AU Core Implementation Guide
2.0.0-ci-build - CI Build Australia flag

AU Core Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-core/ and changes regularly. See the Directory of published versions

Resource Profile: AU Core MedicationRequest

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationrequest Version: 2.0.0-ci-build
Standards status: Trial-use Maturity Level: 2 Computable Name: AUCoreMedicationRequest

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for a MedicationRequest resource to record, search, and fetch medication orders and requests (i.e. prescriptions) associated with a patient. It is based on the AU Base Medication Request profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the MedicationRequest when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

Usage Scenarios

The following are supported usage scenarios for this profile:

  • Query medication orders or prescriptions for a patient (current and historical)
  • Record or update medication orders or prescriptions for a patient

Profile Specific Implementation Guidance

  • See the Medicine Information page for guidance on how medicinal product identification can be structured in FHIR conformant to AU Core.
  • When recording "self-prescribed" medication, MedicationRequest.requester references the Patient or RelatedPerson as the prescriber.
  • MedicationRequest resources can represent a medication using either a code as MedicationRequest.medicationCodeableConcept, or reference a Medication resource using MedicationRequest.medicationReference.
    • Responders are not required to support both a code and a reference, but SHALL support at least one of these methods
    • When referencing a Medication resource, it is preferred the resource is contained but it may be an external resource
    • If an external reference to a Medication resource is used, the responder SHALL support the _include parameter for searching this element
    • A requester SHALL support all methods
  • When populating MedicationRequest.medicationCodeableConcept responders SHALL correctly populate MedicationRequest.medicationCodeableConcept.coding with either a code from Australian Medication or PBS Item Codes, or both, if a coded value is known and MAY populate with a code from another code system.
    • Responders MAY populate with only text if no coded value is known.
  • The MedicationRequest resource can represent the clinical indication as a code with MedicationRequest.reasonCode, or a reference with MedicationRequest.reasonReference to a Condition or other resource.
    • Although both are marked as Must Support, responders are not required to support both a code and a reference, but they SHALL support at least one of these elements
    • A requester SHALL support both elements

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 1.0.0:

  • The resource metadata has changed (description)
  • The data elements list has changed
  • One or more text definitions, invariants or bindings have changed

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* AUBaseMedicationRequest A request for a medication for a patient in an Australian healthcare context
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... Slices for extension Content/Rules for all slices
    .... extension:sexParameterForClinicalUse 0..* (Complex) A context-specific sex parameter for clinical use
    URL: http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse
    .... extension:subsidisedConcurrentSupply 0..1 Coding Grounds for concurrent supply of medication
    URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply
    Binding: Concurrent Supply Grounds . (required)
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... intent ?!SOΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
    ... Slices for medication[x] SOΣ 1..1 Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(Medication)
    .... medication[x]:medicationCodeableConcept SOΣ 0..1 CodeableConcept Coded Prescribed Medication
    Binding: SNOMEDCTMedicationCodes (example)
    Additional BindingsPurpose
    Australian Medication . Preferred
    PBS Item Codes Preferred
    MIMS Preferred
    GTIN Preferred
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ..... Slices for coding Σ 0..* Coding Code defined by a terminology system
    Slice: Unordered, Open by pattern:$this
    ...... coding:All Slices Content/Rules for all slices
    ....... Slices for extension Content/Rules for all slices
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ...... coding:pbs SOΣ 0..* Coding Code defined by a terminology system
    Binding: PBS Item Codes (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... Slices for extension Content/Rules for all slices
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ...... coding:amt SOΣ 0..* Coding Code defined by a terminology system
    Binding: Australian Medication . (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... Slices for extension Content/Rules for all slices
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    .... medication[x]:medicationReference SOΣ 0..1 Reference(AU Core Medication) Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... subject SOΣ 1..1 Reference(AU Core Patient) Who or group medication request is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter SO 0..1 Reference(AU Core Encounter) Encounter created as part of encounter/admission/stay
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    Slice: Unordered, Open by profile:resolve()
    .... supportingInformation:bodyHeight 0..1 Reference(Observation Body Height Profile) Observation of Body Height
    .... supportingInformation:bodyWeight 0..1 Reference(Observation Body Weight Profile) Observation of Body Weight
    ... authoredOn SOΣC 1..1 dateTime Created date
    Constraints: au-core-medreq-01
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... requester SOΣ 1..1 Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) Who/What requested the Request
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonCode SO 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
    Binding: Reason for Request . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonReference SO 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... dosageInstruction SO 0..* AUBaseDosage How the medication should be taken
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... text SOΣ 0..1 string Free text dosage instructions e.g. SIG
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    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.medication[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
    MedicationRequest.medication[x]:medicationCodeableConcept Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:pbs Base required PBS Item Codes 📦6.0.0-ci-build AU Base Implementation Guide vnull
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:amt Base required Australian Medication . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.reasonCode Base preferred Reason for Request . ⏿1.0.1 tx.ontoserver.csiro.au

