Ethiopia FHIR Implementation Guide - HIV Treatment & Care Services, published by Jembi Health Systems. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jembi/ethiopia-hiv/ and changes regularly. See the Directory of published versions

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Resource Profile: Medication Request - ARV

Used to record requests for ARV medication that are prescribed to a patient.

Usage:

• Refer to this Resource Profile: Care Plan - ART Treatment, Medication Administration - For Prescribed ARV Medication and Medication Dispense - ARV
• Examples for this Resource Profile: MedicationRequest/ARVMedicationRequestAliveOnARTExample, MedicationRequest/ARVMedicationRequestForRegimenSwitchExample and MedicationRequest/ARVMedicationRequestInitiatedARTExample

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from GenericMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			GenericMedicationRequest
medication[x]		1..1	Reference(Medication)	Medication to be taken
Slices for medication[x]				Content/Rules for all slices
medication[x]:medicationReference		1..1	Reference(Medication - Represents an ARV Regimen)	Medication to be taken
reasonReference		1..1	Reference(Observation - ARV Regimen Change | Observation - ART Follow-up Status)	Condition or observation that supports why the prescription is being written
basedOn		1..1	Reference(Care Plan - ART Treatment)	What request fulfills
dispenseRequest
quantity		1..1	SimpleQuantity	Amount of medication to supply per dispense Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm
code		1..1	code	Coded form of the unit Fixed Value: TAB
unit		1..1	string	Unit representation Required Pattern: TAB
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	GenericMedicationRequest	Ordering of medication for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier		1..*	Identifier	External ids for this request Slice: Unordered, Open by value:system
identifier:RequestID	S	0..1	Identifier	External ids for this request
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://moh.gov.et/fhir/hiv/identifier/medication
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
Slices for medication[x]	Σ	1..1	Reference(Medication)	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	1..1	Reference(Medication - Represents an ARV Regimen)	Medication to be taken
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
subject	Σ	1..1	Reference(Patient)	Who or group medication request is for
encounter		1..1	Reference(Encounter - Initiated By The Facility Providing the Service)	Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	When request was initially authored
reasonReference		1..1	Reference(Observation - ARV Regimen Change | Observation - ART Follow-up Status)	Condition or observation that supports why the prescription is being written
basedOn	Σ	1..1	Reference(Care Plan - ART Treatment)	What request fulfills
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.identifier:RequestID.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	GenericMedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier		1..*	Identifier	External ids for this request Slice: Unordered, Open by value:system
identifier:RequestID	S	0..1	Identifier	External ids for this request
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://moh.gov.et/fhir/hiv/identifier/medication
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
Slices for medication[x]	Σ	1..1	Reference(Medication)	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	1..1	Reference(Medication - Represents an ARV Regimen)	Medication to be taken
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding		0..*	StrictCoding	A reference to a code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient)	Who or group medication request is for
encounter		1..1	Reference(Encounter - Initiated By The Facility Providing the Service)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding		0..*	StrictCoding	A reference to a code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
reasonReference		1..1	Reference(Observation - ARV Regimen Change | Observation - ART Follow-up Status)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	1..1	Reference(Care Plan - ART Treatment)	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		0..*	Dosage	How the medication should be taken
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized
quantity		1..1	SimpleQuantity	Amount of medication to supply per dispense Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< | <= | >= | > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm
code		1..1	code	Coded form of the unit Fixed Value: TAB
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	1..1	string	Unit representation Required Pattern: TAB
system	ΣC	1..1	uri	System that defines coded unit form
code	Σ	1..1	code	Coded form of the unit
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.identifier:RequestID.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.identifier:RequestID.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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 GenericMedicationRequest

Summary

Mandatory: 3 elements

Structures

This structure refers to these other structures:

