SIL HIE Implementation Guide, published by Kathurima Kimathi. 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/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

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Resource Profile: HIE MedicationRequest

R4B MedicationRequest constrained for HIE ordering and e-prescribing. Focus on status, intent, medication, subject, timing, requester, reasons, dosage, dispense, substitution, and coverage.

Usages:

• Refer to this Profile: HIE MedicationDispense and HIE MedicationRequest
• Examples for this Profile: MedicationRequest/HIEMedicationRequest-example

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
MedicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationRequest.identifier		0..*	Identifier	External ids for this request
MedicationRequest.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
MedicationRequest.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
MedicationRequest.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
MedicationRequest.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
MedicationRequest.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
MedicationRequest.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	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.
MedicationRequest.intent	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
MedicationRequest.category	S This element must be supported. C	1..*	HIECodeableConcept	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. Constraints: cc-text-or-code
MedicationRequest.priority	S This element must be supported. Σ This element is included in summaries.	1..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
MedicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
MedicationRequest.Slices for medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1		Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationRequest.Slices for medication[x].medicationCodeableConcept			CodeableConcept
MedicationRequest.Slices for medication[x].medicationReference			Reference(Medication)
MedicationRequest.Slices for medication[x].medication[x]:medicationCodeableConcept	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Constraints: cc-text-or-code
MedicationRequest.Slices for medication[x].medication[x]:medicationReference	Σ This element is included in summaries.	0..1	HIEReference(Medication)	Medication to be taken
MedicationRequest.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	Who or group medication request is for
MedicationRequest.encounter		1..1	HIEReference(HIE Encounter)	Encounter created as part of encounter/admission/stay
MedicationRequest.supportingInformation		0..*	HIEReference(Resource)	Information to support ordering of the medication
MedicationRequest.authoredOn	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	When request was initially authored
MedicationRequest.requester	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | RelatedPerson | Device)	Who/What requested the Request
MedicationRequest.performer		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
MedicationRequest.performerType	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. Constraints: cc-text-or-code
MedicationRequest.recorder		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole)	Person who entered the request
MedicationRequest.reasonCode	C	0..*	HIECodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered. Constraints: cc-text-or-code
MedicationRequest.reasonReference		0..*	HIEReference(HIE Condition | HIE Observation)	Condition or observation that supports why the prescription is being written
MedicationRequest.basedOn	Σ This element is included in summaries.	0..*	HIEReference(CarePlan | HIE MedicationRequest | HIE ServiceRequest | ImmunizationRecommendation)	What request fulfills
MedicationRequest.courseOfTherapyType	C	0..1	HIECodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Constraints: cc-text-or-code
MedicationRequest.insurance		0..*	HIEReference(Coverage | HIE ClaimResponse)	Associated insurance coverage
MedicationRequest.note		0..*	HIEAnnotation	Information about the prescription
MedicationRequest.dosageInstruction	S This element must be supported.	1..*	Dosage	How the medication should be taken
MedicationRequest.dispenseRequest	S This element must be supported.	1..1	BackboneElement	Medication supply authorization
MedicationRequest.dispenseRequest.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.dispenseRequest.performer		0..1	HIEReference(HIE Organization)	Intended dispenser
MedicationRequest.priorPrescription		0..1	HIEReference(HIE MedicationRequest)	An order/prescription that is being replaced
MedicationRequest.detectedIssue		0..*	HIEReference(DetectedIssue)	Clinical Issue with action
MedicationRequest.eventHistory		0..*	HIEReference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationRequest.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
MedicationRequest.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
MedicationRequest.status	Base	required	medicationrequest Status	📍4.3.0	FHIR Std.
MedicationRequest.intent	Base	required	medicationRequest Intent	📍4.3.0	FHIR Std.
MedicationRequest.category	Base	example	medicationRequest Category Codes	📍4.3.0	FHIR Std.
MedicationRequest.priority	Base	required	RequestPriority	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.performerType	Base	example	Procedure Performer Role Codes	📍4.3.0	FHIR Std.
MedicationRequest.reasonCode	Base	example	Condition/Problem/Diagnosis Codes	📍4.3.0	FHIR Std.
