Virtually Healthcare HL7 FHIR R4 Implementation Guide
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Virtually Healthcare HL7 FHIR R4 Implementation Guide, published by Virtually Healthcare. This guide is not an authorized publication; it is the continuous build for version 0.1.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Virtually-Healthcare/HL7-FHIR-Implementation-Guide/ and changes regularly. See the Directory of published versions

Resource Profile: MedicationRequest

Official URL: https://fhir.virtually.healthcare/StructureDefinition/MedicationRequest Version: 0.1.0-current
Draft as of 2024-12-02 Computable Name: MedicationRequest

HL7 IPA MedicationRequest plus requirements from UKCore-MedicationRequest

Usage:

Formal Views of Profile Content

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

This structure is derived from IPAMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* IPAMedicationRequest Ordering of medication for patient or group
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extensionCourses 0..1 (Complex) EMIS PFS Courses
URL: https://fhir.virtually.healthcare/StructureDefinition/ExtensionCourses
... identifier S 1..* CommonResourceIdentifiers An identifier intended for computation
... medication[x] O 1..1 CodeableConcept Medication to be taken
Binding: VH Medication Code (extensible)
ObligationsActor
SHALL:populate-if-known Clinical Data Repository
SHALL:populate-if-known https://fhir.virtually.healthcare/ActorDefinition/ClinicalDataService
... subject
.... reference S 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 NHSNumbers An identifier intended for computation
... performer 0..1 Reference(Practitioner) Intended performer of administration
.... reference 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 ProfessionalLicense, StaffEnterpriseNumber An identifier intended for computation

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationRequest.medication[x]extensibleVHMedicationCode
https://fhir.virtually.healthcare/ValueSet/VHMedicationCode
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* IPAMedicationRequest Ordering of medication for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extensionCourses 0..1 (Complex) EMIS PFS Courses
URL: https://fhir.virtually.healthcare/StructureDefinition/ExtensionCourses
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..* CommonResourceIdentifiers An identifier intended for computation
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] SΣ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
... medication[x] SOΣ 1..1 CodeableConcept Medication to be taken
Binding: VH Medication Code (extensible)
ObligationsActor
SHALL:populate-if-known Clinical Data Repository
SHALL:populate-if-known https://fhir.virtually.healthcare/ActorDefinition/ClinicalDataService
... subject SΣ 1..1 Reference(IPA-Patient) Who or group medication request is for
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 NHSNumbers An identifier intended for computation
... encounter S 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient) Who/What requested the Request
... performer 0..1 Reference(Practitioner) Intended performer of administration
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 ProfessionalLicense, StaffEnterpriseNumber An identifier intended for computation
... dosageInstruction S 0..* Dosage How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleVHMedicationCode
https://fhir.virtually.healthcare/ValueSet/VHMedicationCode
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* IPAMedicationRequest Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extensionCourses 0..1 (Complex) EMIS PFS Courses
URL: https://fhir.virtually.healthcare/StructureDefinition/ExtensionCourses
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..* CommonResourceIdentifiers An identifier intended for computation
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] SΣ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
... medication[x] SOΣ 1..1 CodeableConcept Medication to be taken
Binding: VH Medication Code (extensible)
ObligationsActor
SHALL:populate-if-known Clinical Data Repository
SHALL:populate-if-known https://fhir.virtually.healthcare/ActorDefinition/ClinicalDataService
... subject SΣ 1..1 Reference(IPA-Patient) Who or group medication request is for
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier 0..1 NHSNumbers An identifier intended for computation
.... display Σ 0..1 string Text alternative for the resource
... encounter S 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient) Who/What requested the Request
... performer 0..1 Reference(Practitioner) Intended performer of administration
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier 0..1 ProfessionalLicense, StaffEnterpriseNumber An identifier intended for computation
.... display Σ 0..1 string Text alternative for the resource
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.

... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing Σ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleVHMedicationCode
https://fhir.virtually.healthcare/ValueSet/VHMedicationCode
from this IG
MedicationRequest.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Differential View

This structure is derived from IPAMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* IPAMedicationRequest Ordering of medication for patient or group
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extensionCourses 0..1 (Complex) EMIS PFS Courses
URL: https://fhir.virtually.healthcare/StructureDefinition/ExtensionCourses
... identifier S 1..* CommonResourceIdentifiers An identifier intended for computation
... medication[x] O 1..1 CodeableConcept Medication to be taken
Binding: VH Medication Code (extensible)
ObligationsActor
SHALL:populate-if-known Clinical Data Repository
SHALL:populate-if-known https://fhir.virtually.healthcare/ActorDefinition/ClinicalDataService
... subject
.... reference S 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 NHSNumbers An identifier intended for computation
... performer 0..1 Reference(Practitioner) Intended performer of administration
.... reference 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 ProfessionalLicense, StaffEnterpriseNumber An identifier intended for computation

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationRequest.medication[x]extensibleVHMedicationCode
https://fhir.virtually.healthcare/ValueSet/VHMedicationCode
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* IPAMedicationRequest Ordering of medication for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extensionCourses 0..1 (Complex) EMIS PFS Courses
URL: https://fhir.virtually.healthcare/StructureDefinition/ExtensionCourses
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..* CommonResourceIdentifiers An identifier intended for computation
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] SΣ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
... medication[x] SOΣ 1..1 CodeableConcept Medication to be taken
Binding: VH Medication Code (extensible)
ObligationsActor
SHALL:populate-if-known Clinical Data Repository
SHALL:populate-if-known https://fhir.virtually.healthcare/ActorDefinition/ClinicalDataService
... subject SΣ 1..1 Reference(IPA-Patient) Who or group medication request is for
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 NHSNumbers An identifier intended for computation
... encounter S 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient) Who/What requested the Request
... performer 0..1 Reference(Practitioner) Intended performer of administration
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... identifier 0..1 ProfessionalLicense, StaffEnterpriseNumber An identifier intended for computation
... dosageInstruction S 0..* Dosage How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleVHMedicationCode
https://fhir.virtually.healthcare/ValueSet/VHMedicationCode
from this IG

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* IPAMedicationRequest Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extensionCourses 0..1 (Complex) EMIS PFS Courses
URL: https://fhir.virtually.healthcare/StructureDefinition/ExtensionCourses
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..* CommonResourceIdentifiers An identifier intended for computation
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] SΣ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
... medication[x] SOΣ 1..1 CodeableConcept Medication to be taken
Binding: VH Medication Code (extensible)
ObligationsActor
SHALL:populate-if-known Clinical Data Repository
SHALL:populate-if-known https://fhir.virtually.healthcare/ActorDefinition/ClinicalDataService
... subject SΣ 1..1 Reference(IPA-Patient) Who or group medication request is for
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier 0..1 NHSNumbers An identifier intended for computation
.... display Σ 0..1 string Text alternative for the resource
... encounter S 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient) Who/What requested the Request
... performer 0..1 Reference(Practitioner) Intended performer of administration
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier 0..1 ProfessionalLicense, StaffEnterpriseNumber An identifier intended for computation
.... display Σ 0..1 string Text alternative for the resource
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.

... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing Σ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleVHMedicationCode
https://fhir.virtually.healthcare/ValueSet/VHMedicationCode
from this IG
MedicationRequest.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

 

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