveyed by the other attributes.

                            ShortComment from the request author only.
                            Control0..1
                            TypeAnnotation
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            172. MedicationRequest.note.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typeid
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            174. MedicationRequest.note.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MedicationRequest.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 176. MedicationRequest.note.author[x]
                              Definition

                              The individual responsible for making the annotation.

                              ShortIndividual responsible for the annotation
                              Comments

                              Organization is used when there's no need for specific attribution as to who made the comment.

                              Control0..0
                              TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              178. MedicationRequest.note.time
                              Definition

                              Indicates when this particular annotation was made.

                              ShortWhen the annotation was made
                              Control0..0
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              180. MedicationRequest.note.text
                              Definition

                              The text of the annotation in markdown format.

                              ShortThe annotation - text content (as markdown)
                              Control1..1
                              Typemarkdown
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              182. MedicationRequest.renderedDosageInstruction
                              Definition

                              The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

                              ShortFull representation of the dosage instructions
                              Control0..0
                              Typemarkdown
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              184. MedicationRequest.effectiveDosePeriod
                              Definition

                              The period over which the medication is to be taken. Where there are multiple dosageInstruction lines (for example, tapering doses), this is the earliest date and the latest end date of the dosageInstructions.

                              ShortPeriod over which the medication is to be taken
                              Control0..0
                              TypePeriod
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              186. MedicationRequest.dosageInstruction
                              Definition

                              ANNUSTAMINE. Täpne annustamisjuhis, kuidas määratud ravimit tuleb võtta.

                              ShortDosage
                              Comments

                              There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. In general, each prescribed drug will be a separate Medication Request.

                              When drug orders are grouped together at the time of order entry, but each of the drugs can be manipulated independently e.g. changing the status of one order to "completed" or "cancelled", changing another order status to "on-hold", the method to "group" all of the medication requests together is to use MedicationRequest.groupIdentifier element. All of the orders grouped together in this manner will have the same groupIdentifier, and separately, each order in the group may have a unique identifier.

                              There are cases that require grouping of Medication orders together when it is necessary to specify optionality e.g. order two drugs at one time, but stating either of these drugs may be used to treat the patient. The use of a RequestOrchestration should be used as a parent for the Medication orders that require this type of grouping. An example when it may be necessary to group medication orders together is when you specify timing relationships e.g. order drug "xyz" with dose 123, then taper the same drug to a different dose after some interval of time precedence: e.g. give drug "abc" followed by drug "def" e.g. give drug 30 minutes before some procedure was performed more generically this supports - hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group. Note that one should NOT use the List or Composition resource to accomplish the above requirements. You may use List or Composition for other business requirements, but not to address the specific requirements of grouping medication orders.

                              Control1..*
                              TypeDosage(EETISDosage)
                              Is Modifierfalse
                              Must Supportfalse
                              Invariantsdos-1: AsNeededFor can only be set if AsNeeded is empty or true (asNeededFor.empty() or asNeeded.empty() or asNeeded)
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              188. MedicationRequest.dosageInstruction.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typeid
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              190. MedicationRequest.dosageInstruction.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 192. MedicationRequest.dosageInstruction.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Summarytrue
                                Requirements

                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                Alternate Namesextensions, user content, modifiers
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                194. MedicationRequest.dosageInstruction.sequence
                                Definition

                                JÄRJEKORD.

                                ShortThe order of the dosage instructions
                                Control0..0
                                Typeinteger
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                196. MedicationRequest.dosageInstruction.text
                                Definition

                                Free text dosage instructions e.g. SIG.

                                ShortFree text dosage instructions e.g. SIG
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                                Max Length:1000
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                198. MedicationRequest.dosageInstruction.additionalInstruction
                                Definition

                                LISAJUHIS.

                                ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                Comments

                                Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or take "immediately following drug x") should be populated in dosage.text.

                                Control0..0
                                BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

                                A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                200. MedicationRequest.dosageInstruction.patientInstruction
                                Definition

                                KOMMENTAAR PATSIENDILE.

