LK NEHR Sri Lanka Patient Summary (IPS based) Implementation Guide
0.1.0 - STU1 Sri Lanka flag

LK NEHR Sri Lanka Patient Summary (IPS based) Implementation Guide, published by Ministry of Health, Sri Lanka. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/lk-gov-health-hiu/lk-nehr-fhir-ips/ and changes regularly. See the Directory of published versions

Resource Profile: Medication Request

Official URL: http://fhir.health.gov.lk/ips/StructureDefinition/medication-request Version: 0.1.0
Active as of 2024-09-22 Computable Name: MedicationRequests

This is to record requests for medication that are prescribed to a patient or for Non-MDS medicines.

Usage:

Formal Views of Profile Content

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

This structure is derived from MedicationRequestIPS

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest MedicationRequestIPS
... Slices for identifier 1..* Identifier External ids for this request
Slice: Unordered, Open by value:system
.... identifier:RequestID 1..1 Identifier External ids for this request
..... type
...... coding
....... system 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 0..1 code Symbol in syntax defined by the system
Required Pattern: FILL
....... display 0..1 string Representation defined by the system
Required Pattern: Filler Identifier
...... text 0..1 string Plain text representation of the concept
Required Pattern: Prescription identifier
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://fhir.health.gov.lk/ips/identifier/medication
..... value 1..1 string The value that is unique
... Slices for medication[x] 1..1 CodeableConcept Medication to be taken
Slice: Unordered, Open by type:$this
.... medication[x]:medicationCodeableConcept 1..1 CodeableConcept Medication to be taken
Binding: Medication Names For Pharmacy (extensible)
Additional BindingsPurpose
Medication Names Not For Pharmacy Extensible
... subject 1..1 Reference(Patient) Who or group medication request is for
... authoredOn 1..1 dateTime When request was initially authored
... requester S 0..1 Reference(Practitioner | Patient | Device Information) Who/What requested the Request
... performer S 0..1 Reference(Practitioner | Patient | Device Information) Intended performer of administration
... recorder S 0..1 Reference(Practitioner) Person who entered the request
... note S 0..* Annotation Information about the prescription
... dosageInstruction
.... timing C 0..1 Timing When medication should be administered
MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
..... repeat
...... count 1..1 positiveInt Number of times to repeat
...... duration 1..1 decimal How long when it happens
...... durationUnit 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
...... frequency S 0..1 positiveInt Event occurs frequency times per period
...... period S 0..1 decimal Event occurs frequency times per period
...... periodUnit S 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
..... code S 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: Drug Frequency Codes (preferred)
.... doseAndRate
..... Slices for dose[x] 1..1 SimpleQuantity Amount of medication per dose
Slice: Unordered, Open by type:$this
...... dose[x]:doseQuantity 1..1 SimpleQuantity A fixed quantity (no comparator)
... dispenseRequest
.... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationRequest.medication[x]:medicationCodeableConceptextensibleVSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy)
Additional Bindings Purpose Documentation
Medication Names Not For Pharmacy Extensible

A list of medications that typically are not prescribed for collection at the pharamcy a.k.a. Non-Medical Supplies.

http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd
from this IG
MedicationRequest.dosageInstruction.timing.codepreferredVSDrugFrequency (a valid code from Drug Frequency Codes)
http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency
from this IG