MedicationRequest.courseOfTherapyType	Base	example	medicationRequest Course of Therapy Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	MedicationRequest.identifier.type, MedicationRequest.category, MedicationRequest.medication[x]:medicationCodeableConcept, MedicationRequest.performerType, MedicationRequest.reasonCode, MedicationRequest.courseOfTherapyType	Text is optional, coding is required	coding.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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
MedicationRequest.identifier
MedicationRequest.identifier.use		1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
MedicationRequest.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible)
MedicationRequest.identifier.system		1..1	uri	The namespace for the identifier value
MedicationRequest.identifier.value	S This element must be supported.	1..1	string	The value that is unique
MedicationRequest.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
MedicationRequest.status	S This element must be supported.	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
MedicationRequest.intent	S This element must be supported.	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
MedicationRequest.category	S This element must be supported.	1..*	HIECodeableConcept	Type of medication usage
MedicationRequest.priority	S This element must be supported.	1..1	code	routine | urgent | asap | stat
MedicationRequest.Slices for medication[x]	S This element must be supported.	1..1	CodeableConcept, Reference(Medication)	Medication to be taken Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationRequest.Slices for medication[x].medication[x]:medicationCodeableConcept		0..1	HIECodeableConcept	Medication to be taken
MedicationRequest.Slices for medication[x].medication[x]:medicationReference		0..1	HIEReference(Medication)	Medication to be taken
MedicationRequest.subject	S This element must be supported.	1..1	HIEReference(HIE Patient)	Who or group medication request is for
MedicationRequest.encounter		1..1	HIEReference(HIE Encounter)	Encounter created as part of encounter/admission/stay
MedicationRequest.supportingInformation		0..*	HIEReference(Resource)	Information to support ordering of the medication
MedicationRequest.authoredOn	S This element must be supported.	1..1	dateTime	When request was initially authored
MedicationRequest.requester	S This element must be supported.	1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | RelatedPerson | Device)	Who/What requested the Request
MedicationRequest.performer		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
MedicationRequest.performerType		0..1	HIECodeableConcept	Desired kind of performer of the medication administration
MedicationRequest.recorder		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole)	Person who entered the request
MedicationRequest.reasonCode		0..*	HIECodeableConcept	Reason or indication for ordering or not ordering the medication
MedicationRequest.reasonReference		0..*	HIEReference(HIE Condition | HIE Observation)	Condition or observation that supports why the prescription is being written
MedicationRequest.basedOn		0..*	HIEReference(CarePlan | HIE MedicationRequest | HIE ServiceRequest | ImmunizationRecommendation)	What request fulfills
MedicationRequest.courseOfTherapyType		0..1	HIECodeableConcept	Overall pattern of medication administration
MedicationRequest.insurance		0..*	HIEReference(Coverage | HIE ClaimResponse)	Associated insurance coverage
MedicationRequest.note		0..*	HIEAnnotation	Information about the prescription
MedicationRequest.dosageInstruction	S This element must be supported.	1..*	Dosage	How the medication should be taken
MedicationRequest.dispenseRequest	S This element must be supported.	1..1	BackboneElement	Medication supply authorization
MedicationRequest.dispenseRequest.performer		0..1	HIEReference(HIE Organization)	Intended dispenser
MedicationRequest.substitution
MedicationRequest.substitution.Slices for allowed[x]		1..1	boolean, CodeableConcept	Whether substitution is allowed or not Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
MedicationRequest.substitution.Slices for allowed[x].allowed[x]:allowedCodeableConcept		0..1	HIECodeableConcept	Whether substitution is allowed or not
MedicationRequest.substitution.reason		0..1	HIECodeableConcept	Why should (not) substitution be made
MedicationRequest.priorPrescription		0..1	HIEReference(HIE MedicationRequest)	An order/prescription that is being replaced
MedicationRequest.detectedIssue		0..*	HIEReference(DetectedIssue)	Clinical Issue with action
MedicationRequest.eventHistory		0..*	HIEReference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
MedicationRequest.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
MedicationRequest.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
MedicationRequest.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
MedicationRequest.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
MedicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationRequest.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
MedicationRequest.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
MedicationRequest.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationRequest.identifier		0..*	Identifier	External ids for this request
MedicationRequest.identifier.id		0..1	id	Unique id for inter-element referencing
MedicationRequest.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationRequest.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
MedicationRequest.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
MedicationRequest.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
MedicationRequest.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
MedicationRequest.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
MedicationRequest.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
MedicationRequest.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	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.
