HL7 Europe Medication Prescription and Dispense
0.1.0 - ci-build 150

HL7 Europe Medication Prescription and Dispense, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/mpd/ and changes regularly. See the Directory of published versions

Logical Model: EprescriptionEhn - Detailed Descriptions

Draft as of 2024-12-08

Definitions for the Prescription logical model.

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

0. Prescription
Definition

Prescription. Several Sections of the eHN guideline.

ShortA - Prescription
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Prescription.patient
Definition

Patient administrative data

ShortA.1.1 Patient administrative data
Control0..*
Typehttp://hl7.eu/fhir/r5/mpd/StructureDefinition/Subject
4. Prescription.authentication
Definition

Authentication of the prescription

ShortA.1.2 Authentication of the prescription
Control0..*
TypeBackboneElement
6. Prescription.authentication.identifier
Definition

A unique string generated by an EPS (Electronic Prescribing System) to uniquely identify a prescription; this unique code is needed for traceability. It might be used to register whether a prescription, and/or the maximum number of repeats, has already been dispensed. The identifier can consist of a root and an extension [ISO 21090:2011].

ShortA.1.2.1 Identifier of the Prescription
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
8. Prescription.authentication.date
Definition

The date and optionally the time the prescription was issued.

  • Preferred system(s): ISO 8601
ShortA.1.2.2 Issue date
Control0..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. Prescription.prescriber
Definition

Identification of the prescribing health professional

ShortA.1.3 Identification of the prescribing health professional
Control0..1
TypeBackboneElement
12. Prescription.prescriber.familyName
Definition

The family name/surname/last name of the prescriber. This enables the prescriber to be traced in the event of questions or emergencies.

ShortA.1.3.1 Familyname
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
14. Prescription.prescriber.givenName
Definition

The given name/ first name of the prescriber. This enables the prescriber to be traced in the event of questions or emergencies.

ShortA.1.3.2 Given name
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
16. Prescription.prescriber.qualification
Definition

The professional title of the prescribing health professional, which may be used to prove the authority of the prescriber.

ShortA.1.3.3 Professional qualifications
Control0..*
TypeCodeableConcept
18. Prescription.prescriber.contact
Definition

Details for direct contact could be an email address and/or phone/fax number of the prescriber in order for the dispenser and/or patient to contact the prescriber. This might be necessary if problems arise with dosage, allergies, reimbursement etc.

ShortA.1.3.4 Details for direct contact
Control0..*
TypeContactPoint
20. Prescription.prescriber.workAddress
Definition

This is the address of the hospital or the practice, etc. where the health professional normally works, meets patients and prescribes medication. Minimally, the country should be specified.

ShortA.1.3.5 Work address
Control0..*
TypeAddress
22. Prescription.prescriber.signature
Definition

Digital signature or token as proof of the authenticity of the prescriber.

ShortA.1.3.6 Signature
Control0..*
TypeSignature
24. Prescription.prescriber.identifier
Definition

A unique number or code issued for the purpose of identifying a health care provider [ISO/TS 27527:2010]; this may be a licence or registration number which can be used to trace the prescriber and to check whether a medicinal product was prescribed by the right person according to the law of the prescribing country.

ShortA.1.3.7 Health care provider identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
26. Prescription.product
Definition

Identification of the prescribed product

ShortA1.4 Identification of the prescribed product
Control0..1
Typehttp://hl7.eu/fhir/r5/mpd/StructureDefinition/MedicinalProduct
28. Prescription.details
Definition

Prescription information

ShortA.1.5 Prescription information
Control0..1
TypeBackboneElement
30. Prescription.details.quantity
Definition

Total quantity or volume of the medicinal product that is prescribed to the specific patient. It can be provided as number of packages, given that the pack size is sufficiently described, or it can be the overall amount in appropriate units of measure (UCUM) or units of presentation (EDQM) (ml, g, tablets, vials). Depending on national legislation, this quantity may or may not be dispensed in one dispensation.

  • Preferred system(s): UCUM, EDQM
ShortA.1.5.2 Quantity of prescribed product
Control0..*
TypeQuantity
32. Prescription.details.doseRegimen
Definition

The regimen governing the dose quantity per single administration, the dose frequency, and/or speed of administration (in the event of intravenous administration). Note: this information may be used by the dispenser to calculate the quantity to be dispensed.