Constraints

IdGradePath(s)DetailsRequirements
MedicationRequest-DosageInstruction-1errorMedicationRequest.dosageInstruction.timingIf the Repeat Frequency does not exist then the Timing Code SHALL be present.
: repeat.frequency.exists().not() implies code.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* MedicationRequestIPS 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 1..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://fhir.health.gov.lk/ips/identifier/medication
..... value Σ 1..1 string The value that is unique
Example General: 123456
... 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] SΣ 1..1 CodeableConcept Medication to be taken
Slice: Unordered, Closed by type:$this
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medication[x]:medicationCodeableConcept SΣ 1..1 CodeableConcept Medication to be taken
Binding: Medication Names For Pharmacy (extensible)
Additional BindingsPurpose
Medication Names Not For Pharmacy Extensible
... subject SΣ 1..1 Reference(Patient) Who or group medication request is for
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... encounter 1..1 Reference(Target Facility Encounter) Encounter created as part of encounter/admission/stay
... authoredOn Σ 1..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | Patient | Device Information) Who/What requested the Request
... performer S 0..1 Reference(Practitioner | Patient | Device Information) Intended performer of administration
... recorder S 0..1 Reference(Practitioner) Person who entered the request
... note S 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... timing SΣC 0..1 Timing When medication should be administered
MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... repeat ΣC 0..1 Element When the event is to occur
tim-1: if there's a duration, there needs to be duration units
tim-2: if there's a period, there needs to be period units
tim-4: duration SHALL be a non-negative value
tim-5: period SHALL be a non-negative value
tim-6: If there's a periodMax, there must be a period
tim-7: If there's a durationMax, there must be a duration
tim-8: If there's a countMax, there must be a count
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
...... count Σ 1..1 positiveInt Number of times to repeat
...... duration Σ 1..1 decimal How long when it happens
...... durationUnit Σ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... frequency SΣ 0..1 positiveInt Event occurs frequency times per period
...... period SΣ 0..1 decimal Event occurs frequency times per period
...... periodUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: Drug Frequency Codes (preferred)
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.identifier:RequestID.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConceptextensibleVSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy)
Additional Bindings Purpose Documentation
Medication Names Not For Pharmacy Extensible

A list of medications that typically are not prescribed for collection at the pharamcy a.k.a. Non-Medical Supplies.

http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd
from this IG
MedicationRequest.dosageInstruction.timing.repeat.durationUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.codepreferredVSDrugFrequency (a valid code from Drug Frequency Codes)
http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency
from this IG

Constraints

IdGradePath(s)DetailsRequirements
MedicationRequest-DosageInstruction-1errorMedicationRequest.dosageInstruction.timingIf the Repeat Frequency does not exist then the Timing Code SHALL be present.
: repeat.frequency.exists().not() implies code.exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf there's an offset, there must be a when (and not C, CM, CD, CV)
: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* MedicationRequestIPS Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... 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 1..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.

...... 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 Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: FILL
....... display Σ 0..1 string Representation defined by the system
Required Pattern: Filler Identifier
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
Required Pattern: Prescription identifier
..... system Σ 1..1 uri The namespace for the identifier value
Required Pattern: http://fhir.health.gov.lk/ips/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] SΣ 1..1 CodeableConcept Medication to be taken
Slice: Unordered, Closed by type:$this
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medication[x]:medicationCodeableConcept SΣ 1..1 CodeableConcept Medication to be taken
Binding: Medication Names For Pharmacy (extensible)
Additional BindingsPurpose
Medication Names Not For Pharmacy Extensible
... subject SΣ 1..1 Reference(Patient) Who or group medication request is for
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... encounter 1..1 Reference(Target Facility Encounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn Σ 1..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | Patient | Device Information) Who/What requested the Request
... performer S 0..1 Reference(Practitioner | Patient | Device Information) 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 S 0..1 Reference(Practitioner) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... instantiatesCanonical 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 S 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣC 0..1 Timing When medication should be administered
MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... event Σ 0..* dateTime When the event occurs
..... repeat ΣC 0..1 Element When the event is to occur
tim-1: if there's a duration, there needs to be duration units
tim-2: if there's a period, there needs to be period units
tim-4: duration SHALL be a non-negative value
tim-5: period SHALL be a non-negative value
tim-6: If there's a periodMax, there must be a period
tim-7: If there's a durationMax, there must be a duration
tim-8: If there's a countMax, there must be a count
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... bounds[x] Σ 0..1 Length/Range of lengths, or (Start and/or end) limits
....... boundsDuration Duration
....... boundsRange Range
....... boundsPeriod Period
...... count Σ 1..1 positiveInt Number of times to repeat
...... countMax Σ 0..1 positiveInt Maximum number of times to repeat
...... duration Σ 1..1 decimal How long when it happens
...... durationMax Σ 0..1 decimal How long when it happens (Max)
...... durationUnit Σ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... frequency SΣ 0..1 positiveInt Event occurs frequency times per period
...... frequencyMax Σ 0..1 positiveInt Event occurs up to frequencyMax times per period
...... period SΣ 0..1 decimal Event occurs frequency times per period
...... periodMax Σ 0..1 decimal Upper limit of period (3-4 hours)
...... periodUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... dayOfWeek Σ 0..* code mon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
...... timeOfDay Σ 0..* time Time of day for action
...... when Σ 0..* code Code for time period of occurrence
Binding: EventTiming (required): Real world event relating to the schedule.