    Constraints

    Id Grade Path(s) Description Expression
    au-core-medreq-01 error MedicationRequest.authoredOn Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10)
    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()

    This structure is derived from AUBaseMedicationRequest

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* AUBaseMedicationRequest A request for a medication for a patient in an Australian healthcare context
    ... status SO 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... intent SO 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for medication[x] SO 1..1 CodeableConcept, Reference(Medication) Medication to be taken
    Slice: Unordered, Closed by type:$this
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medication[x]:medicationCodeableConcept SO 0..1 CodeableConcept Coded Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ..... Slices for coding 0..* Coding Code defined by a terminology system
    Slice: Unordered, Open by pattern:$this
    ...... coding:pbs SO 0..* Coding Code defined by a terminology system
    Binding: PBS Item Codes (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ...... coding:amt SO 0..* Coding Code defined by a terminology system
    Binding: Australian Medication . (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medication[x]:medicationReference SO 0..1 Reference(AU Core Medication) Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter SO 0..1 Reference(AU Core Encounter) Encounter created as part of encounter/admission/stay
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... authoredOn SOC 1..1 dateTime Created date
    Constraints: au-core-medreq-01
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... requester SO 1..1 Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) Who/What requested the Request
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonCode SO 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonReference SO 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... dosageInstruction SO 0..* AUBaseDosage How the medication should be taken
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... text SO 0..1 string Free text dosage instructions e.g. SIG
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:pbs Base required PBS Item Codes 📦6.0.0-ci-build AU Base Implementation Guide vnull
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:amt Base required Australian Medication . ⏿1.0.2 tx.ontoserver.csiro.au