MedicationRequest.statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
MedicationRequest.intent	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
MedicationRequest.category	S This element must be supported. C	1..*	HIECodeableConcept	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. Constraints: cc-text-or-code
MedicationRequest.priority	S This element must be supported. Σ This element is included in summaries.	1..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
MedicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
MedicationRequest.reported[x]	Σ This element is included in summaries.	0..1		Reported rather than primary record
MedicationRequest.reported[x].reportedBoolean			boolean
MedicationRequest.reported[x].reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
MedicationRequest.Slices for medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1		Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationRequest.Slices for medication[x].medicationCodeableConcept			CodeableConcept
MedicationRequest.Slices for medication[x].medicationReference			Reference(Medication)
MedicationRequest.Slices for medication[x].medication[x]:medicationCodeableConcept	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Constraints: cc-text-or-code
MedicationRequest.Slices for medication[x].medication[x]:medicationReference	Σ This element is included in summaries.	0..1	HIEReference(Medication)	Medication to be taken
MedicationRequest.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	Who or group medication request is for
MedicationRequest.encounter		1..1	HIEReference(HIE Encounter)	Encounter created as part of encounter/admission/stay
MedicationRequest.supportingInformation		0..*	HIEReference(Resource)	Information to support ordering of the medication
MedicationRequest.authoredOn	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	When request was initially authored
MedicationRequest.requester	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | RelatedPerson | Device)	Who/What requested the Request
MedicationRequest.performer		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
MedicationRequest.performerType	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. Constraints: cc-text-or-code
MedicationRequest.recorder		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole)	Person who entered the request
MedicationRequest.reasonCode	C	0..*	HIECodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered. Constraints: cc-text-or-code
MedicationRequest.reasonReference		0..*	HIEReference(HIE Condition | HIE Observation)	Condition or observation that supports why the prescription is being written
MedicationRequest.instantiatesCanonical	Σ This element is included in summaries.	0..*	canonical()	Instantiates FHIR protocol or definition
MedicationRequest.instantiatesUri	Σ This element is included in summaries.	0..*	uri	Instantiates external protocol or definition
MedicationRequest.basedOn	Σ This element is included in summaries.	0..*	HIEReference(CarePlan | HIE MedicationRequest | HIE ServiceRequest | ImmunizationRecommendation)	What request fulfills
MedicationRequest.groupIdentifier	Σ This element is included in summaries.	0..1	Identifier	Composite request this is part of
MedicationRequest.courseOfTherapyType	C	0..1	HIECodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Constraints: cc-text-or-code
MedicationRequest.insurance		0..*	HIEReference(Coverage | HIE ClaimResponse)	Associated insurance coverage
MedicationRequest.note		0..*	HIEAnnotation	Information about the prescription
MedicationRequest.dosageInstruction	S This element must be supported.	1..*	Dosage	How the medication should be taken
MedicationRequest.dispenseRequest	S This element must be supported.	1..1	BackboneElement	Medication supply authorization
MedicationRequest.dispenseRequest.id		0..1	string	Unique id for inter-element referencing
MedicationRequest.dispenseRequest.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.dispenseRequest.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.dispenseRequest.initialFill		0..1	BackboneElement	First fill details
MedicationRequest.dispenseRequest.initialFill.id		0..1	string	Unique id for inter-element referencing
MedicationRequest.dispenseRequest.initialFill.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.dispenseRequest.initialFill.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.dispenseRequest.initialFill.quantity	C	0..1	SimpleQuantity(4.3.0)	First fill quantity Constraints: sqty-1
MedicationRequest.dispenseRequest.initialFill.duration		0..1	Duration	First fill duration
MedicationRequest.dispenseRequest.dispenseInterval		0..1	Duration	Minimum period of time between dispenses
MedicationRequest.dispenseRequest.validityPeriod		0..1	Period	Time period supply is authorized for
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized
MedicationRequest.dispenseRequest.quantity	C	0..1	SimpleQuantity(4.3.0)	Amount of medication to supply per dispense Constraints: sqty-1
MedicationRequest.dispenseRequest.expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
MedicationRequest.dispenseRequest.performer		0..1	HIEReference(HIE Organization)	Intended dispenser
MedicationRequest.substitution		0..1	BackboneElement	Any restrictions on medication substitution
MedicationRequest.substitution.id		0..1	string	Unique id for inter-element referencing
MedicationRequest.substitution.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.substitution.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.substitution.Slices for allowed[x]		1..1		Whether substitution is allowed or not Slice: Unordered, Closed by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
MedicationRequest.substitution.Slices for allowed[x].allowedBoolean			boolean
MedicationRequest.substitution.Slices for allowed[x].allowedCodeableConcept			CodeableConcept
MedicationRequest.substitution.Slices for allowed[x].allowed[x]:allowedCodeableConcept	C	0..1	HIECodeableConcept	Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. Constraints: cc-text-or-code
MedicationRequest.substitution.reason	C	0..1	HIECodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason Constraints: cc-text-or-code
MedicationRequest.priorPrescription		0..1	HIEReference(HIE MedicationRequest)	An order/prescription that is being replaced
MedicationRequest.detectedIssue		0..*	HIEReference(DetectedIssue)	Clinical Issue with action
MedicationRequest.eventHistory		0..*	HIEReference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationRequest.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
MedicationRequest.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
MedicationRequest.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
MedicationRequest.status	Base	required	medicationrequest Status	📍4.3.0	FHIR Std.
