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

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Resource Profile: Medication Request

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

Usage:

• Use this Resource Profile: HHIMS Transactional Bundle
• Refer to this Resource Profile: Drug Dispensation
• Examples for this Resource Profile: MedicationRequest/MedicationRequestsExample and MedicationRequest/MedicationRequestsWithCodedFrequencyExample

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 MedicationRequestIPS

Name	Flags	Card.	Type	Description & Constraints
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:$this
medication[x]:medicationCodeableConcept		1..1	CodeableConcept	Medication to be taken Binding: Medication Names For Pharmacy (extensible) Additional Bindings Purpose Medication Names Not For Pharmacy Extensible
subject		1..1	Reference(Patient)	Who or group medication request is for
encounter		1..1	Reference(Target Facility Encounter)	Encounter created as part of encounter/admission/stay
authoredOn		1..1	dateTime	When request was initially authored
requester	S	0..1	Reference(Practitioner | Patient | Device Information)	Who/What requested the Request
performer	S	0..1	Reference(Practitioner | Patient | Device Information)	Intended performer of administration
recorder	S	0..1	Reference(Practitioner)	Person who entered the request
note	S	0..*	Annotation	Information about the prescription
dosageInstruction
timing	C	0..1	Timing	When medication should be administered MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
repeat
count		1..1	positiveInt	Number of times to repeat
duration		1..1	decimal	How long when it happens
durationUnit		1..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM)
frequency	S	0..1	positiveInt	Event occurs frequency times per period
period	S	0..1	decimal	Event occurs frequency times per period
periodUnit	S	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM)
code	S	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: Drug Frequency Codes (preferred)
doseAndRate
Slices for dose[x]		1..1	SimpleQuantity	Amount of medication per dose Slice: Unordered, Open by type:$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
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationRequest.medication[x]:medicationCodeableConcept	extensible	VSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy) http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd from this IG
MedicationRequest.dosageInstruction.timing.code	preferred	VSDrugFrequency (a valid code from Drug Frequency Codes) http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
MedicationRequest-DosageInstruction-1	error	MedicationRequest.dosageInstruction.timing	If the Repeat Frequency does not exist then the Timing Code SHALL be present. : repeat.frequency.exists().not() implies code.exists()

Name	Flags	Card.	Type	Description & Constraints
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
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]	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 Bindings Purpose 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
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]	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConcept	extensible	VSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy) http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd from this IG
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	VSDrugFrequency (a valid code from Drug Frequency Codes) http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency from this IG

Constraints

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

Name	Flags	Card.	Type	Description & Constraints
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 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		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 Bindings Purpose 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
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]	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConcept	extensible	VSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy) http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd from this IG
MedicationRequest.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types 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.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	required	DaysOfWeek http://hl7.org/fhir/ValueSet/days-of-week|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	VSDrugFrequency (a valid code from Drug Frequency Codes) http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency from this IG
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type 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
MedicationRequest-DosageInstruction-1	error	MedicationRequest.dosageInstruction.timing	If the Repeat Frequency does not exist then the Timing Code SHALL be present. : repeat.frequency.exists().not() implies code.exists()
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()
qty-3	error	MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity	The comparator is not used on a SimpleQuantity : comparator.empty()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()

This structure is derived from MedicationRequestIPS

Summary

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

Structures

This structure refers to these other structures:

• Patient (http://fhir.health.gov.lk/ips/StructureDefinition/ips-patient)
• Target Facility Encounter (http://fhir.health.gov.lk/ips/StructureDefinition/target-facility-encounter)
• Practitioner (http://fhir.health.gov.lk/ips/StructureDefinition/practitioner)
• Device Information (http://fhir.health.gov.lk/ips/StructureDefinition/device-information)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

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

Name	Flags	Card.	Type	Description & Constraints
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:$this
medication[x]:medicationCodeableConcept		1..1	CodeableConcept	Medication to be taken Binding: Medication Names For Pharmacy (extensible) Additional Bindings Purpose Medication Names Not For Pharmacy Extensible
subject		1..1	Reference(Patient)	Who or group medication request is for
encounter		1..1	Reference(Target Facility Encounter)	Encounter created as part of encounter/admission/stay
authoredOn		1..1	dateTime	When request was initially authored
requester	S	0..1	Reference(Practitioner | Patient | Device Information)	Who/What requested the Request
performer	S	0..1	Reference(Practitioner | Patient | Device Information)	Intended performer of administration
recorder	S	0..1	Reference(Practitioner)	Person who entered the request
note	S	0..*	Annotation	Information about the prescription
dosageInstruction
timing	C	0..1	Timing	When medication should be administered MedicationRequest-DosageInstruction-1: If the Repeat Frequency does not exist then the Timing Code SHALL be present.
repeat
count		1..1	positiveInt	Number of times to repeat
duration		1..1	decimal	How long when it happens
durationUnit		1..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM)
frequency	S	0..1	positiveInt	Event occurs frequency times per period
period	S	0..1	decimal	Event occurs frequency times per period
periodUnit	S	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM)
code	S	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: Drug Frequency Codes (preferred)
doseAndRate
Slices for dose[x]		1..1	SimpleQuantity	Amount of medication per dose Slice: Unordered, Open by type:$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
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationRequest.medication[x]:medicationCodeableConcept	extensible	VSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy) http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd from this IG
MedicationRequest.dosageInstruction.timing.code	preferred	VSDrugFrequency (a valid code from Drug Frequency Codes) http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
MedicationRequest-DosageInstruction-1	error	MedicationRequest.dosageInstruction.timing	If the Repeat Frequency does not exist then the Timing Code SHALL be present. : repeat.frequency.exists().not() implies code.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
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
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]	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 Bindings Purpose 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
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]	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConcept	extensible	VSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy) http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd from this IG
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	VSDrugFrequency (a valid code from Drug Frequency Codes) http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency from this IG

Constraints

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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
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 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		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 Bindings Purpose 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
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]	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
MedicationRequest.medication[x]:medicationCodeableConcept	extensible	VSMedicationNamesForMSD (a valid code from Medication Names For Pharmacy) http://fhir.health.gov.lk/ips/ValueSet/vs-medication-name-msd from this IG
MedicationRequest.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types 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.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	required	DaysOfWeek http://hl7.org/fhir/ValueSet/days-of-week|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	VSDrugFrequency (a valid code from Drug Frequency Codes) http://fhir.health.gov.lk/ips/ValueSet/vs-drug-frequency from this IG
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type 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
MedicationRequest-DosageInstruction-1	error	MedicationRequest.dosageInstruction.timing	If the Repeat Frequency does not exist then the Timing Code SHALL be present. : repeat.frequency.exists().not() implies code.exists()
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()
qty-3	error	MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity	The comparator is not used on a SimpleQuantity : comparator.empty()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()

This structure is derived from MedicationRequestIPS

Summary

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

Structures

This structure refers to these other structures:

• Patient (http://fhir.health.gov.lk/ips/StructureDefinition/ips-patient)
• Target Facility Encounter (http://fhir.health.gov.lk/ips/StructureDefinition/target-facility-encounter)
• Practitioner (http://fhir.health.gov.lk/ips/StructureDefinition/practitioner)
• Device Information (http://fhir.health.gov.lk/ips/StructureDefinition/device-information)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

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]