    Constraints

    Id Grade Path(s) Description Expression
    au-core-medreq-01 error MedicationRequest.authoredOn Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10)
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* AUBaseMedicationRequest A request for a medication for a patient in an Australian healthcare context
    ... 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:sexParameterForClinicalUse 0..* (Complex) A context-specific sex parameter for clinical use
    URL: http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse
    .... extension:subsidisedConcurrentSupply 0..1 Coding Grounds for concurrent supply of medication
    URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply
    Binding: Concurrent Supply Grounds . (required)
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier, AUETPPrescriptionIdentifier, AULocalPrescriptionIdentifier External ids for this request
    ... status ?!SOΣ 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.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... statusReason 0..1 CodeableConcept Reason for current status
    Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
    ... intent ?!SOΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... category 0..* CodeableConcept Type of medication usage
    Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
    ... priority Σ 0..1 code routine | urgent | asap | stat
    Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
    ... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
    ... reported[x] Σ 0..1 Reported rather than primary record
    .... reportedBoolean boolean
    .... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
    ... Slices for medication[x] SOΣ 1..1 Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(Medication)
    .... medication[x]:medicationCodeableConcept SOΣ 0..1 CodeableConcept Coded Prescribed Medication
    Binding: SNOMEDCTMedicationCodes (example)
    Additional BindingsPurpose
    Australian Medication . Preferred
    PBS Item Codes Preferred
    MIMS Preferred
    GTIN Preferred
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... Slices for coding Σ 0..* Coding Code defined by a terminology system
    Slice: Unordered, Open by pattern:$this
    ...... coding:All Slices Content/Rules for all slices
    ....... id 0..1 string Unique id for inter-element referencing
    ....... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ....... system Σ 0..1 uri Identity of the terminology system
    ....... version Σ 0..1 string Version of the system - if relevant
    ....... code Σ 0..1 code Symbol in syntax defined by the system
    ....... display Σ 0..1 string Representation defined by the system
    ....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ...... coding:pbs SOΣ 0..* Coding Code defined by a terminology system
    Binding: PBS Item Codes (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... id 0..1 string Unique id for inter-element referencing
    ....... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ....... system Σ 0..1 uri Identity of the terminology system
    ....... version Σ 0..1 string Version of the system - if relevant
    ....... code Σ 0..1 code Symbol in syntax defined by the system
    ....... display Σ 0..1 string Representation defined by the system
    ....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ...... coding:amt SOΣ 0..* Coding Code defined by a terminology system
    Binding: Australian Medication . (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... id 0..1 string Unique id for inter-element referencing
    ....... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ....... system Σ 0..1 uri Identity of the terminology system
    ....... version Σ 0..1 string Version of the system - if relevant
    ....... code Σ 0..1 code Symbol in syntax defined by the system
    ....... display Σ 0..1 string Representation defined by the system
    ....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ..... text Σ 0..1 string Medication primary text
    .... medication[x]:medicationReference SOΣ 0..1 Reference(AU Core Medication) Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... subject SOΣ 1..1 Reference(AU Core Patient) Who or group medication request is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter SO 0..1 Reference(AU Core Encounter) Encounter created as part of encounter/admission/stay
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    Slice: Unordered, Open by profile:resolve()
    .... supportingInformation:bodyHeight 0..1 Reference(Observation Body Height Profile) Observation of Body Height
    .... supportingInformation:bodyWeight 0..1 Reference(Observation Body Weight Profile) Observation of Body Weight
    ... authoredOn SOΣC 1..1 dateTime Created date
    Constraints: au-core-medreq-01
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... requester SOΣ 1..1 Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) Who/What requested the Request
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... 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 SO 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
    Binding: Reason for Request . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonReference SO 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
    ... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
    ... groupIdentifier Σ 0..1 Identifier Composite request this is part of
    ... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
    ... note 0..* Annotation Information about the prescription
    ... dosageInstruction SO 0..* AUBaseDosage How the medication should be taken
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... 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 SOΣ 0..1 string Free text dosage instructions e.g. SIG
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
    Binding: SNOMEDCTAdditionalDosageInstructions (preferred)
    .... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
    .... timing Σ 0..1 Timing When medication should be administered
    .... asNeeded[x] Σ 0..1 Take "as needed" (for x)
    Binding: Clinical Finding . (preferred)
    ..... asNeededBoolean boolean
    ..... asNeededCodeableConcept CodeableConcept
    .... site Σ 0..1 CodeableConcept Body site to administer to
    Binding: Body Site . (preferred)
    .... route Σ 0..1 CodeableConcept How drug should enter body
    Binding: Route of Administration . (preferred)
    .... method Σ 0..1 CodeableConcept Technique for administering medication
    Binding: SNOMEDCTAdministrationMethodCodes (preferred)
    .... doseAndRate Σ 0..* Element Amount of medication administered
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
    Binding: DoseAndRateType (example): The kind of dose or rate specified.
    ..... dose[x] Σ 0..1 Amount of medication per dose
    ...... doseRange Range
    ...... doseQuantity Quantity(SimpleQuantity)
    ..... rate[x] Σ 0..1 Amount of medication per unit of time
    ...... rateRatio Ratio
    ...... rateRange Range
    ...... rateQuantity Quantity(SimpleQuantity)
    .... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
    .... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
    .... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
    ... dispenseRequest 0..1 BackboneElement Requested dispensing
    .... 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 Maximum repeats authorised
    .... 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 Brand substitution 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
    .... allowed[x] 1..1 Brand substitution flag
    Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
    ..... allowedBoolean boolean
    ..... allowedCodeableConcept CodeableConcept
    .... reason 0..1 CodeableConcept Why should (not) substitution be made
    Binding: Medicine Substitution Reason . (preferred)
    ... 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.medication[x]:medicationCodeableConcept Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:pbs Base required PBS Item Codes 📦6.0.0-ci-build AU Base Implementation Guide vnull
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:amt Base required Australian Medication . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
    MedicationRequest.reasonCode Base preferred Reason for Request . ⏿1.0.1 tx.ontoserver.csiro.au
    MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​additionalInstruction Base preferred SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​asNeeded[x] Base preferred Clinical Finding . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.dosageInstruction.​site Base preferred Body Site . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.dosageInstruction.​route Base preferred Route of Administration . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.dosageInstruction.​method Base preferred 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 preferred Medicine Substitution Reason . ⏿1.0.1 tx.ontoserver.csiro.au