                                ShortPatient or consumer oriented instructions
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                202. MedicationRequest.dosageInstruction.timing
                                Definition

                                ANNUSTAMISE AEG.

                                ShortWhen medication should be administered
                                Comments

                                This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                                Control0..1
                                TypeTiming
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                204. MedicationRequest.dosageInstruction.timing.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                206. MedicationRequest.dosageInstruction.timing.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 208. MedicationRequest.dosageInstruction.timing.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  210. MedicationRequest.dosageInstruction.timing.event
                                  Definition

                                  Identifies specific times when the event occurs.

                                  ShortWhen the event occurs
                                  Control0..0
                                  TypedateTime
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  212. MedicationRequest.dosageInstruction.timing.repeat
                                  Definition

                                  ANNUSTAMISE KORDUS.

                                  ShortWhen the event is to occur.
                                  Control0..1
                                  TypeElement
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Many timing schedules are determined by regular repetitions.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                                  tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                                  tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                                  tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                                  tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                                  tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                                  tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                                  tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse()))
                                  tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                                  214. MedicationRequest.dosageInstruction.timing.repeat.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  216. MedicationRequest.dosageInstruction.timing.repeat.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 218. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
                                    Definition

                                    Ravikuuri piirid (pikkus/ulatus/kestus). Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                    ShortLength/Range of lengths, or (Start and/or end) limits.
                                    Control0..1
                                    TypeChoice of: Duration, Range, Period
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 220. MedicationRequest.dosageInstruction.timing.repeat.count
                                      Definition

                                      KORDUSED.

                                      ShortNumber of times to repeat
                                      Comments

                                      If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                                      Control0..1
                                      This element is affected by the following invariants: tim-8
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Repetitions may be limited by end time or total occurrences.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      222. MedicationRequest.dosageInstruction.timing.repeat.countMax
                                      Definition

                                      MAKSIMAALNE KORDUSTE ARV. If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                                      ShortMaximum number of times to repeat
                                      Control0..0
                                      This element is affected by the following invariants: tim-8
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      224. MedicationRequest.dosageInstruction.timing.repeat.duration
                                      Definition

                                      KESTUS. How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                                      ShortHow long when it happens
                                      Comments

                                      For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                      Control0..0
                                      This element is affected by the following invariants: tim-7, tim-1, tim-4
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Some activities are not instantaneous and need to be maintained for a period of time.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      226. MedicationRequest.dosageInstruction.timing.repeat.durationMax
                                      Definition

                                      MAKSIMAALNE KESTUS. If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                                      ShortHow long when it happens (Max)
                                      Comments

                                      For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                      Control0..0
                                      This element is affected by the following invariants: tim-7
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Some activities are not instantaneous and need to be maintained for a period of time.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      228. MedicationRequest.dosageInstruction.timing.repeat.durationUnit
                                      Definition

                                      KESTUS ja ÜHIK. The units of time for the duration, in UCUM units Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

                                      ShortThe units of time for the duration.
                                      Control0..1
                                      This element is affected by the following invariants: tim-1
                                      BindingThe codes SHALL be taken from UnitsOfTime
                                      (required to http://hl7.org/fhir/ValueSet/units-of-time|5.0.0)

                                      A unit of time (units from UCUM).

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      230. MedicationRequest.dosageInstruction.timing.repeat.frequency
                                      Definition

                                      Indicates the number of repetitions that should occur within a period. I.e. Event occurs frequency times per period.

                                      ShortMitu korda (ajaühikus).
                                      Control0..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      232. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
                                      Definition

                                      MAKSIMAALNE ANNUSTAMISTE ARV. If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                                      ShortEvent occurs up to frequencyMax times per period
                                      Control0..0
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      234. MedicationRequest.dosageInstruction.timing.repeat.period
                                      Definition

                                      (mitu korda) aja(ühikus).