ShortA.1.5.3 Dose regimen
Control0..*
TypeBackboneElement
34. Prescription.details.doseRegimen.numOfIntakes
Definition

The number of units per intake that the patient is taking. Example: 1 tablet

  • Preferred system(s): UCUM, EDQM
ShortA.1.5.3.1 Number of units per intake
Control0..*
TypeQuantity
36. Prescription.details.doseRegimen.frequencyOfIntakes
Definition

Frequency of intakes per hour/day/week/month. Example: every 24 hours

  • Preferred system(s): UCUM, HL7 TimingEvent
ShortA.1.5.3.2 Frequency of intakes
Control0..*
TypeTiming
38. Prescription.details.route
Definition

The route of administration as prescribed. Example: oral intake

  • Preferred system(s): EDQM
ShortA.1.5.4 Route of administration
Control0..*
TypeCodeableConcept
40. Prescription.details.duration
Definition

The duration of the treatment as indicated by the Prescriber. Example: 14 days. Can be left blank for long-term therapies.

  • Preferred system(s): UCUM
ShortA.1.5.5 Duration of treatment
Control0..*
TypePeriod
42. Prescription.details.startDate
Definition

The time and date on which it is agreed that therapy will start.

  • Preferred system(s): ISO 8601
ShortA.1.5.6 Starting date of therapy
Control0..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. Prescription.details.directionsOfUse
Definition

Information about the directions for use of the prescribed medicinal product (such as ?with food? or ?before a meal?) and any cautionary advice for correct use of the prescribed medicinal product by the patient.

  • Preferred system(s): HL7 TimingEvent
ShortA.1.5.7 Directions for use
Control0..*
TypeCodeableConcept
46. Prescription.details.expiryDate
Definition

This might be dependent on local or national policy or legislation, in accordance with the treatment plan or because the therapeutic need for the prescribed medicine has expired.

  • Preferred system(s): ISO 8601
ShortA.1.5.8 Prescription expiry date
Control0..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. Prescription.details.repeats
Definition

In some countries, when medicinal products are dispensed for the first time, the patient may only receive medication for a short period of time. When a patient starts taking medication for a chronic illness, the prescriber can issue a prescription for a longer period that is now separated by repeats. In addition, the maximum quantity (A.1.4.3) of the prescribed product that may be dispensed in one dispensation may be stated here. Decision on dispensability is made in the country of prescription.

ShortA.1.5.9 Repeats
Control0..*
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
50. Prescription.details.reason
Definition

The reason why the medicine is being prescribed, including the option to mention that the medicinal product is being prescribed for ?off label? use. The reason for the prescription gives the dispenser the opportunity to review the prescription for medication safety issues. Note: in some countries it is obligatory to state the reason for prescription on the prescription itself for some or all medicinal products.

ShortA.1.5.10 Reason for prescription
Control0..*
TypeCodeableConcept
52. Prescription.details.substitution
Definition

Substitution handling can be recorded to indicate whether and to what extent substitution is allowed by the prescriber.

ShortA.1.5.11 Substitution
Control0..*
TypeCodeableConcept

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

0. Prescription
Definition

Prescription. Several Sections of the eHN guideline.


Base definition for all types defined in FHIR type system.

ShortA - PrescriptionBase for all types and resources
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Prescription.patient
Definition

Patient administrative data

ShortA.1.1 Patient administrative data
Control0..*
Typehttp://hl7.eu/fhir/r5/mpd/StructureDefinition/Subject
4. Prescription.authentication
Definition

Authentication of the prescription

ShortA.1.2 Authentication of the prescription
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Prescription.authentication.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

A unique string generated by an EPS (Electronic Prescribing System) to uniquely identify a prescription; this unique code is needed for traceability. It might be used to register whether a prescription, and/or the maximum number of repeats, has already been dispensed. The identifier can consist of a root and an extension [ISO 21090:2011].

ShortA.1.2.1 Identifier of the Prescription
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
10. Prescription.authentication.date
Definition

The date and optionally the time the prescription was issued.

  • Preferred system(s): ISO 8601
ShortA.1.2.2 Issue date
Control0..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. Prescription.prescriber
Definition

Identification of the prescribing health professional

ShortA.1.3 Identification of the prescribing health professional
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Prescription.prescriber.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

The family name/surname/last name of the prescriber. This enables the prescriber to be traced in the event of questions or emergencies.

ShortA.1.3.1 Familyname
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
18. Prescription.prescriber.givenName
Definition

The given name/ first name of the prescriber. This enables the prescriber to be traced in the event of questions or emergencies.

