2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build

2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide, published by Centers for Disease Control and Prevention (CDC). This guide is not an authorized publication; it is the continuous build for version 2022.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/opioid-cds-r4/ and changes regularly. See the Directory of published versions

Resource Profile: CDC_MedicationRequest

Official URL: http://fhir.org/guides/cdc/opioid-cds/StructureDefinition/cdc-medicationrequest Version: 2022.1.0
Draft as of 2017-04-21 Computable Name: CDC_MedicationRequest

Profile of MedicationRequest for use with 2022 CDC Clinical Practice Guideline

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

This structure is derived from CPGMedicationRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* CPGMedicationRequest Ordering of medication for patient or group
... medication[x] S 1..1 CodeableConcept Medication to be taken
... dosageInstruction S 1..1 Dosage How the medication should be taken
.... timing S 1..1 Timing When medication should be administered
..... repeat S 1..1 Element When the event is to occur
...... frequency S 1..1 positiveInt Event occurs frequency times per period
...... period S 1..1 decimal Event occurs frequency times per period
...... periodUnit S 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
.... asNeeded[x] S 0..1 boolean Take "as needed" (for x)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* CPGMedicationRequest Ordering of medication for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:rationale S 0..1 markdown Explanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!SΣ 0..1 boolean True if request is prohibiting action
... medication[x] SΣ 1..1 CodeableConcept Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
... subject SΣ 1..1 Reference(CPGPatient) Who or group medication request is for
... encounter S 0..1 Reference(CPGEncounter) Encounter created as part of encounter/admission/stay
... supportingInformation S 0..* Reference(Resource) Pertinent information
... instantiatesCanonical SΣ 0..* canonical() Source
... dosageInstruction S 1..1 Dosage How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... timing SΣ 1..1 Timing When medication should be administered
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... repeat SΣC 1..1 Element When the event is to occur
Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
...... frequency SΣ 1..1 positiveInt Event occurs frequency times per period
...... period SΣ 1..1 decimal Event occurs frequency times per period
...... periodUnit SΣ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).
.... asNeeded[x] SΣ 0..1 boolean Take "as needed" (for x)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* CPGMedicationRequest Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:rationale S 0..1 markdown Explanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!SΣ 0..1 boolean True if request is prohibiting action
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ 1..1 CodeableConcept Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
... subject SΣ 1..1 Reference(CPGPatient) Who or group medication request is for
... encounter S 0..1 Reference(CPGEncounter) Encounter created as part of encounter/admission/stay
... supportingInformation S 0..* Reference(Resource) Pertinent information
... authoredOn Σ 0..1 dateTime When request was initially authored
... requester Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... instantiatesCanonical SΣ 0..* canonical() Source
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 1..1 Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text Σ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣ 1..1 Timing When medication should be administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... event Σ 0..* dateTime When the event occurs
..... repeat SΣC 1..1 Element When the event is to occur
Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... bounds[x] Σ 0..1 Length/Range of lengths, or (Start and/or end) limits
....... boundsDuration Duration
....... boundsRange Range
....... boundsPeriod Period
...... count Σ 0..1 positiveInt Number of times to repeat
...... countMax Σ 0..1 positiveInt Maximum number of times to repeat
...... duration Σ 0..1 decimal How long when it happens
...... durationMax Σ 0..1 decimal How long when it happens (Max)
...... durationUnit Σ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).
...... frequency SΣ 1..1 positiveInt Event occurs frequency times per period
...... frequencyMax Σ 0..1 positiveInt Event occurs up to frequencyMax times per period
...... period SΣ 1..1 decimal Event occurs frequency times per period
...... periodMax Σ 0..1 decimal Upper limit of period (3-4 hours)
...... periodUnit SΣ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).
...... dayOfWeek Σ 0..* code mon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
...... timeOfDay Σ 0..* time Time of day for action
...... when Σ 0..* code Code for time period of occurrence
Binding: EventTiming (required): Real world event relating to the schedule.
...... offset Σ 0..1 unsignedInt Minutes from event (before or after)
..... code Σ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
.... asNeeded[x] SΣ 0..1 boolean Take "as needed" (for x)
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.
..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity(4.0.1) Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity(4.0.1) Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.statusReason Base example Medication request status reason codes 📦4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base example Condition/Problem/Diagnosis Codes 📦4.0.1 FHIR Std.
MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.durationUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek Base required DaysOfWeek 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.when Base required EventTiming 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.code Base preferred TimingAbbreviation 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​route Base example SNOMED CT Route Codes 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📍4.0.1 FHIR Std.
MedicationRequest.substitution.​allowed[x] Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v6.5
MedicationRequest.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v6.5