                                      ShortThe duration to which the frequency applies. I.e. Event occurs frequency times per period
                                      Control0..1
                                      This element is affected by the following invariants: tim-6, tim-5, tim-2
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      236. MedicationRequest.dosageInstruction.timing.repeat.periodMax
                                      Definition

                                      MAKSIMAALNE PERIOOD ANNUSTAMISE VAHEL. If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                                      ShortUpper limit of period (3-4 hours)
                                      Control0..0
                                      This element is affected by the following invariants: tim-6
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      238. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
                                      Definition

                                      T(mitu korda aja)ühikus. Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

                                      ShortThe units of time for the period in UCUM units
                                      Control0..1
                                      This element is affected by the following invariants: tim-2
                                      BindingThe codes SHALL be taken from UnitsOfTime
                                      (required to http://hl7.org/fhir/ValueSet/units-of-time|5.0.0)

                                      A unit of time (units from UCUM).

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      240. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
                                      Definition

                                      NÄDALAPÄEV. If one or more days of week is provided, then the action happens only on the specified day(s).

                                      Short If one or more days of week is provided, then the action happens only on the specified day(s).
                                      Comments

                                      If no days are specified, the action is assumed to happen every day as otherwise specified.

                                      Control0..0
                                      BindingThe codes SHALL be taken from DaysOfWeek
                                      (required to http://hl7.org/fhir/ValueSet/days-of-week|5.0.0)
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      242. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
                                      Definition

                                      PÄEVA OSA. Specified time of day for action to take place.

                                      ShortSpecified time of day for action to take place.
                                      Comments

                                      When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. If there's a timeOfDay, there cannot be a when, or vice versa.

                                      Control0..*
                                      This element is affected by the following invariants: tim-10
                                      Typetime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      244. MedicationRequest.dosageInstruction.timing.repeat.when
                                      Definition

                                      MILLEGA SEOTUD.

                                      ShortCode for time period of occurrence
                                      Comments

                                      When more than one event is listed, the event is tied to the union of the specified events.

                                      Control0..0
                                      This element is affected by the following invariants: tim-9, tim-10
                                      BindingThe codes SHALL be taken from EventTiming
                                      (required to http://hl7.org/fhir/ValueSet/event-timing|5.0.0)

                                      Real-world event relating to the schedule.

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Timings are frequently determined by occurrences such as waking, eating and sleep.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      246. MedicationRequest.dosageInstruction.timing.repeat.offset
                                      Definition

                                      PERIOOD ENNE VÕI PÄRAST.

                                      ShortMinutes from event (before or after)
                                      Control0..0
                                      This element is affected by the following invariants: tim-9
                                      TypeunsignedInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      248. MedicationRequest.dosageInstruction.timing.code
                                      Definition

                                      A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                                      ShortC | BID | TID | QID | AM | PM | QD | QOD | +
                                      Comments

                                      BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                                      Control0..0
                                      BindingThe codes SHOULD be taken from TimingAbbreviation
                                      (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation)

                                      Code for a known / defined timing pattern.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      250. MedicationRequest.dosageInstruction.asNeeded
                                      Definition

                                      VAJADUSEL

                                      ShortTake "as needed"
                                      Comments

                                      Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated.

                                      Control0..0
                                      This element is affected by the following invariants: dos-1
                                      Typeboolean
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      252. MedicationRequest.dosageInstruction.asNeededFor
                                      Definition

                                      Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept).

                                      ShortTake "as needed" (for x)
                                      Comments

                                      Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                      Control0..1
                                      This element is affected by the following invariants: dos-1
                                      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                      (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                                      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.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      254. MedicationRequest.dosageInstruction.site
                                      Definition

                                      KEHAPIIRKOND.

                                      ShortBody site to administer to
                                      Comments

                                      If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                      Control0..0
                                      BindingFor example codes, see SNOMEDCTAnatomicalStructureAdministrationSites
                                      (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

                                      A coded concept describing the site location the medicine enters into or onto the body.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A coded specification of the anatomic site where the medication first enters the body.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      256. MedicationRequest.dosageInstruction.route
                                      Definition

                                      MANUSTAMISVIIS.

