Virtually Healthcare HL7 FHIR Implementation Guide
0.1.0-current - ci-build
Virtually Healthcare HL7 FHIR 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/Virtually-Healthcare-FHIR-Implementation-Guide/ and changes regularly. See the Directory of published versions
Draft as of 2024-11-06 |
Definitions for the MedicationRequest resource profile.
Guidance on how to interpret the contents of this table can be found here
0. MedicationRequest | |||||||
2. MedicationRequest.identifier | |||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 1..? | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.identifier . The slices areUnordered and Closed, and can be differentiated using the following discriminators: | ||||||
4. MedicationRequest.identifier:CommonResourceIdentifiers | |||||||
Slice Name | CommonResourceIdentifiers | ||||||
Short | Common Resource Identifiers | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..* | ||||||
Type | Identifier(Common Resource Identifiers) | ||||||
6. MedicationRequest.medication[x] | |||||||
Type | CodeableConcept, Reference(Medication) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Obligations |
| ||||||
Standard Status | Normative (from Trial Use) | ||||||
8. MedicationRequest.subject | |||||||
10. MedicationRequest.subject.reference | |||||||
Control | 1..? | ||||||
Must Support | true | ||||||
12. MedicationRequest.subject.identifier | |||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Type | Identifier(NHS, HCSN and CHI Numbers) | ||||||
14. MedicationRequest.performer | |||||||
Type | Reference(Practitioner) | ||||||
16. MedicationRequest.performer.reference | |||||||
Control | 1..? | ||||||
18. MedicationRequest.performer.identifier | |||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Type | Identifier(UK Professional License, Staff Enterprise Number) |
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. | ||||||
Short | Ordering of medication for patient or group | ||||||
Control | 0..* | ||||||
Is Modifier | false | ||||||
Alternate Names | Prescription, Order | ||||||
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) | ||||||
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. | ||||||
Short | A 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 it's narrative along with other profiles, value sets, etc. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | uri | ||||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
4. MedicationRequest.extension:medicationRepeatInformation | |||||||
Slice Name | medicationRepeatInformation | ||||||
Definition | Medication repeat information. | ||||||
Short | Medication repeat information | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Extension(Extension UK Core Medication Repeat Information) (Complex Extension) | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
6. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||||
Standard Status | Normative (from Trial Use) | ||||||
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 Names | extensions, user content | ||||||
Invariants | ele-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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.modifierExtension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
8. MedicationRequest.identifier | |||||||
Definition | 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. | ||||||
Short | External ids for this request | ||||||
Comments | This is a business identifier, not a resource identifier. | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 10..* This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.identifier . The slices areUnordered and Closed, and can be differentiated using the following discriminators: | ||||||
10. MedicationRequest.identifier:CommonResourceIdentifiers | |||||||
Slice Name | CommonResourceIdentifiers | ||||||
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. 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. | ||||||
Short | Common Resource IdentifiersExternal ids for this request | ||||||
Comments | This is a business identifier, not a resource identifier. | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier(Common Resource Identifiers) | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
12. MedicationRequest.status | |||||||
Definition | A code specifying the current state of the order. Generally, this will be active or completed state. | ||||||
Short | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown | ||||||
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHALL be taken from medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 )A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||||
Type | code | ||||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
14. MedicationRequest.intent | |||||||
Definition | Whether the request is a proposal, plan, or an original order. | ||||||
Short | 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHALL be taken from medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 )The kind of medication order. | ||||||
Type | code | ||||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
16. MedicationRequest.category | |||||||
Definition | Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). | ||||||
Short | Type of medication usage | ||||||
Comments | The category can be used to include where the medication is expected to be consumed or other types of requests. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see UK Core Medication Request Categoryhttp://hl7.org/fhir/ValueSet/medicationrequest-category (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory )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. | ||||||
Type | CodeableConcept | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
18. MedicationRequest.doNotPerform | |||||||
Definition | If true indicates that the provider is asking for the medication request not to occur. | ||||||
Short | True if request is prohibiting action | ||||||
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform". | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | boolean | ||||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
20. MedicationRequest.medication[x] | |||||||
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. | ||||||
Short | Medication 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from For example codes, see UK Core Medication Codehttp://hl7.org/fhir/ValueSet/medication-codes (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode )A coded concept identifying substance or product that can be ordered. | ||||||
Type | CodeableConcept, Reference(Medication) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Obligations |
| ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