...... offset Σ 0..1 unsignedInt Minutes from event (before or after)
..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: Drug Frequency Codes (preferred)
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... Slices for dose[x] Σ 1..1 SimpleQuantity Amount of medication per dose
Slice: Unordered, Closed by type:$this
...... dose[x]:doseQuantity C 1..1 SimpleQuantity A fixed quantity (no comparator)
qty-3: If a code for the unit is present, the system SHALL also be present
sqty-1: The comparator is not used on a 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 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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... data-absent-reason 0..1 code validityPeriod absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
..... start ΣC 0..1 dateTime Starting time with inclusive boundary
..... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.identifier:RequestID.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.identifier:RequestID.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConceptextensibleVSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy)
Additional Bindings Purpose Documentation
Medication Names Not For Pharmacy Extensible

A list of medications that typically are not prescribed for collection at the pharamcy a.k.a. Non-Medical Supplies.

http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd
from this IG
MedicationRequest.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeekrequiredDaysOfWeek
http://hl7.org/fhir/ValueSet/days-of-week|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.whenrequiredEventTiming
http://hl7.org/fhir/ValueSet/event-timing|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.codepreferredVSDrugFrequency (a valid code from Drug Frequency Codes)
http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency
from this IG
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
MedicationRequest-DosageInstruction-1errorMedicationRequest.dosageInstruction.timingIf the Repeat Frequency does not exist then the Timing Code SHALL be present.
: repeat.frequency.exists().not() implies code.exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
qty-3errorMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantityIf a code for the unit is present, the system SHALL also be present
: code.empty() or system.exists()
sqty-1errorMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantityThe comparator is not used on a SimpleQuantity
: comparator.empty()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf there's an offset, there must be a when (and not C, CM, CD, CV)
: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()

This structure is derived from MedicationRequestIPS

Summary

Mandatory: 7 elements(5 nested mandatory elements)
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of MedicationRequest.identifier
  • The element 1 is sliced based on the value of MedicationRequest.medication[x]
  • The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.dose[x]

Differential View

This structure is derived from MedicationRequestIPS

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest MedicationRequestIPS
... Slices for identifier 1..* Identifier External ids for this request
Slice: Unordered, Open by value:system
.... identifier:RequestID 1..1 Identifier External ids for this request
..... type
...... coding
....... system 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
....... code 0..1 code Symbol in syntax defined by the system
Required Pattern: FILL
....... display 0..1 string Representation defined by the system
Required Pattern: Filler Identifier
...... text 0..1 string Plain text representation of the concept
Required Pattern: Prescription identifier
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://fhir.health.gov.lk/ips/identifier/medication
..... value 1..1 string The value that is unique
... Slices for medication[x] 1..1 CodeableConcept Medication to be taken
Slice: Unordered, Open by type:$this
.... medication[x]:medicationCodeableConcept 1..1 CodeableConcept Medication to be taken
Binding: Medication Names For Pharmacy (extensible)
Additional BindingsPurpose
Medication Names Not For Pharmacy Extensible
... subject 1..1 Reference(Patient) Who or group medication request is for
... authoredOn 1..1 dateTime When request was initially authored
... requester S 0..1 Reference(Practitioner | Patient | Device Information) Who/What requested the Request
... performer S 0..1 Reference(Practitioner | Patient | Device Information) Intended performer of administration
... recorder S 0..1 Reference(Practitioner) Person who entered the request
... note S 0..* Annotation Information about the prescription
... dosageInstruction
.... timing C 0..1 Timing When medication should be administered
MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
..... repeat
...... count 1..1 positiveInt Number of times to repeat
...... duration 1..1 decimal How long when it happens
...... durationUnit 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
...... frequency S 0..1 positiveInt Event occurs frequency times per period
...... period S 0..1 decimal Event occurs frequency times per period
...... periodUnit S 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
..... code S 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: Drug Frequency Codes (preferred)
.... doseAndRate
..... Slices for dose[x] 1..1 SimpleQuantity Amount of medication per dose
Slice: Unordered, Open by type:$this
...... dose[x]:doseQuantity 1..1 SimpleQuantity A fixed quantity (no comparator)
... dispenseRequest
.... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationRequest.medication[x]:medicationCodeableConceptextensibleVSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy)
Additional Bindings Purpose Documentation
Medication Names Not For Pharmacy Extensible