MedicationRequest.statusReason	Base	example	medicationRequest Status Reason Codes	📍4.3.0	FHIR Std.
MedicationRequest.intent	Base	required	medicationRequest Intent	📍4.3.0	FHIR Std.
MedicationRequest.category	Base	example	medicationRequest Category Codes	📍4.3.0	FHIR Std.
MedicationRequest.priority	Base	required	RequestPriority	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.performerType	Base	example	Procedure Performer Role Codes	📍4.3.0	FHIR Std.
MedicationRequest.reasonCode	Base	example	Condition/Problem/Diagnosis Codes	📍4.3.0	FHIR Std.
MedicationRequest.courseOfTherapyType	Base	example	medicationRequest Course of Therapy Codes	📍4.3.0	FHIR Std.
MedicationRequest.substitution.​allowed[x]	Base	example	ActSubstanceAdminSubstitutionCode	📦3.0.0	THO v7.4
MedicationRequest.substitution.​allowed[x]:allowedCodeableConcept	Base	example	ActSubstanceAdminSubstitutionCode	📦3.0.0	THO v7.4
MedicationRequest.substitution.​reason	Base	example	SubstanceAdminSubstitutionReason	📦3.0.0	THO v7.4

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	MedicationRequest.identifier.type, MedicationRequest.category, MedicationRequest.medication[x]:medicationCodeableConcept, MedicationRequest.performerType, MedicationRequest.reasonCode, MedicationRequest.courseOfTherapyType, MedicationRequest.substitution.allowed[x]:allowedCodeableConcept, MedicationRequest.substitution.reason	Text is optional, coding is required	coding.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.exists() and ('#'+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(uri) = '#').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()
dom-r4b	warning	MedicationRequest.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()
sqty-1	error	MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.quantity	The comparator is not used on a SimpleQuantity	comparator.empty()

This structure is derived from MedicationRequest

Summary

Mandatory: 9 elements(4 nested mandatory elements)
Must-Support: 12 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)
• HIE Encounter (https://nshr.dha.go.ke/fhir/StructureDefinition/encounter)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)
• HIE PractitionerRole (https://nshr.dha.go.ke/fhir/StructureDefinition/practitionerrole)
• HIE Condition (https://nshr.dha.go.ke/fhir/StructureDefinition/condition)
• HIE Observation (https://nshr.dha.go.ke/fhir/StructureDefinition/observation)
• HIE MedicationRequest (https://nshr.dha.go.ke/fhir/StructureDefinition/medicationrequest)
• HIE ServiceRequest (https://nshr.dha.go.ke/fhir/StructureDefinition/servicerequest)
• HIE ClaimResponse (https://nshr.dha.go.ke/fhir/StructureDefinition/claimresponse)
• HIE Annotation (https://nshr.dha.go.ke/fhir/StructureDefinition/annotation)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.medication[x]
• The element 1 is sliced based on the value of MedicationRequest.substitution.allowed[x]

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
MedicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationRequest.identifier		0..*	Identifier	External ids for this request
MedicationRequest.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
MedicationRequest.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
MedicationRequest.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
MedicationRequest.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
MedicationRequest.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
MedicationRequest.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	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.