22. MedicationRequest.subject | |||||||
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given. | ||||||
Short | Who or group medication request is 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Patient, Group) | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
24. MedicationRequest.subject.reference | |||||||
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. | ||||||
Short | Literal reference, Relative, internal or absolute URL | ||||||
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||||
Control | 10..1 This element is affected by the following invariants: ref-1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
26. MedicationRequest.subject.identifier | |||||||
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||||
Short | An identifier intended for computationLogical reference, when literal reference is not known | ||||||
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier(NHS, HCSN and CHI Numbers) | ||||||
Is Modifier | false | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
28. MedicationRequest.authoredOn | |||||||
Definition | The date (and perhaps time) when the prescription was initially written or authored on. | ||||||
Short | When request was initially authored | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | dateTime | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
30. MedicationRequest.requester | |||||||
Definition | The individual, organization, or device that initiated the request and has responsibility for its activation. | ||||||
Short | Who/What requested the Request | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device) | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
32. MedicationRequest.performer | |||||||
Definition | The specified desired performer of the medication treatment (e.g. the performer of the medication administration). | ||||||
Short | Intended performer of administration | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Practitioner, Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam) | ||||||
Is Modifier | false | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
34. MedicationRequest.performer.reference | |||||||
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. | ||||||
Short | Literal reference, Relative, internal or absolute URL | ||||||
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||||
Control | 10..1 This element is affected by the following invariants: ref-1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
36. MedicationRequest.performer.identifier | |||||||
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||||
Short | An identifier intended for computationLogical reference, when literal reference is not known | ||||||
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier(UK Professional License, Staff Enterprise Number) | ||||||
Is Modifier | false | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
38. MedicationRequest.dosageInstruction | |||||||
Definition | Indicates how the medication is to be used by the patient. | ||||||
Short | 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Dosage | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
40. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||||
42. MedicationRequest.dosageInstruction.text | |||||||
Definition | Free text dosage instructions e.g. SIG. | ||||||
Short | Free text dosage instructions e.g. SIG | ||||||
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
44. MedicationRequest.dosageInstruction.timing | |||||||
Definition | When medication should be administered. | ||||||
Short | When 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Timing | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
46. MedicationRequest.dosageInstruction.doseAndRate | |||||||
Definition | The amount of medication administered. | ||||||
Short | Amount of medication administered | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Element | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
48. MedicationRequest.dosageInstruction.doseAndRate.dose[x] | |||||||
Definition | Amount of medication per dose. | ||||||
Short | Amount of medication per dose | ||||||
Comments | 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Choice of: Range, Quantity(SimpleQuantity) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
Requirements | The amount of therapeutic or other substance given at one administration event. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
50. MedicationRequest.dosageInstruction.doseAndRate.rate[x] | |||||||
Definition | Amount of medication per unit of time. | ||||||
Short | Amount 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 grammer 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
52. MedicationRequest.dispenseRequest | |||||||
Definition | 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. | ||||||
Short | Medication supply authorization | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | BackboneElement | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
54. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||||
56. MedicationRequest.dispenseRequest.quantity | |||||||
Definition | The amount that is to be dispensed for one fill. | ||||||
Short | Amount of medication to supply per dispense | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Quantity(SimpleQuantity) | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-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() ) | ||||||
58. 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. | ||||||
Short | Any restrictions on medication substitution | ||||||
Control | 10..1 This element is affected by the following invariants: ele-1 | ||||||
Type | BackboneElement | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
60. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||||
62. MedicationRequest.substitution.allowed[x] | |||||||
Definition | The purpose of this element is to allow the prescriber to dispense a different drug from what was prescribed. True if the prescriber allows a different drug to be dispensed from what was prescribed. | ||||||
Short | 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode )Identifies the type of substitution allowed. | ||||||
Type | Choice of: boolean, CodeableConcept | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Invariants | ele-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. | ||||||
Short | Ordering of medication for patient or group | ||||||
Control | 0..* | ||||||
Alternate Names | Prescription, Order | ||||||
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() )dom-6: A resource should have narrative for robust management ( text.`div`.exists() )dom-5: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty() ) | ||||||