                                      ShortHow drug should enter body
                                      Control0..0
                                      BindingFor example codes, see SNOMEDCTRouteCodes
                                      (example to http://hl7.org/fhir/ValueSet/route-codes)

                                      A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      258. MedicationRequest.dosageInstruction.method
                                      Definition

                                      MANUSTAMISMEETOD. Näiteks subkutaanne

                                      ShortTechnique for administering medication
                                      Comments

                                      Terminologies used often pre-coordinate this term with the route and or form of administration.

                                      Control0..0
                                      BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                      (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

                                      A coded concept describing the technique by which the medicine is administered.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      260. MedicationRequest.dosageInstruction.doseAndRate
                                      Definition

                                      ANNUS JA KIIRUS.

                                      ShortAmount of medication administered, to be administered or typical amount to be administered
                                      Control1..1
                                      TypeElement
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      262. MedicationRequest.dosageInstruction.doseAndRate.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      264. MedicationRequest.dosageInstruction.doseAndRate.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 266. MedicationRequest.dosageInstruction.doseAndRate.type
                                        Definition

                                        The kind of dose or rate specified, for example, ordered or calculated.

                                        ShortThe kind of dose or rate specified
                                        Control0..0
                                        BindingFor example codes, see DoseAndRateType
                                        (example to http://terminology.hl7.org/ValueSet/dose-rate-type)

                                        The kind of dose or rate specified.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        If the type is not populated, assume to be "ordered".

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        268. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                                        Definition

                                        RAVIMI KOGUS ÜHE KASUTUSKORRA AJAL.

                                        ShortA fixed quantity (no comparator)
                                        Comments

                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                        Control0..1
                                        TypeQuantity(SimpleQuantity)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Requirements

                                        The amount of therapeutic or other substance given at one administration event.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                        sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                        270. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
                                        Definition

                                        MANUSTAMISE KIIRUS. Amount of medication per unit of time.

                                        ShortAmount of medication per unit of time
                                        Comments

                                        It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                        It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammar where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                        Control0..0
                                        TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        272. MedicationRequest.dosageInstruction.maxDosePerPeriod
                                        Definition

                                        MAKSIMAALNE ANNUS PERIOODIS. Upper limit on medication per unit of time.

                                        ShortUpper limit on medication per unit of time
                                        Comments

                                        This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                        Control0..0
                                        TypeRatio
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        274. MedicationRequest.dosageInstruction.maxDosePerAdministration
                                        Definition

                                        MAKSIMAALNE ANNUS ÜHE ANNUSTAMISE KOHTA. Upper limit on medication per administration.

                                        ShortUpper limit on medication per administration
                                        Comments

                                        This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                        Control0..0
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        276. MedicationRequest.dosageInstruction.maxDosePerLifetime
                                        Definition

                                        MAKSIMAALNE ANNUS ELUS. Upper limit on medication per lifetime of the patient.

                                        ShortUpper limit on medication per lifetime of the patient
                                        Control0..0
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        278. MedicationRequest.dispenseRequest
                                        Definition

                                        Täpne info ravimi väljamüügi kohta.

                                        ShortIndicates the specific details for the dispense or medication supply part of a medication request.
                                        Control0..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        280. MedicationRequest.dispenseRequest.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..0
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        282. MedicationRequest.dispenseRequest.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        284. MedicationRequest.dispenseRequest.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        286. MedicationRequest.dispenseRequest.initialFill
                                        Definition

                                        Indicates the quantity or duration for the first dispense of the medication.

                                        ShortFirst fill details
                                        Comments

                                        If populating this element, either the quantity or the duration must be included.

                                        Control0..0
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        293. MedicationRequest.dispenseRequest.dispenseInterval
                                        Definition

                                        The minimum period of time that must occur between dispenses of the medication.