A list of medications that typically are not prescribed for collection at the pharamcy a.k.a. Non-Medical Supplies.

http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd
from this IG
MedicationRequest.dosageInstruction.timing.codepreferredVSDrugFrequency (a valid code from Drug Frequency Codes)
http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency
from this IG

Constraints

IdGradePath(s)DetailsRequirements
MedicationRequest-DosageInstruction-1errorMedicationRequest.dosageInstruction.timingIf the Repeat Frequency does not exist then the Timing Code SHALL be present.
: repeat.frequency.exists().not() implies code.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* MedicationRequestIPS 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 1..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://fhir.health.gov.lk/ips/identifier/medication
..... value Σ 1..1 string The value that is unique
Example General: 123456
... 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] SΣ 1..1 CodeableConcept Medication to be taken
Slice: Unordered, Closed by type:$this
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medication[x]:medicationCodeableConcept SΣ 1..1 CodeableConcept Medication to be taken
Binding: Medication Names For Pharmacy (extensible)
Additional BindingsPurpose
Medication Names Not For Pharmacy Extensible
... subject SΣ 1..1 Reference(Patient) Who or group medication request is for
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... encounter 1..1 Reference(Target Facility Encounter) Encounter created as part of encounter/admission/stay
... authoredOn Σ 1..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | Patient | Device Information) Who/What requested the Request
... performer S 0..1 Reference(Practitioner | Patient | Device Information) Intended performer of administration
... recorder S 0..1 Reference(Practitioner) Person who entered the request
... note S 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... timing SΣC 0..1 Timing When medication should be administered
MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... repeat ΣC 0..1 Element When the event is to occur
tim-1: if there's a duration, there needs to be duration units
tim-2: if there's a period, there needs to be period units
tim-4: duration SHALL be a non-negative value
tim-5: period SHALL be a non-negative value
tim-6: If there's a periodMax, there must be a period
tim-7: If there's a durationMax, there must be a duration
tim-8: If there's a countMax, there must be a count
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
...... count Σ 1..1 positiveInt Number of times to repeat
...... duration Σ 1..1 decimal How long when it happens
...... durationUnit Σ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... frequency SΣ 0..1 positiveInt Event occurs frequency times per period
...... period SΣ 0..1 decimal Event occurs frequency times per period
...... periodUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: Drug Frequency Codes (preferred)
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.identifier:RequestID.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConceptextensibleVSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy)
Additional Bindings Purpose Documentation
Medication Names Not For Pharmacy Extensible

A list of medications that typically are not prescribed for collection at the pharamcy a.k.a. Non-Medical Supplies.

http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd
from this IG
MedicationRequest.dosageInstruction.timing.repeat.durationUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.codepreferredVSDrugFrequency (a valid code from Drug Frequency Codes)
http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency
from this IG

Constraints

IdGradePath(s)DetailsRequirements
MedicationRequest-DosageInstruction-1errorMedicationRequest.dosageInstruction.timingIf the Repeat Frequency does not exist then the Timing Code SHALL be present.
: repeat.frequency.exists().not() implies code.exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf there's an offset, there must be a when (and not C, CM, CD, CV)
: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* MedicationRequestIPS Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... 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 1..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.