    Constraints

    Id Grade Path(s) Description Expression
    au-core-medreq-01 error MedicationRequest.authoredOn Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10)
    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()

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* AUBaseMedicationRequest A request for a medication for a patient in an Australian healthcare context
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... Slices for extension Content/Rules for all slices
    .... extension:sexParameterForClinicalUse 0..* (Complex) A context-specific sex parameter for clinical use
    URL: http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse
    .... extension:subsidisedConcurrentSupply 0..1 Coding Grounds for concurrent supply of medication
    URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply
    Binding: Concurrent Supply Grounds . (required)
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... intent ?!SOΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
    ... Slices for medication[x] SOΣ 1..1 Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(Medication)
    .... medication[x]:medicationCodeableConcept SOΣ 0..1 CodeableConcept Coded Prescribed Medication
    Binding: SNOMEDCTMedicationCodes (example)
    Additional BindingsPurpose
    Australian Medication . Preferred
    PBS Item Codes Preferred
    MIMS Preferred
    GTIN Preferred
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ..... Slices for coding Σ 0..* Coding Code defined by a terminology system
    Slice: Unordered, Open by pattern:$this
    ...... coding:All Slices Content/Rules for all slices
    ....... Slices for extension Content/Rules for all slices
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ...... coding:pbs SOΣ 0..* Coding Code defined by a terminology system
    Binding: PBS Item Codes (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... Slices for extension Content/Rules for all slices
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ...... coding:amt SOΣ 0..* Coding Code defined by a terminology system
    Binding: Australian Medication . (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... Slices for extension Content/Rules for all slices
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    .... medication[x]:medicationReference SOΣ 0..1 Reference(AU Core Medication) Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... subject SOΣ 1..1 Reference(AU Core Patient) Who or group medication request is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter SO 0..1 Reference(AU Core Encounter) Encounter created as part of encounter/admission/stay
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    Slice: Unordered, Open by profile:resolve()
    .... supportingInformation:bodyHeight 0..1 Reference(Observation Body Height Profile) Observation of Body Height
    .... supportingInformation:bodyWeight 0..1 Reference(Observation Body Weight Profile) Observation of Body Weight
    ... authoredOn SOΣC 1..1 dateTime Created date
    Constraints: au-core-medreq-01
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... requester SOΣ 1..1 Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) Who/What requested the Request
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonCode SO 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
    Binding: Reason for Request . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonReference SO 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... dosageInstruction SO 0..* AUBaseDosage How the medication should be taken
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... text SOΣ 0..1 string Free text dosage instructions e.g. SIG
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    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.medication[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
    MedicationRequest.medication[x]:medicationCodeableConcept Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:pbs Base required PBS Item Codes 📦6.0.0-ci-build AU Base Implementation Guide vnull
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:amt Base required Australian Medication . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.reasonCode Base preferred Reason for Request . ⏿1.0.1 tx.ontoserver.csiro.au

    Constraints

    Id Grade Path(s) Description Expression
    au-core-medreq-01 error MedicationRequest.authoredOn Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10)
    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()