MedicationRequest.intent	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
MedicationRequest.category	S This element must be supported. C	1..*	HIECodeableConcept	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. Constraints: cc-text-or-code
MedicationRequest.priority	S This element must be supported. Σ This element is included in summaries.	1..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
MedicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
MedicationRequest.Slices for medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1		Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationRequest.Slices for medication[x].medicationCodeableConcept			CodeableConcept
MedicationRequest.Slices for medication[x].medicationReference			Reference(Medication)
MedicationRequest.Slices for medication[x].medication[x]:medicationCodeableConcept	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Constraints: cc-text-or-code
MedicationRequest.Slices for medication[x].medication[x]:medicationReference	Σ This element is included in summaries.	0..1	HIEReference(Medication)	Medication to be taken
MedicationRequest.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	Who or group medication request is for
MedicationRequest.encounter		1..1	HIEReference(HIE Encounter)	Encounter created as part of encounter/admission/stay
MedicationRequest.supportingInformation		0..*	HIEReference(Resource)	Information to support ordering of the medication
MedicationRequest.authoredOn	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	When request was initially authored
MedicationRequest.requester	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | RelatedPerson | Device)	Who/What requested the Request
MedicationRequest.performer		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
MedicationRequest.performerType	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. Constraints: cc-text-or-code
MedicationRequest.recorder		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole)	Person who entered the request
MedicationRequest.reasonCode	C	0..*	HIECodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered. Constraints: cc-text-or-code
MedicationRequest.reasonReference		0..*	HIEReference(HIE Condition | HIE Observation)	Condition or observation that supports why the prescription is being written
MedicationRequest.basedOn	Σ This element is included in summaries.	0..*	HIEReference(CarePlan | HIE MedicationRequest | HIE ServiceRequest | ImmunizationRecommendation)	What request fulfills
MedicationRequest.courseOfTherapyType	C	0..1	HIECodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Constraints: cc-text-or-code
MedicationRequest.insurance		0..*	HIEReference(Coverage | HIE ClaimResponse)	Associated insurance coverage
MedicationRequest.note		0..*	HIEAnnotation	Information about the prescription
MedicationRequest.dosageInstruction	S This element must be supported.	1..*	Dosage	How the medication should be taken
MedicationRequest.dispenseRequest	S This element must be supported.	1..1	BackboneElement	Medication supply authorization
MedicationRequest.dispenseRequest.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.dispenseRequest.performer		0..1	HIEReference(HIE Organization)	Intended dispenser
MedicationRequest.priorPrescription		0..1	HIEReference(HIE MedicationRequest)	An order/prescription that is being replaced
MedicationRequest.detectedIssue		0..*	HIEReference(DetectedIssue)	Clinical Issue with action
MedicationRequest.eventHistory		0..*	HIEReference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationRequest.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
MedicationRequest.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
MedicationRequest.status	Base	required	medicationrequest Status	📍4.3.0	FHIR Std.
MedicationRequest.intent	Base	required	medicationRequest Intent	📍4.3.0	FHIR Std.
MedicationRequest.category	Base	example	medicationRequest Category Codes	📍4.3.0	FHIR Std.
MedicationRequest.priority	Base	required	RequestPriority	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.performerType	Base	example	Procedure Performer Role Codes	📍4.3.0	FHIR Std.
MedicationRequest.reasonCode	Base	example	Condition/Problem/Diagnosis Codes	📍4.3.0	FHIR Std.