...... 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 Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 0..1 uri Identity of the terminology system
Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: FILL
....... display Σ 0..1 string Representation defined by the system
Required Pattern: Filler Identifier
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
Required Pattern: Prescription identifier
..... system Σ 1..1 uri The namespace for the identifier value
Required Pattern: http://fhir.health.gov.lk/ips/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] SΣ 1..1 CodeableConcept Medication to be taken
Slice: Unordered, Closed by type:$this
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medication[x]:medicationCodeableConcept SΣ 1..1 CodeableConcept Medication to be taken
Binding: Medication Names For Pharmacy (extensible)
Additional BindingsPurpose
Medication Names Not For Pharmacy Extensible
... subject SΣ 1..1 Reference(Patient) Who or group medication request is for
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... encounter 1..1 Reference(Target Facility Encounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn Σ 1..1 dateTime When request was initially authored
... requester SΣ 0..1 Reference(Practitioner | Patient | Device Information) Who/What requested the Request
... performer S 0..1 Reference(Practitioner | Patient | Device Information) 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 S 0..1 Reference(Practitioner) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... instantiatesCanonical 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 S 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣC 0..1 Timing When medication should be administered
MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... event Σ 0..* dateTime When the event occurs
..... repeat ΣC 0..1 Element When the event is to occur
tim-1: if there's a duration, there needs to be duration units
tim-2: if there's a period, there needs to be period units
tim-4: duration SHALL be a non-negative value
tim-5: period SHALL be a non-negative value
tim-6: If there's a periodMax, there must be a period
tim-7: If there's a durationMax, there must be a duration
tim-8: If there's a countMax, there must be a count
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... bounds[x] Σ 0..1 Length/Range of lengths, or (Start and/or end) limits
....... boundsDuration Duration
....... boundsRange Range
....... boundsPeriod Period
...... count Σ 1..1 positiveInt Number of times to repeat
...... countMax Σ 0..1 positiveInt Maximum number of times to repeat
...... duration Σ 1..1 decimal How long when it happens
...... durationMax Σ 0..1 decimal How long when it happens (Max)
...... durationUnit Σ 1..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... frequency SΣ 0..1 positiveInt Event occurs frequency times per period
...... frequencyMax Σ 0..1 positiveInt Event occurs up to frequencyMax times per period
...... period SΣ 0..1 decimal Event occurs frequency times per period
...... periodMax Σ 0..1 decimal Upper limit of period (3-4 hours)
...... periodUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... dayOfWeek Σ 0..* code mon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
...... timeOfDay Σ 0..* time Time of day for action
...... when Σ 0..* code Code for time period of occurrence
Binding: EventTiming (required): Real world event relating to the schedule.


...... offset Σ 0..1 unsignedInt Minutes from event (before or after)
..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
Binding: Drug Frequency Codes (preferred)
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... Slices for dose[x] Σ 1..1 SimpleQuantity Amount of medication per dose
Slice: Unordered, Closed by type:$this
...... dose[x]:doseQuantity C 1..1 SimpleQuantity A fixed quantity (no comparator)
qty-3: If a code for the unit is present, the system SHALL also be present
sqty-1: The comparator is not used on a 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 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
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... data-absent-reason 0..1 code validityPeriod absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
..... start ΣC 0..1 dateTime Starting time with inclusive boundary
..... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity S 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.identifier:RequestID.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.identifier:RequestID.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConceptextensibleVSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy)
Additional Bindings Purpose Documentation
Medication Names Not For Pharmacy Extensible

A list of medications that typically are not prescribed for collection at the pharamcy a.k.a. Non-Medical Supplies.

http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd
from this IG
MedicationRequest.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeekrequiredDaysOfWeek
http://hl7.org/fhir/ValueSet/days-of-week|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.whenrequiredEventTiming
http://hl7.org/fhir/ValueSet/event-timing|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.codepreferredVSDrugFrequency (a valid code from Drug Frequency Codes)
http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency
from this IG
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
MedicationRequest-DosageInstruction-1errorMedicationRequest.dosageInstruction.timingIf the Repeat Frequency does not exist then the Timing Code SHALL be present.
: repeat.frequency.exists().not() implies code.exists()
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
qty-3errorMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantityIf a code for the unit is present, the system SHALL also be present
: code.empty() or system.exists()
sqty-1errorMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantityThe comparator is not used on a SimpleQuantity
: comparator.empty()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf there's an offset, there must be a when (and not C, CM, CD, CV)
: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()

This structure is derived from MedicationRequestIPS

Summary

Mandatory: 7 elements(5 nested mandatory elements)
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of MedicationRequest.identifier
  • The element 1 is sliced based on the value of MedicationRequest.medication[x]
  • The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.dose[x]

 

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