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()

This structure is derived from CPGMedicationRequest

Summary

Mandatory: 7 elements
Must-Support: 8 elements

Differential View

This structure is derived from CPGMedicationRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* CPGMedicationRequest Ordering of medication for patient or group
... medication[x] S 1..1 CodeableConcept Medication to be taken
... dosageInstruction S 1..1 Dosage How the medication should be taken
.... timing S 1..1 Timing When medication should be administered
..... repeat S 1..1 Element When the event is to occur
...... frequency S 1..1 positiveInt Event occurs frequency times per period
...... period S 1..1 decimal Event occurs frequency times per period
...... periodUnit S 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
.... asNeeded[x] S 0..1 boolean Take "as needed" (for x)

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* CPGMedicationRequest Ordering of medication for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:rationale S 0..1 markdown Explanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!SΣ 0..1 boolean True if request is prohibiting action
... medication[x] SΣ 1..1 CodeableConcept Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
... subject SΣ 1..1 Reference(CPGPatient) Who or group medication request is for
... encounter S 0..1 Reference(CPGEncounter) Encounter created as part of encounter/admission/stay
... supportingInformation S 0..* Reference(Resource) Pertinent information
... instantiatesCanonical SΣ 0..* canonical() Source
... dosageInstruction S 1..1 Dosage How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... timing SΣ 1..1 Timing When medication should be administered
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... repeat SΣC 1..1 Element When the event is to occur
Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
...... frequency SΣ 1..1 positiveInt Event occurs frequency times per period
...... period SΣ 1..1 decimal Event occurs frequency times per period
...... periodUnit SΣ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).
.... asNeeded[x] SΣ 0..1 boolean Take "as needed" (for x)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest 0..* CPGMedicationRequest Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:rationale S 0..1 markdown Explanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!SΣ 0..1 boolean True if request is prohibiting action
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ 1..1 CodeableConcept Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
... subject SΣ 1..1 Reference(CPGPatient) Who or group medication request is for
... encounter S 0..1 Reference(CPGEncounter) Encounter created as part of encounter/admission/stay
... supportingInformation S 0..* Reference(Resource) Pertinent information
... authoredOn Σ 0..1 dateTime When request was initially authored
... requester Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... instantiatesCanonical SΣ 0..* canonical() Source
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 1..1 Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text Σ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣ 1..1 Timing When medication should be administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... event Σ 0..* dateTime When the event occurs
..... repeat SΣC 1..1 Element When the event is to occur
Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... bounds[x] Σ 0..1 Length/Range of lengths, or (Start and/or end) limits
....... boundsDuration Duration
....... boundsRange Range
....... boundsPeriod Period
...... count Σ 0..1 positiveInt Number of times to repeat
...... countMax Σ 0..1 positiveInt Maximum number of times to repeat
...... duration Σ 0..1 decimal How long when it happens
...... durationMax Σ 0..1 decimal How long when it happens (Max)
...... durationUnit Σ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).
...... frequency SΣ 1..1 positiveInt Event occurs frequency times per period
...... frequencyMax Σ 0..1 positiveInt Event occurs up to frequencyMax times per period
...... period SΣ 1..1 decimal Event occurs frequency times per period
...... periodMax Σ 0..1 decimal Upper limit of period (3-4 hours)
...... periodUnit SΣ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).
...... dayOfWeek Σ 0..* code mon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
...... timeOfDay Σ 0..* time Time of day for action
...... when Σ 0..* code Code for time period of occurrence
Binding: EventTiming (required): Real world event relating to the schedule.
...... offset Σ 0..1 unsignedInt Minutes from event (before or after)
..... code Σ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
.... asNeeded[x] SΣ 0..1 boolean Take "as needed" (for x)
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.
..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity(4.0.1) Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity(4.0.1) Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationRequest.status Base required Medicationrequest status 📍4.0.1 FHIR Std.
MedicationRequest.statusReason Base example Medication request status reason codes 📦4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📍4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base example Condition/Problem/Diagnosis Codes 📦4.0.1 FHIR Std.
MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.durationUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek Base required DaysOfWeek 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.when Base required EventTiming 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​timing.code Base preferred TimingAbbreviation 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​route Base example SNOMED CT Route Codes 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📍4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📍4.0.1 FHIR Std.
MedicationRequest.substitution.​allowed[x] Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v6.5
MedicationRequest.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v6.5

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()

This structure is derived from CPGMedicationRequest

Summary

Mandatory: 7 elements
Must-Support: 8 elements

 

Other representations of profile: CSV, Excel, Schematron