2. MedicationRequest.id | |||||||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||||
Short | Logical id of this artifact | ||||||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||||
Control | 0..1 | ||||||
Type | id | ||||||
Summary | true | ||||||
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. | ||||||
Short | Metadata about the resource | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Meta | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
6. 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. | ||||||
Short | A 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 it's narrative along with other profiles, value sets, etc. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | uri | ||||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
8. MedicationRequest.language | |||||||
Definition | The base language in which the resource is written. | ||||||
Short | Language 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). | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||||
Type | code | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
10. 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. | ||||||
Short | Text summary of the resource, for human interpretation | ||||||
Comments | Contained resources do not have 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Narrative | ||||||
Alternate Names | narrative, html, xhtml, display | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
12. MedicationRequest.contained | |||||||
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||||
Short | Contained, 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. | ||||||
Control | 0..* | ||||||
Type | Resource | ||||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||||
14. MedicationRequest.extension | |||||||
Definition | 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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
16. MedicationRequest.extension:medicationRepeatInformation | |||||||
Slice Name | medicationRepeatInformation | ||||||
Definition | Medication repeat information. | ||||||
Short | Medication repeat information | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Extension(Extension UK Core Medication Repeat Information) (Complex Extension) | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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.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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||||
Standard Status | Normative (from Trial Use) | ||||||
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 Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.modifierExtension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
20. MedicationRequest.identifier | |||||||
Definition | 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. | ||||||
Short | External ids for this request | ||||||
Comments | This is a business identifier, not a resource identifier. | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 1..* This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.identifier . The slices areUnordered and Closed, and can be differentiated using the following discriminators: | ||||||
22. MedicationRequest.identifier:CommonResourceIdentifiers | |||||||
Slice Name | CommonResourceIdentifiers | ||||||
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. | ||||||
Short | Common Resource Identifiers | ||||||
Comments | This is a business identifier, not a resource identifier. | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier(Common Resource Identifiers) | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
24. MedicationRequest.status | |||||||
Definition | A code specifying the current state of the order. Generally, this will be active or completed state. | ||||||
Short | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown | ||||||
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHALL be taken from medicationrequest Status (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 )A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||||
Type | code | ||||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
26. MedicationRequest.statusReason | |||||||
Definition | Captures the reason for the current state of the MedicationRequest. | ||||||
Short | Reason for current status | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see medicationRequest Status Reason Codes (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason )Identifies the reasons for a given status. | ||||||
Type | CodeableConcept | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
28. MedicationRequest.intent | |||||||
Definition | Whether the request is a proposal, plan, or an original order. | ||||||
Short | 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHALL be taken from medicationRequest Intent (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 )The kind of medication order. | ||||||
Type | code | ||||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
30. MedicationRequest.category | |||||||
Definition | Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). | ||||||
Short | Type of medication usage | ||||||
Comments | The category can be used to include where the medication is expected to be consumed or other types of requests. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Binding | Unless not suitable, these codes SHALL be taken from UK Core Medication Request Category (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory )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. | ||||||
Type | CodeableConcept | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
32. MedicationRequest.priority | |||||||
Definition | Indicates how quickly the Medication Request should be addressed with respect to other requests. | ||||||
Short | routine | urgent | asap | stat | ||||||
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHALL be taken from RequestPriority (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1 )Identifies the level of importance to be assigned to actioning the request. | ||||||
Type | code | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
34. MedicationRequest.doNotPerform | |||||||
Definition | If true indicates that the provider is asking for the medication request not to occur. | ||||||
Short | True if request is prohibiting action | ||||||
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform". | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | boolean | ||||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
36. MedicationRequest.reported[x] | |||||||
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. | ||||||