    Differential View

    This structure is derived from AUBaseMedicationRequest

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* AUBaseMedicationRequest A request for a medication for a patient in an Australian healthcare context
    ... status SO 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... intent SO 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for medication[x] SO 1..1 CodeableConcept, Reference(Medication) Medication to be taken
    Slice: Unordered, Closed by type:$this
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medication[x]:medicationCodeableConcept SO 0..1 CodeableConcept Coded Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ..... Slices for coding 0..* Coding Code defined by a terminology system
    Slice: Unordered, Open by pattern:$this
    ...... coding:pbs SO 0..* Coding Code defined by a terminology system
    Binding: PBS Item Codes (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ...... coding:amt SO 0..* Coding Code defined by a terminology system
    Binding: Australian Medication . (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medication[x]:medicationReference SO 0..1 Reference(AU Core Medication) Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter SO 0..1 Reference(AU Core Encounter) Encounter created as part of encounter/admission/stay
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... authoredOn SOC 1..1 dateTime Created date
    Constraints: au-core-medreq-01
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... requester SO 1..1 Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) Who/What requested the Request
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonCode SO 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonReference SO 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... dosageInstruction SO 0..* AUBaseDosage How the medication should be taken
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... text SO 0..1 string Free text dosage instructions e.g. SIG
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:pbs Base required PBS Item Codes 📦6.0.0-ci-build AU Base Implementation Guide vnull
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:amt Base required Australian Medication . ⏿1.0.2 tx.ontoserver.csiro.au

    Constraints

    Id Grade Path(s) Description Expression
    au-core-medreq-01 error MedicationRequest.authoredOn Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10)