ShortA.1.3.2 Given name
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
20. Prescription.prescriber.qualification
Definition

The professional title of the prescribing health professional, which may be used to prove the authority of the prescriber.

ShortA.1.3.3 Professional qualifications
Control0..*
TypeCodeableConcept
22. Prescription.prescriber.contact
Definition

Details for direct contact could be an email address and/or phone/fax number of the prescriber in order for the dispenser and/or patient to contact the prescriber. This might be necessary if problems arise with dosage, allergies, reimbursement etc.

ShortA.1.3.4 Details for direct contact
Control0..*
TypeContactPoint
24. Prescription.prescriber.workAddress
Definition

This is the address of the hospital or the practice, etc. where the health professional normally works, meets patients and prescribes medication. Minimally, the country should be specified.

ShortA.1.3.5 Work address
Control0..*
TypeAddress
26. Prescription.prescriber.signature
Definition

Digital signature or token as proof of the authenticity of the prescriber.

ShortA.1.3.6 Signature
Control0..*
TypeSignature
28. Prescription.prescriber.identifier
Definition

A unique number or code issued for the purpose of identifying a health care provider [ISO/TS 27527:2010]; this may be a licence or registration number which can be used to trace the prescriber and to check whether a medicinal product was prescribed by the right person according to the law of the prescribing country.

ShortA.1.3.7 Health care provider identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
30. Prescription.product
Definition

Identification of the prescribed product

ShortA1.4 Identification of the prescribed product
Control0..1
Typehttp://hl7.eu/fhir/r5/mpd/StructureDefinition/MedicinalProduct
32. Prescription.details
Definition

Prescription information

ShortA.1.5 Prescription information
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Prescription.details.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Total quantity or volume of the medicinal product that is prescribed to the specific patient. It can be provided as number of packages, given that the pack size is sufficiently described, or it can be the overall amount in appropriate units of measure (UCUM) or units of presentation (EDQM) (ml, g, tablets, vials). Depending on national legislation, this quantity may or may not be dispensed in one dispensation.

  • Preferred system(s): UCUM, EDQM
ShortA.1.5.2 Quantity of prescribed product
Control0..*
TypeQuantity
38. Prescription.details.doseRegimen
Definition

The regimen governing the dose quantity per single administration, the dose frequency, and/or speed of administration (in the event of intravenous administration). Note: this information may be used by the dispenser to calculate the quantity to be dispensed.

ShortA.1.5.3 Dose regimen
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Prescription.details.doseRegimen.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

The number of units per intake that the patient is taking. Example: 1 tablet

  • Preferred system(s): UCUM, EDQM
ShortA.1.5.3.1 Number of units per intake
Control0..*
TypeQuantity
44. Prescription.details.doseRegimen.frequencyOfIntakes
Definition

Frequency of intakes per hour/day/week/month. Example: every 24 hours

  • Preferred system(s): UCUM, HL7 TimingEvent
ShortA.1.5.3.2 Frequency of intakes
Control0..*
TypeTiming
46. Prescription.details.route
Definition

The route of administration as prescribed. Example: oral intake

  • Preferred system(s): EDQM
ShortA.1.5.4 Route of administration
Control0..*
TypeCodeableConcept
48. Prescription.details.duration
Definition

The duration of the treatment as indicated by the Prescriber. Example: 14 days. Can be left blank for long-term therapies.

  • Preferred system(s): UCUM
ShortA.1.5.5 Duration of treatment
Control0..*
TypePeriod
50. Prescription.details.startDate
Definition

The time and date on which it is agreed that therapy will start.

  • Preferred system(s): ISO 8601
ShortA.1.5.6 Starting date of therapy
Control0..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. Prescription.details.directionsOfUse
Definition

Information about the directions for use of the prescribed medicinal product (such as ?with food? or ?before a meal?) and any cautionary advice for correct use of the prescribed medicinal product by the patient.

  • Preferred system(s): HL7 TimingEvent
ShortA.1.5.7 Directions for use
Control0..*
TypeCodeableConcept
54. Prescription.details.expiryDate
Definition

This might be dependent on local or national policy or legislation, in accordance with the treatment plan or because the therapeutic need for the prescribed medicine has expired.