MedicationRequest.courseOfTherapyType	Base	example	medicationRequest Course of Therapy Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	MedicationRequest.identifier.type, MedicationRequest.category, MedicationRequest.medication[x]:medicationCodeableConcept, MedicationRequest.performerType, MedicationRequest.reasonCode, MedicationRequest.courseOfTherapyType	Text is optional, coding is required	coding.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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
MedicationRequest.identifier
MedicationRequest.identifier.use		1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
MedicationRequest.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible)
MedicationRequest.identifier.system		1..1	uri	The namespace for the identifier value
MedicationRequest.identifier.value	S This element must be supported.	1..1	string	The value that is unique
MedicationRequest.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
MedicationRequest.status	S This element must be supported.	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
MedicationRequest.intent	S This element must be supported.	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
MedicationRequest.category	S This element must be supported.	1..*	HIECodeableConcept	Type of medication usage
MedicationRequest.priority	S This element must be supported.	1..1	code	routine | urgent | asap | stat
MedicationRequest.Slices for medication[x]	S This element must be supported.	1..1	CodeableConcept, Reference(Medication)	Medication to be taken Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationRequest.Slices for medication[x].medication[x]:medicationCodeableConcept		0..1	HIECodeableConcept	Medication to be taken
MedicationRequest.Slices for medication[x].medication[x]:medicationReference		0..1	HIEReference(Medication)	Medication to be taken
MedicationRequest.subject	S This element must be supported.	1..1	HIEReference(HIE Patient)	Who or group medication request is for
MedicationRequest.encounter		1..1	HIEReference(HIE Encounter)	Encounter created as part of encounter/admission/stay
MedicationRequest.supportingInformation		0..*	HIEReference(Resource)	Information to support ordering of the medication
MedicationRequest.authoredOn	S This element must be supported.	1..1	dateTime	When request was initially authored
MedicationRequest.requester	S This element must be supported.	1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | RelatedPerson | Device)	Who/What requested the Request
MedicationRequest.performer		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
MedicationRequest.performerType		0..1	HIECodeableConcept	Desired kind of performer of the medication administration
MedicationRequest.recorder		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole)	Person who entered the request
MedicationRequest.reasonCode		0..*	HIECodeableConcept	Reason or indication for ordering or not ordering the medication
MedicationRequest.reasonReference		0..*	HIEReference(HIE Condition | HIE Observation)	Condition or observation that supports why the prescription is being written
MedicationRequest.basedOn		0..*	HIEReference(CarePlan | HIE MedicationRequest | HIE ServiceRequest | ImmunizationRecommendation)	What request fulfills
MedicationRequest.courseOfTherapyType		0..1	HIECodeableConcept	Overall pattern of medication administration
MedicationRequest.insurance		0..*	HIEReference(Coverage | HIE ClaimResponse)	Associated insurance coverage
MedicationRequest.note		0..*	HIEAnnotation	Information about the prescription
MedicationRequest.dosageInstruction	S This element must be supported.	1..*	Dosage	How the medication should be taken
MedicationRequest.dispenseRequest	S This element must be supported.	1..1	BackboneElement	Medication supply authorization
MedicationRequest.dispenseRequest.performer		0..1	HIEReference(HIE Organization)	Intended dispenser
MedicationRequest.substitution
MedicationRequest.substitution.Slices for allowed[x]		1..1	boolean, CodeableConcept	Whether substitution is allowed or not Slice: Unordered, Open by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
MedicationRequest.substitution.Slices for allowed[x].allowed[x]:allowedCodeableConcept		0..1	HIECodeableConcept	Whether substitution is allowed or not
MedicationRequest.substitution.reason		0..1	HIECodeableConcept	Why should (not) substitution be made
MedicationRequest.priorPrescription		0..1	HIEReference(HIE MedicationRequest)	An order/prescription that is being replaced
MedicationRequest.detectedIssue		0..*	HIEReference(DetectedIssue)	Clinical Issue with action
MedicationRequest.eventHistory		0..*	HIEReference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
MedicationRequest.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
MedicationRequest.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
MedicationRequest.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
MedicationRequest.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
MedicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationRequest.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
MedicationRequest.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
MedicationRequest.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationRequest.identifier		0..*	Identifier	External ids for this request
MedicationRequest.identifier.id		0..1	id	Unique id for inter-element referencing
MedicationRequest.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationRequest.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
MedicationRequest.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
MedicationRequest.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
MedicationRequest.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
MedicationRequest.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
MedicationRequest.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
MedicationRequest.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	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.