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* AUBaseMedicationRequest A request for a medication for a patient in an Australian healthcare context
    ... 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:sexParameterForClinicalUse 0..* (Complex) A context-specific sex parameter for clinical use
    URL: http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse
    .... extension:subsidisedConcurrentSupply 0..1 Coding Grounds for concurrent supply of medication
    URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply
    Binding: Concurrent Supply Grounds . (required)
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier, AUETPPrescriptionIdentifier, AULocalPrescriptionIdentifier External ids for this request
    ... status ?!SOΣ 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.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... statusReason 0..1 CodeableConcept Reason for current status
    Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
    ... intent ?!SOΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... category 0..* CodeableConcept Type of medication usage
    Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
    ... priority Σ 0..1 code routine | urgent | asap | stat
    Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
    ... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
    ... reported[x] Σ 0..1 Reported rather than primary record
    .... reportedBoolean boolean
    .... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
    ... Slices for medication[x] SOΣ 1..1 Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(Medication)
    .... medication[x]:medicationCodeableConcept SOΣ 0..1 CodeableConcept Coded Prescribed Medication
    Binding: SNOMEDCTMedicationCodes (example)
    Additional BindingsPurpose
    Australian Medication . Preferred
    PBS Item Codes Preferred
    MIMS Preferred
    GTIN Preferred
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... Slices for coding Σ 0..* Coding Code defined by a terminology system
    Slice: Unordered, Open by pattern:$this
    ...... coding:All Slices Content/Rules for all slices
    ....... id 0..1 string Unique id for inter-element referencing
    ....... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ....... system Σ 0..1 uri Identity of the terminology system
    ....... version Σ 0..1 string Version of the system - if relevant
    ....... code Σ 0..1 code Symbol in syntax defined by the system
    ....... display Σ 0..1 string Representation defined by the system
    ....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ...... coding:pbs SOΣ 0..* Coding Code defined by a terminology system
    Binding: PBS Item Codes (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... id 0..1 string Unique id for inter-element referencing
    ....... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ....... system Σ 0..1 uri Identity of the terminology system
    ....... version Σ 0..1 string Version of the system - if relevant
    ....... code Σ 0..1 code Symbol in syntax defined by the system
    ....... display Σ 0..1 string Representation defined by the system
    ....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ...... coding:amt SOΣ 0..* Coding Code defined by a terminology system
    Binding: Australian Medication . (required)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ....... id 0..1 string Unique id for inter-element referencing
    ....... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ........ extension:medicationClass 0..1 Coding Medication type
    URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
    Binding: Medication Type (required)
    ....... system Σ 0..1 uri Identity of the terminology system
    ....... version Σ 0..1 string Version of the system - if relevant
    ....... code Σ 0..1 code Symbol in syntax defined by the system
    ....... display Σ 0..1 string Representation defined by the system
    ....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
    ..... text Σ 0..1 string Medication primary text
    .... medication[x]:medicationReference SOΣ 0..1 Reference(AU Core Medication) Prescribed Medication
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... subject SOΣ 1..1 Reference(AU Core Patient) Who or group medication request is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter SO 0..1 Reference(AU Core Encounter) Encounter created as part of encounter/admission/stay
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    Slice: Unordered, Open by profile:resolve()
    .... supportingInformation:bodyHeight 0..1 Reference(Observation Body Height Profile) Observation of Body Height
    .... supportingInformation:bodyWeight 0..1 Reference(Observation Body Weight Profile) Observation of Body Weight
    ... authoredOn SOΣC 1..1 dateTime Created date
    Constraints: au-core-medreq-01
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... requester SOΣ 1..1 Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) Who/What requested the Request
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... 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 SO 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
    Binding: Reason for Request . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... reasonReference SO 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
    ... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
    ... groupIdentifier Σ 0..1 Identifier Composite request this is part of
    ... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
    ... note 0..* Annotation Information about the prescription
    ... dosageInstruction SO 0..* AUBaseDosage How the medication should be taken
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... 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 SOΣ 0..1 string Free text dosage instructions e.g. SIG
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
    Binding: SNOMEDCTAdditionalDosageInstructions (preferred)
    .... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
    .... timing Σ 0..1 Timing When medication should be administered
    .... asNeeded[x] Σ 0..1 Take "as needed" (for x)
    Binding: Clinical Finding . (preferred)
    ..... asNeededBoolean boolean
    ..... asNeededCodeableConcept CodeableConcept
    .... site Σ 0..1 CodeableConcept Body site to administer to
    Binding: Body Site . (preferred)
    .... route Σ 0..1 CodeableConcept How drug should enter body
    Binding: Route of Administration . (preferred)
    .... method Σ 0..1 CodeableConcept Technique for administering medication
    Binding: SNOMEDCTAdministrationMethodCodes (preferred)
    .... doseAndRate Σ 0..* Element Amount of medication administered
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
    Binding: DoseAndRateType (example): The kind of dose or rate specified.
    ..... dose[x] Σ 0..1 Amount of medication per dose
    ...... doseRange Range
    ...... doseQuantity Quantity(SimpleQuantity)
    ..... rate[x] Σ 0..1 Amount of medication per unit of time
    ...... rateRatio Ratio
    ...... rateRange Range
    ...... rateQuantity Quantity(SimpleQuantity)
    .... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
    .... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
    .... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
    ... dispenseRequest 0..1 BackboneElement Requested dispensing
    .... 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 Maximum repeats authorised
    .... 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 Brand substitution 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
    .... allowed[x] 1..1 Brand substitution flag
    Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
    ..... allowedBoolean boolean
    ..... allowedCodeableConcept CodeableConcept
    .... reason 0..1 CodeableConcept Why should (not) substitution be made
    Binding: Medicine Substitution Reason . (preferred)
    ... 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.medication[x]:medicationCodeableConcept Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:pbs Base required PBS Item Codes 📦6.0.0-ci-build AU Base Implementation Guide vnull
    MedicationRequest.medication[x]:medicationCodeableConcept.​coding:amt Base required Australian Medication . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
    MedicationRequest.reasonCode Base preferred Reason for Request . ⏿1.0.1 tx.ontoserver.csiro.au
    MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​additionalInstruction Base preferred SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​asNeeded[x] Base preferred Clinical Finding . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.dosageInstruction.​site Base preferred Body Site . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.dosageInstruction.​route Base preferred Route of Administration . ⏿1.0.2 tx.ontoserver.csiro.au
    MedicationRequest.dosageInstruction.​method Base preferred 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 preferred Medicine Substitution Reason . ⏿1.0.1 tx.ontoserver.csiro.au

    Constraints

    Id Grade Path(s) Description Expression
    au-core-medreq-01 error MedicationRequest.authoredOn Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10)
    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()

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

    FHIR search operations are described here and the syntax used to describe AU Core interactions is defined here.

    Any search parameter defined in FHIR may be 'allowed' by the system unless explicitly marked as "SHALL NOT". A few items are marked as MAY in this implementation guide to highlight their potential relevance.

    Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
    patient SHALL reference The requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both.