Short | Reported rather than primary record | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Choice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
38. MedicationRequest.medication[x] | |||||||
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. | ||||||
Short | Medication 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from UK Core Medication Code (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode )A coded concept identifying substance or product that can be ordered. | ||||||
Type | CodeableConcept | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Must Support | true | ||||||
Obligations |
| ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
40. MedicationRequest.subject | |||||||
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given. | ||||||
Short | Who or group medication request is 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Patient, Group) | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
42. MedicationRequest.subject.id | |||||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
Summary | false | ||||||
44. MedicationRequest.subject.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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* | ||||||
Type | Extension | ||||||
Is Modifier | false | ||||||
Summary | false | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.subject.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
46. MedicationRequest.subject.reference | |||||||
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. | ||||||
Short | Literal reference, Relative, internal or absolute URL | ||||||
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||||
Control | 1..1 This element is affected by the following invariants: ref-1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
48. MedicationRequest.subject.type | |||||||
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||||
Short | Type the reference refers to (e.g. "Patient") | ||||||
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||||
Control | 0..1 | ||||||
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types )Aa resource (or, for logical models, the URI of the logical model). | ||||||
Type | uri | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
50. MedicationRequest.subject.identifier | |||||||
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. | ||||||
Short | An identifier intended for computation | ||||||
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier(NHS, HCSN and CHI Numbers) | ||||||
Is Modifier | false | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
52. MedicationRequest.subject.display | |||||||
Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||||
Short | Text alternative for the resource | ||||||
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
54. MedicationRequest.encounter | |||||||
Definition | The Encounter during which this [x] was created or to which the creation of this record is tightly associated. | ||||||
Short | Encounter 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Encounter) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
56. MedicationRequest.supportingInformation | |||||||
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication. | ||||||
Short | Information to support ordering of the medication | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Resource) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
58. MedicationRequest.authoredOn | |||||||
Definition | The date (and perhaps time) when the prescription was initially written or authored on. | ||||||
Short | When request was initially authored | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | dateTime | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
60. MedicationRequest.requester | |||||||
Definition | The individual, organization, or device that initiated the request and has responsibility for its activation. | ||||||
Short | Who/What requested the Request | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device) | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
62. MedicationRequest.performer | |||||||
Definition | The specified desired performer of the medication treatment (e.g. the performer of the medication administration). | ||||||
Short | Intended performer of administration | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Practitioner) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
64. MedicationRequest.performer.id | |||||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
Summary | false | ||||||
66. MedicationRequest.performer.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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* | ||||||
Type | Extension | ||||||
Is Modifier | false | ||||||
Summary | false | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.performer.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
68. MedicationRequest.performer.reference | |||||||
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. | ||||||
Short | Literal reference, Relative, internal or absolute URL | ||||||
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||||
Control | 1..1 This element is affected by the following invariants: ref-1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
70. MedicationRequest.performer.type | |||||||
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||||
Short | Type the reference refers to (e.g. "Patient") | ||||||
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||||
Control | 0..1 | ||||||
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types )Aa resource (or, for logical models, the URI of the logical model). | ||||||
Type | uri | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
72. MedicationRequest.performer.identifier | |||||||
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. | ||||||
Short | An identifier intended for computation | ||||||
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier(UK Professional License, Staff Enterprise Number) | ||||||
Is Modifier | false | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
74. MedicationRequest.performer.display | |||||||
Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||||
Short | Text alternative for the resource | ||||||
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
Is Modifier | false | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
76. MedicationRequest.performerType | |||||||
Definition | Indicates the type of performer of the administration of the medication. | ||||||
Short | Desired 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see ProcedurePerformerRoleCodes (example to http://hl7.org/fhir/ValueSet/performer-role )Identifies the type of individual that is desired to administer the medication. | ||||||