• Medication - Represents an ARV Regimen (http://moh.gov.et/fhir/hiv/StructureDefinition/arv-regimen-medication)
• Observation - ARV Regimen Change (http://moh.gov.et/fhir/hiv/StructureDefinition/arv-regimen-changed-observation)
• Observation - ART Follow-up Status (http://moh.gov.et/fhir/hiv/StructureDefinition/art-followup-status-observation)
• Care Plan - ART Treatment (http://moh.gov.et/fhir/hiv/StructureDefinition/art-follow-up-careplan)

Differential View

This structure is derived from GenericMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			GenericMedicationRequest
medication[x]		1..1	Reference(Medication)	Medication to be taken
Slices for medication[x]				Content/Rules for all slices
medication[x]:medicationReference		1..1	Reference(Medication - Represents an ARV Regimen)	Medication to be taken
reasonReference		1..1	Reference(Observation - ARV Regimen Change | Observation - ART Follow-up Status)	Condition or observation that supports why the prescription is being written
basedOn		1..1	Reference(Care Plan - ART Treatment)	What request fulfills
dispenseRequest
quantity		1..1	SimpleQuantity	Amount of medication to supply per dispense Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm
code		1..1	code	Coded form of the unit Fixed Value: TAB
unit		1..1	string	Unit representation Required Pattern: TAB
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	GenericMedicationRequest	Ordering of medication for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier		1..*	Identifier	External ids for this request Slice: Unordered, Open by value:system
identifier:RequestID	S	0..1	Identifier	External ids for this request
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://moh.gov.et/fhir/hiv/identifier/medication
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
Slices for medication[x]	Σ	1..1	Reference(Medication)	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	1..1	Reference(Medication - Represents an ARV Regimen)	Medication to be taken
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
subject	Σ	1..1	Reference(Patient)	Who or group medication request is for
encounter		1..1	Reference(Encounter - Initiated By The Facility Providing the Service)	Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	When request was initially authored
reasonReference		1..1	Reference(Observation - ARV Regimen Change | Observation - ART Follow-up Status)	Condition or observation that supports why the prescription is being written
basedOn	Σ	1..1	Reference(Care Plan - ART Treatment)	What request fulfills
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.identifier:RequestID.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	GenericMedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier		1..*	Identifier	External ids for this request Slice: Unordered, Open by value:system
identifier:RequestID	S	0..1	Identifier	External ids for this request
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://moh.gov.et/fhir/hiv/identifier/medication
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
Slices for medication[x]	Σ	1..1	Reference(Medication)	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	1..1	Reference(Medication - Represents an ARV Regimen)	Medication to be taken
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding		0..*	StrictCoding	A reference to a code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient)	Who or group medication request is for
encounter		1..1	Reference(Encounter - Initiated By The Facility Providing the Service)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding		0..*	StrictCoding	A reference to a code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
reasonReference		1..1	Reference(Observation - ARV Regimen Change | Observation - ART Follow-up Status)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	1..1	Reference(Care Plan - ART Treatment)	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		0..*	Dosage	How the medication should be taken
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized
quantity		1..1	SimpleQuantity	Amount of medication to supply per dispense Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< | <= | >= | > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm
code		1..1	code	Coded form of the unit Fixed Value: TAB
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	1..1	string	Unit representation Required Pattern: TAB
system	ΣC	1..1	uri	System that defines coded unit form
code	Σ	1..1	code	Coded form of the unit
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.identifier:RequestID.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.identifier:RequestID.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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 GenericMedicationRequest

Summary

Mandatory: 3 elements

Structures

This structure refers to these other structures:

• Medication - Represents an ARV Regimen (http://moh.gov.et/fhir/hiv/StructureDefinition/arv-regimen-medication)
• Observation - ARV Regimen Change (http://moh.gov.et/fhir/hiv/StructureDefinition/arv-regimen-changed-observation)
• Observation - ART Follow-up Status (http://moh.gov.et/fhir/hiv/StructureDefinition/art-followup-status-observation)
• Care Plan - ART Treatment (http://moh.gov.et/fhir/hiv/StructureDefinition/art-follow-up-careplan)

Other representations of profile: CSV, Excel, Schematron