  • Preferred system(s): ISO 8601
ShortA.1.5.8 Prescription expiry date
Control0..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
56. Prescription.details.repeats
Definition

In some countries, when medicinal products are dispensed for the first time, the patient may only receive medication for a short period of time. When a patient starts taking medication for a chronic illness, the prescriber can issue a prescription for a longer period that is now separated by repeats. In addition, the maximum quantity (A.1.4.3) of the prescribed product that may be dispensed in one dispensation may be stated here. Decision on dispensability is made in the country of prescription.

ShortA.1.5.9 Repeats
Control0..*
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. Prescription.details.reason
Definition

The reason why the medicine is being prescribed, including the option to mention that the medicinal product is being prescribed for ?off label? use. The reason for the prescription gives the dispenser the opportunity to review the prescription for medication safety issues. Note: in some countries it is obligatory to state the reason for prescription on the prescription itself for some or all medicinal products.

ShortA.1.5.10 Reason for prescription
Control0..*
TypeCodeableConcept
60. Prescription.details.substitution
Definition

Substitution handling can be recorded to indicate whether and to what extent substitution is allowed by the prescriber.

ShortA.1.5.11 Substitution
Control0..*
TypeCodeableConcept

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

0. Prescription
Definition

Prescription. Several Sections of the eHN guideline.

ShortA - Prescription
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Prescription.patient
Definition

Patient administrative data

ShortA.1.1 Patient administrative data
Control0..*
Typehttp://hl7.eu/fhir/r5/mpd/StructureDefinition/Subject
4. Prescription.authentication
Definition

Authentication of the prescription

ShortA.1.2 Authentication of the prescription
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Prescription.authentication.id
Definition

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

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

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

ShortAdditional content defined by implementations
Comments

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

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

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

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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

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

    A unique string generated by an EPS (Electronic Prescribing System) to uniquely identify a prescription; this unique code is needed for traceability. It might be used to register whether a prescription, and/or the maximum number of repeats, has already been dispensed. The identifier can consist of a root and an extension [ISO 21090:2011].

    ShortA.1.2.1 Identifier of the Prescription
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    14. Prescription.authentication.date
    Definition

    The date and optionally the time the prescription was issued.

    • Preferred system(s): ISO 8601
    ShortA.1.2.2 Issue date
    Control0..*
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    16. Prescription.prescriber
    Definition

    Identification of the prescribing health professional

    ShortA.1.3 Identification of the prescribing health professional
    Control0..1
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Prescription.prescriber.id
    Definition

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

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

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

    ShortAdditional content defined by implementations
    Comments

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

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

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

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      The family name/surname/last name of the prescriber. This enables the prescriber to be traced in the event of questions or emergencies.

      ShortA.1.3.1 Familyname
      Control0..*
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      26. Prescription.prescriber.givenName
      Definition

      The given name/ first name of the prescriber. This enables the prescriber to be traced in the event of questions or emergencies.

      ShortA.1.3.2 Given name
      Control0..*
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      28. Prescription.prescriber.qualification
      Definition

      The professional title of the prescribing health professional, which may be used to prove the authority of the prescriber.

      ShortA.1.3.3 Professional qualifications
      Control0..*
      TypeCodeableConcept
      30. Prescription.prescriber.contact
      Definition

      Details for direct contact could be an email address and/or phone/fax number of the prescriber in order for the dispenser and/or patient to contact the prescriber. This might be necessary if problems arise with dosage, allergies, reimbursement etc.

      ShortA.1.3.4 Details for direct contact
      Control0..*
      TypeContactPoint
      32. Prescription.prescriber.workAddress
      Definition

      This is the address of the hospital or the practice, etc. where the health professional normally works, meets patients and prescribes medication. Minimally, the country should be specified.

      ShortA.1.3.5 Work address
      Control0..*
      TypeAddress
      34. Prescription.prescriber.signature
      Definition

      Digital signature or token as proof of the authenticity of the prescriber.

      ShortA.1.3.6 Signature
      Control0..*
      TypeSignature
      36. Prescription.prescriber.identifier
      Definition

      A unique number or code issued for the purpose of identifying a health care provider [ISO/TS 27527:2010]; this may be a licence or registration number which can be used to trace the prescriber and to check whether a medicinal product was prescribed by the right person according to the law of the prescribing country.