Type | CodeableConcept | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
78. 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. | ||||||
Short | Person who entered the request | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Practitioner, PractitionerRole) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
80. MedicationRequest.reasonCode | |||||||
Definition | The reason or the indication for ordering or not ordering the medication. | ||||||
Short | 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see Condition/Problem/DiagnosisCodes (example to http://hl7.org/fhir/ValueSet/condition-code )A coded concept indicating why the medication was ordered. | ||||||
Type | CodeableConcept | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
82. MedicationRequest.reasonReference | |||||||
Definition | Condition or observation that supports why the medication was ordered. | ||||||
Short | Condition or observation that supports why the prescription is being written | ||||||
Comments | This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Condition, Observation) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
84. MedicationRequest.instantiatesCanonical | |||||||
Definition | The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. | ||||||
Short | Instantiates FHIR protocol or definition | ||||||
Comments | |||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | canonical | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
86. MedicationRequest.instantiatesUri | |||||||
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. | ||||||
Short | Instantiates external protocol or definition | ||||||
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | uri | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
88. MedicationRequest.basedOn | |||||||
Definition | A plan or request that is fulfilled in whole or in part by this medication request. | ||||||
Short | What request fulfills | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation) | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
90. MedicationRequest.groupIdentifier | |||||||
Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. | ||||||
Short | Composite request this is part of | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Identifier | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
92. MedicationRequest.courseOfTherapyType | |||||||
Definition | The description of the course of therapy for a medication request. | ||||||
Short | A course of therapy for a medication request | ||||||
Comments | This attribute should not be confused with the protocol of the medication. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | Unless not suitable, these codes SHALL be taken from UK Core Medication Request Course Of Therapy (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCourseOfTherapy )Identifies the overall pattern of medication administratio. | ||||||
Type | CodeableConcept | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
94. MedicationRequest.insurance | |||||||
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. | ||||||
Short | Associated insurance coverage | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Coverage, ClaimResponse) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
96. MedicationRequest.note | |||||||
Definition | Extra information about the prescription that could not be conveyed by the other attributes. | ||||||
Short | Information about the prescription | ||||||
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Annotation | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
98. MedicationRequest.dosageInstruction | |||||||
Definition | Indicates how the medication is to be used by the patient. | ||||||
Short | 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Dosage | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
100. 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. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
102. 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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.dosageInstruction.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
104. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() ) | ||||||
106. MedicationRequest.dosageInstruction.sequence | |||||||
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. | ||||||
Short | The order of the dosage instructions | ||||||
Comments | 32 bit number; for values larger than this, use decimal | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | integer | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
108. MedicationRequest.dosageInstruction.text | |||||||
Definition | Free text dosage instructions e.g. SIG. | ||||||
Short | Free text dosage instructions e.g. SIG | ||||||
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | string | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Must Support | true | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
110. MedicationRequest.dosageInstruction.additionalInstruction | |||||||
Definition | 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"). | ||||||
Short | Supplemental 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 "immediately following drug x") should be populated in dosage.text. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Binding | For 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". | ||||||
Type | CodeableConcept | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
112. MedicationRequest.dosageInstruction.patientInstruction | |||||||
Definition | Instructions in terms that are understood by the patient or consumer. | ||||||
Short | Patient or consumer oriented instructions | ||||||
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | string | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
114. MedicationRequest.dosageInstruction.timing | |||||||
Definition | When medication should be administered. | ||||||
Short | When 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Timing | ||||||
Must Support | true | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
116. MedicationRequest.dosageInstruction.asNeeded[x] | |||||||
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). | ||||||
Short | Take "as needed" (for x) | ||||||
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from SNOMEDCTMedicationAsNeededReasonCodes (preferred 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. | ||||||
Type | Choice of: boolean, CodeableConcept | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
118. MedicationRequest.dosageInstruction.site | |||||||
Definition | Body site to administer to. | ||||||