    The requester SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
    patient+status SHALL reference+token
    patient+intent SHOULD reference+token
    patient+intent+status SHOULD reference+token+token
    _id SHOULD token
    patient+intent+authoredon SHOULD reference+token+date
    authoredon MAY date A requester SHALL provide a value precise to the second + time offset. A responder SHALL support a value precise to the second + time offset.

    The requester SHALL support these search comparators gt, lt, ge, le. The responder SHALL support these search comparators gt, lt, ge, le.

    The requester SHOULD support multipleAnd, and if multipleAnd is supported, SHALL support the search comparators gt, lt, ge, le. The responder SHOULD support multipleAnd, and if multipleAnd is supported, SHALL support the search comparators gt, lt, ge, le.
    intent MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.
    status MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.

    The requester SHALL support multipleOr. The responder SHALL support multipleOr.

    Mandatory Search Parameters

    The following search parameters and search parameter combinations SHALL be supported:

    1. SHALL support searching using the patient search parameter:
      • SHOULD support these _include parameters: MedicationRequest:medication
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

      GET [base]/MedicationRequest?patient={Type/}[id] or optionally GET [base]/MedicationRequest?patient.identifier=[system|][code]

      Example:

      1. GET [base]/MedicationRequest?patient=5678
      2. GET [base]/MedicationRequest?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
      3. GET [base]/MedicationRequest?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952&_include=MedicationRequest:medication
      4. GET [base]/MedicationRequest?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

      Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient (how to search by reference and how to search by token)

    2. SHALL support searching using the combination of the patient and status search parameters:
      • SHOULD support these _include parameters: MedicationRequest:medication
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
      • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

      GET [base]/MedicationRequest?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/MedicationRequest?patient=5678&status=active
      2. GET [base]/MedicationRequest?patient=5678&status=active&_include=MedicationRequest:medication

      Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and status (how to search by reference and how to search by token)

    Optional Search Parameters

    The following search parameters and search parameter combinations SHOULD be supported:

    1. SHOULD support searching using the _id search parameter:
      • SHOULD support these _include parameters: MedicationRequest:medication

      GET [base]/MedicationRequest?_id=[id]

      Example:

      1. GET [base]/MedicationRequest?_id=2169591
      2. GET [base]/MedicationRequest?_id=2169591&_include=MedicationRequest:medication

      Implementation Notes: Fetches a bundle with the requested MedicationRequest, instead of just the resource itself, and allows for the inclusion of additional search parameters such as _include, _revinclude, or _lastUpdated (how to search by id of the resource)

    2. SHOULD support searching using the combination of the patient and intent and authoredon search parameters:
      • SHOULD support these _include parameters: MedicationRequest:medication
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
      • SHALL support these authoredon comparators: gt,lt,ge,le
      • SHOULD support multipleAnd search on authoredon (e.g.authoredon=[date]&authoredon=[date]]&...), and if multipleAnd is supported, SHALL support the search comparators gt,lt,ge,le

      GET [base]/MedicationRequest?patient={Type/}[id]&intent={system|}[code]&authoredon={gt|lt|ge|le}[date]{&authoredon={gt|lt|ge|le}[date]&...}

      Example:

      1. GET [base]/MedicationRequest?patient=5678&intent=order&authoredon=ge2020-01-01T00:00:00Z

      Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent and date (how to search by reference and how to search by token and how to search by date)

    3. SHOULD support searching using the combination of the patient and intent search parameters:
      • SHOULD support these _include parameters: MedicationRequest:medication
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

      GET [base]/MedicationRequest?patient={Type/}[id]&intent={system|}[code]

      Example:

      1. GET [base]/MedicationRequest?patient=5678&intent=order

      Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent (how to search by reference and how to search by token)

    4. SHOULD support searching using the combination of the patient and intent and status search parameters:
      • SHOULD support these _include parameters: MedicationRequest:medication
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
      • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

      GET [base]/MedicationRequest?patient={Type/}[id]&intent={system|}[code]&status={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/MedicationRequest?patient=5678&intent=order&status=active
      2. GET [base]/MedicationRequest?patient=5678&intent=order&status=active&_include=MedicationRequest:medication

      Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent and status (how to search by reference and how to search by token)