                                        ShortMinimum period of time between dispenses
                                        Control0..0
                                        TypeDuration
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        295. MedicationRequest.dispenseRequest.validityPeriod
                                        Definition

                                        RETSEPTI KEHTIVUS AEG. Periood väljakirjutamise hetkest alates, mil on võimalik ravimit välja osta.

                                        ShortTime period supply is authorized for
                                        Comments

                                        It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

                                        Control1..1
                                        TypePeriod
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        297. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                        Definition

                                        An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

                                        ShortNumber of refills authorized
                                        Comments

                                        If displaying "number of authorized fills", add 1 to this number.

                                        Control0..0
                                        TypeunsignedInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        299. MedicationRequest.dispenseRequest.quantity
                                        Definition

                                        The amount that is to be dispensed for one fill.

                                        ShortAmount of medication to supply per dispense
                                        Control0..0
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        301. MedicationRequest.dispenseRequest.expectedSupplyDuration
                                        Definition

                                        Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

                                        ShortNumber of days supply per dispense
                                        Comments

                                        In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

                                        Control0..0
                                        TypeDuration
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        303. MedicationRequest.dispenseRequest.dispenser
                                        Definition

                                        KASUTATAKSE AINULT MÜÜGILOATA RAVIMI APTEEGI BRONEERIMISE PUHUL. Indicates the intended performing Organization that will dispense the medication as specified by the prescriber.

                                        ShortIntended performer of dispense
                                        Control0..1
                                        TypeReference(EETISOrganization)referenced
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        305. MedicationRequest.dispenseRequest.dispenserInstruction
                                        Definition

                                        Provides additional information to the dispenser, for example, counselling to be provided to the patient.

                                        ShortAdditional information for the dispenser
                                        Control0..0
                                        TypeAnnotation
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        307. MedicationRequest.dispenseRequest.doseAdministrationAid
                                        Definition

                                        Provides information about the type of adherence packaging to be supplied for the medication dispense.

                                        ShortType of adherence packaging to use for the dispense
                                        Control0..0
                                        BindingFor example codes, see MedicationDoseAids
                                        (example to http://hl7.org/fhir/ValueSet/medication-dose-aid)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        309. MedicationRequest.substitution
                                        Definition

                                        Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

                                        ShortAsendamine. Any restrictions on medication substitution
                                        Control0..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        311. MedicationRequest.substitution.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        313. MedicationRequest.substitution.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        315. MedicationRequest.substitution.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        317. MedicationRequest.substitution.allowed[x]
                                        Definition

                                        Kas asendamine on keelatud.

                                        ShortTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
                                        Comments

                                        This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                        Control1..1
                                        Typeboolean
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        319. MedicationRequest.substitution.reason
                                        Definition

                                        Asendamatuse põhjus (loend).

                                        Indicates the reason for the substitution, or why substitution must not be performed.

                                        ShortWhy should (not) substitution be made
                                        Control0..1
                                        BindingThe codes SHOULD be taken from ER_Asendamatuse põhjus
                                        (preferred to https://fhir.ee/ValueSet/ravimi-asendamatuse-pohjus)

                                        Asendamatuse põhjus. Loend

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        321. MedicationRequest.substitution.reason.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeid
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        323. MedicationRequest.substitution.reason.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on MedicationRequest.substitution.reason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 325. MedicationRequest.substitution.reason.coding
                                          Definition

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                          Control0..*
                                          BindingThe codes SHOULD be taken from ER_Asendamatuse põhjus
                                          (preferred to https://fhir.ee/ValueSet/ravimi-asendamatuse-pohjus)

                                          Asendamise keelamise loend

                                          TypeCoding
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          327. MedicationRequest.substitution.reason.text
                                          Definition

                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                          ShortPlain text representation of the concept
                                          Comments

                                          Very often the text is the same as a displayName of one of the codings.

                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          329. MedicationRequest.eventHistory
                                          Definition

                                          Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

                                          ShortA list of events of interest in the lifecycle
                                          Comments

                                          This might not include provenances for all versions of the request – only those deemed "relevant" or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                          Control0..0
                                          TypeReference(Provenance)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))