Short | Body 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 bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from UK Core Body Site (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite )A coded concept describing the site location the medicine enters into or onto the body. | ||||||
Type | CodeableConcept | ||||||
Summary | true | ||||||
Requirements | A coded specification of the anatomic site where the medication first enters the body. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
120. MedicationRequest.dosageInstruction.route | |||||||
Definition | How drug should enter body. | ||||||
Short | How drug should enter body | ||||||
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from UK Core Substance Or Product Administration Route (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute )A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | ||||||
Type | CodeableConcept | ||||||
Summary | true | ||||||
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
122. MedicationRequest.dosageInstruction.method | |||||||
Definition | Technique for administering medication. | ||||||
Short | Technique for administering medication | ||||||
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | The codes SHOULD be taken from UK Core Medication Dosage Method (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod )A coded concept describing the technique by which the medicine is administered. | ||||||
Type | CodeableConcept | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
124. MedicationRequest.dosageInstruction.doseAndRate | |||||||
Definition | The amount of medication administered. | ||||||
Short | Amount of medication administered | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Element | ||||||
Must Support | true | ||||||
Summary | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
126. 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. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
128. 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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
130. MedicationRequest.dosageInstruction.doseAndRate.type | |||||||
Definition | The kind of dose or rate specified, for example, ordered or calculated. | ||||||
Short | The kind of dose or rate specified | ||||||
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see DoseAndRateType (example to http://hl7.org/fhir/ValueSet/dose-rate-type )The kind of dose or rate specified. | ||||||
Type | CodeableConcept | ||||||
Summary | true | ||||||
Requirements | If the type is not populated, assume to be "ordered". | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
132. MedicationRequest.dosageInstruction.doseAndRate.dose[x] | |||||||
Definition | Amount of medication per dose. | ||||||
Short | Amount of medication per dose | ||||||
Comments | 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Choice of: Range, Quantity(SimpleQuantity) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
Requirements | The amount of therapeutic or other substance given at one administration event. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
134. MedicationRequest.dosageInstruction.doseAndRate.rate[x] | |||||||
Definition | Amount of medication per unit of time. | ||||||
Short | Amount 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 grammer 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Must Support | true | ||||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
136. MedicationRequest.dosageInstruction.maxDosePerPeriod | |||||||
Definition | Upper limit on medication per unit of time. | ||||||
Short | Upper 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". | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Ratio | ||||||
Summary | true | ||||||
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. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ( (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()) ) | ||||||
138. MedicationRequest.dosageInstruction.maxDosePerAdministration | |||||||
Definition | Upper limit on medication per administration. | ||||||
Short | Upper 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Quantity(SimpleQuantity) | ||||||
Is Modifier | false | ||||||
Summary | true | ||||||
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. | ||||||
Invariants | ele-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() ) | ||||||
140. MedicationRequest.dosageInstruction.maxDosePerLifetime | |||||||
Definition | Upper limit on medication per lifetime of the patient. | ||||||
Short | Upper limit on medication per lifetime of the patient | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Quantity(SimpleQuantity) | ||||||
Is Modifier | false | ||||||
Summary | true | ||||||
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. | ||||||
Invariants | ele-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() ) | ||||||
142. MedicationRequest.dispenseRequest | |||||||
Definition | 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. | ||||||
Short | Medication supply authorization | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | BackboneElement | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
144. 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. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
146. 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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.dispenseRequest.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
148. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() ) | ||||||
150. MedicationRequest.dispenseRequest.initialFill | |||||||
Definition | Indicates the quantity or duration for the first dispense of the medication. | ||||||
Short | First fill details | ||||||
Comments | If populating this element, either the quantity or the duration must be included. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | BackboneElement | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
152. MedicationRequest.dispenseRequest.initialFill.id | |||||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
154. MedicationRequest.dispenseRequest.initialFill.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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.dispenseRequest.initialFill.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
156. MedicationRequest.dispenseRequest.initialFill.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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() ) | ||||||
158. MedicationRequest.dispenseRequest.initialFill.quantity | |||||||
Definition | The amount or quantity to provide as part of the first dispense. | ||||||
Short | First fill quantity | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Quantity(SimpleQuantity) | ||||||