      ShortA.1.3.7 Health care provider identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      38. Prescription.product
      Definition

      Identification of the prescribed product

      ShortA1.4 Identification of the prescribed product
      Control0..1
      Typehttp://hl7.eu/fhir/r5/mpd/StructureDefinition/MedicinalProduct
      40. Prescription.details
      Definition

      Prescription information

      ShortA.1.5 Prescription information
      Control0..1
      TypeBackboneElement
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Prescription.details.id
      Definition

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

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

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

      ShortAdditional content defined by implementations
      Comments

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

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

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

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        Total quantity or volume of the medicinal product that is prescribed to the specific patient. It can be provided as number of packages, given that the pack size is sufficiently described, or it can be the overall amount in appropriate units of measure (UCUM) or units of presentation (EDQM) (ml, g, tablets, vials). Depending on national legislation, this quantity may or may not be dispensed in one dispensation.

        • Preferred system(s): UCUM, EDQM
        ShortA.1.5.2 Quantity of prescribed product
        Control0..*
        TypeQuantity
        50. Prescription.details.doseRegimen
        Definition

        The regimen governing the dose quantity per single administration, the dose frequency, and/or speed of administration (in the event of intravenous administration). Note: this information may be used by the dispenser to calculate the quantity to be dispensed.

        ShortA.1.5.3 Dose regimen
        Control0..*
        TypeBackboneElement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Prescription.details.doseRegimen.id
        Definition

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

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

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

        ShortAdditional content defined by implementations
        Comments

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

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

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

          The number of units per intake that the patient is taking. Example: 1 tablet

          • Preferred system(s): UCUM, EDQM
          ShortA.1.5.3.1 Number of units per intake
          Control0..*
          TypeQuantity
          60. Prescription.details.doseRegimen.frequencyOfIntakes
          Definition

          Frequency of intakes per hour/day/week/month. Example: every 24 hours

          • Preferred system(s): UCUM, HL7 TimingEvent
          ShortA.1.5.3.2 Frequency of intakes
          Control0..*
          TypeTiming
          62. Prescription.details.route
          Definition

          The route of administration as prescribed. Example: oral intake

          • Preferred system(s): EDQM
          ShortA.1.5.4 Route of administration
          Control0..*
          TypeCodeableConcept
          64. Prescription.details.duration
          Definition

          The duration of the treatment as indicated by the Prescriber. Example: 14 days. Can be left blank for long-term therapies.

          • Preferred system(s): UCUM
          ShortA.1.5.5 Duration of treatment
          Control0..*
          TypePeriod
          66. Prescription.details.startDate
          Definition

          The time and date on which it is agreed that therapy will start.

          • Preferred system(s): ISO 8601
          ShortA.1.5.6 Starting date of therapy
          Control0..*
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          68. Prescription.details.directionsOfUse
          Definition

          Information about the directions for use of the prescribed medicinal product (such as ?with food? or ?before a meal?) and any cautionary advice for correct use of the prescribed medicinal product by the patient.

          • Preferred system(s): HL7 TimingEvent
          ShortA.1.5.7 Directions for use
          Control0..*
          TypeCodeableConcept
          70. Prescription.details.expiryDate
          Definition

          This might be dependent on local or national policy or legislation, in accordance with the treatment plan or because the therapeutic need for the prescribed medicine has expired.

          • Preferred system(s): ISO 8601
          ShortA.1.5.8 Prescription expiry date
          Control0..*
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          72. Prescription.details.repeats
          Definition

          In some countries, when medicinal products are dispensed for the first time, the patient may only receive medication for a short period of time. When a patient starts taking medication for a chronic illness, the prescriber can issue a prescription for a longer period that is now separated by repeats. In addition, the maximum quantity (A.1.4.3) of the prescribed product that may be dispensed in one dispensation may be stated here. Decision on dispensability is made in the country of prescription.

          ShortA.1.5.9 Repeats
          Control0..*
          Typeinteger
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          74. Prescription.details.reason
          Definition

          The reason why the medicine is being prescribed, including the option to mention that the medicinal product is being prescribed for ?off label? use. The reason for the prescription gives the dispenser the opportunity to review the prescription for medication safety issues. Note: in some countries it is obligatory to state the reason for prescription on the prescription itself for some or all medicinal products.

          ShortA.1.5.10 Reason for prescription
          Control0..*
          TypeCodeableConcept
          76. Prescription.details.substitution
          Definition

          Substitution handling can be recorded to indicate whether and to what extent substitution is allowed by the prescriber.

          ShortA.1.5.11 Substitution
          Control0..*
          TypeCodeableConcept