Is Modifier | false | ||||||
Invariants | ele-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() ) | ||||||
160. MedicationRequest.dispenseRequest.initialFill.duration | |||||||
Definition | The length of time that the first dispense is expected to last. | ||||||
Short | First fill duration | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Duration | ||||||
Invariants | ele-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() )drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. ( code.exists() implies ((system = %ucum) and value.exists()) ) | ||||||
162. MedicationRequest.dispenseRequest.dispenseInterval | |||||||
Definition | The minimum period of time that must occur between dispenses of the medication. | ||||||
Short | Minimum period of time between dispenses | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Duration | ||||||
Invariants | ele-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() )drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. ( code.exists() implies ((system = %ucum) and value.exists()) ) | ||||||
164. MedicationRequest.dispenseRequest.validityPeriod | |||||||
Definition | This indicates the validity period of a prescription (stale dating the Prescription). | ||||||
Short | Time 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Period | ||||||
Requirements | Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )per-1: If present, start SHALL have a lower value than end ( start.hasValue().not() or end.hasValue().not() or (start <= end) ) | ||||||
166. 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. | ||||||
Short | Number of refills authorized | ||||||
Comments | If displaying "number of authorized fills", add 1 to this number. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | unsignedInt | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
168. MedicationRequest.dispenseRequest.quantity | |||||||
Definition | The amount that is to be dispensed for one fill. | ||||||
Short | Amount of medication to supply per dispense | ||||||
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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Quantity(SimpleQuantity) | ||||||
Is Modifier | false | ||||||
Must Support | true | ||||||
Invariants | ele-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() ) | ||||||
170. 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. | ||||||
Short | Number 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. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Duration | ||||||
Invariants | ele-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() )drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. ( code.exists() implies ((system = %ucum) and value.exists()) ) | ||||||
172. MedicationRequest.dispenseRequest.performer | |||||||
Definition | Indicates the intended dispensing Organization specified by the prescriber. | ||||||
Short | Intended dispenser | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Organization) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
174. 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. | ||||||
Short | Any restrictions on medication substitution | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Type | BackboneElement | ||||||
Must Support | true | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
176. 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. | ||||||
Short | Unique id for inter-element referencing | ||||||
Control | 0..1 | ||||||
Type | string | ||||||
XML Format | In the XML format, this property is represented as an attribute. | ||||||
178. 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 manageable, 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. | ||||||
Short | Additional 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Standard Status | Normative (from Trial Use) | ||||||
Alternate Names | extensions, user content | ||||||
Invariants | ele-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() ) | ||||||
Slicing | This element introduces a set of slices on MedicationRequest.substitution.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
180. 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 manageable, 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). | ||||||
Short | Extensions 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. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Extension | ||||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
Summary | true | ||||||
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 Names | extensions, user content, modifiers | ||||||
Invariants | ele-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() ) | ||||||
182. MedicationRequest.substitution.allowed[x] | |||||||
Definition | The purpose of this element is to allow the prescriber to dispense a different drug from what was prescribed. | ||||||
Short | 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. | ||||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see ActSubstanceAdminSubstitutionCode (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode )Identifies the type of substitution allowed. | ||||||
Type | Choice of: boolean, CodeableConcept | ||||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
184. MedicationRequest.substitution.reason | |||||||
Definition | Indicates the reason for the substitution, or why substitution must or must not be performed. | ||||||
Short | Why should (not) substitution be made | ||||||
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Binding | For example codes, see SubstanceAdminSubstitutionReason (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason )A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | ||||||
Type | CodeableConcept | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||||
186. MedicationRequest.priorPrescription | |||||||
Definition | A link to a resource representing an earlier order related order or prescription. | ||||||
Short | An order/prescription that is being replaced | ||||||
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(MedicationRequest) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
188. MedicationRequest.detectedIssue | |||||||
Definition | Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. | ||||||
Short | Clinical Issue with action | ||||||
Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(DetectedIssue) | ||||||
Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) | ||||||
190. 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. | ||||||
Short | A 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.). | ||||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
Type | Reference(Provenance) | ||||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) |