MedicationRequest.statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
MedicationRequest.intent	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
MedicationRequest.category	S This element must be supported. C	1..*	HIECodeableConcept	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. Constraints: cc-text-or-code
MedicationRequest.priority	S This element must be supported. Σ This element is included in summaries.	1..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
MedicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
MedicationRequest.reported[x]	Σ This element is included in summaries.	0..1		Reported rather than primary record
MedicationRequest.reported[x].reportedBoolean			boolean
MedicationRequest.reported[x].reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
MedicationRequest.Slices for medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1		Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationRequest.Slices for medication[x].medicationCodeableConcept			CodeableConcept
MedicationRequest.Slices for medication[x].medicationReference			Reference(Medication)
MedicationRequest.Slices for medication[x].medication[x]:medicationCodeableConcept	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. Constraints: cc-text-or-code
MedicationRequest.Slices for medication[x].medication[x]:medicationReference	Σ This element is included in summaries.	0..1	HIEReference(Medication)	Medication to be taken
MedicationRequest.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	Who or group medication request is for
MedicationRequest.encounter		1..1	HIEReference(HIE Encounter)	Encounter created as part of encounter/admission/stay
MedicationRequest.supportingInformation		0..*	HIEReference(Resource)	Information to support ordering of the medication
MedicationRequest.authoredOn	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	When request was initially authored
MedicationRequest.requester	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | RelatedPerson | Device)	Who/What requested the Request
MedicationRequest.performer		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Organization | HIE Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
MedicationRequest.performerType	Σ This element is included in summaries. C	0..1	HIECodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. Constraints: cc-text-or-code
MedicationRequest.recorder		1..1	HIEReference(HIE Practitioner | HIE PractitionerRole)	Person who entered the request
MedicationRequest.reasonCode	C	0..*	HIECodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered. Constraints: cc-text-or-code
MedicationRequest.reasonReference		0..*	HIEReference(HIE Condition | HIE Observation)	Condition or observation that supports why the prescription is being written
MedicationRequest.instantiatesCanonical	Σ This element is included in summaries.	0..*	canonical()	Instantiates FHIR protocol or definition
MedicationRequest.instantiatesUri	Σ This element is included in summaries.	0..*	uri	Instantiates external protocol or definition
MedicationRequest.basedOn	Σ This element is included in summaries.	0..*	HIEReference(CarePlan | HIE MedicationRequest | HIE ServiceRequest | ImmunizationRecommendation)	What request fulfills
MedicationRequest.groupIdentifier	Σ This element is included in summaries.	0..1	Identifier	Composite request this is part of
MedicationRequest.courseOfTherapyType	C	0..1	HIECodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Constraints: cc-text-or-code
MedicationRequest.insurance		0..*	HIEReference(Coverage | HIE ClaimResponse)	Associated insurance coverage
MedicationRequest.note		0..*	HIEAnnotation	Information about the prescription
MedicationRequest.dosageInstruction	S This element must be supported.	1..*	Dosage	How the medication should be taken
MedicationRequest.dispenseRequest	S This element must be supported.	1..1	BackboneElement	Medication supply authorization
MedicationRequest.dispenseRequest.id		0..1	string	Unique id for inter-element referencing
MedicationRequest.dispenseRequest.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.dispenseRequest.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.dispenseRequest.initialFill		0..1	BackboneElement	First fill details
MedicationRequest.dispenseRequest.initialFill.id		0..1	string	Unique id for inter-element referencing
MedicationRequest.dispenseRequest.initialFill.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.dispenseRequest.initialFill.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.dispenseRequest.initialFill.quantity	C	0..1	SimpleQuantity(4.3.0)	First fill quantity Constraints: sqty-1
MedicationRequest.dispenseRequest.initialFill.duration		0..1	Duration	First fill duration
MedicationRequest.dispenseRequest.dispenseInterval		0..1	Duration	Minimum period of time between dispenses
MedicationRequest.dispenseRequest.validityPeriod		0..1	Period	Time period supply is authorized for
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized
MedicationRequest.dispenseRequest.quantity	C	0..1	SimpleQuantity(4.3.0)	Amount of medication to supply per dispense Constraints: sqty-1
MedicationRequest.dispenseRequest.expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
MedicationRequest.dispenseRequest.performer		0..1	HIEReference(HIE Organization)	Intended dispenser
MedicationRequest.substitution		0..1	BackboneElement	Any restrictions on medication substitution
MedicationRequest.substitution.id		0..1	string	Unique id for inter-element referencing
MedicationRequest.substitution.extension		0..*	Extension	Additional content defined by implementations
MedicationRequest.substitution.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationRequest.substitution.Slices for allowed[x]		1..1		Whether substitution is allowed or not Slice: Unordered, Closed by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them Other type slices that contain no new information are not shown in this view
MedicationRequest.substitution.Slices for allowed[x].allowedBoolean			boolean
MedicationRequest.substitution.Slices for allowed[x].allowedCodeableConcept			CodeableConcept
MedicationRequest.substitution.Slices for allowed[x].allowed[x]:allowedCodeableConcept	C	0..1	HIECodeableConcept	Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. Constraints: cc-text-or-code
MedicationRequest.substitution.reason	C	0..1	HIECodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason Constraints: cc-text-or-code
MedicationRequest.priorPrescription		0..1	HIEReference(HIE MedicationRequest)	An order/prescription that is being replaced
MedicationRequest.detectedIssue		0..*	HIEReference(DetectedIssue)	Clinical Issue with action
MedicationRequest.eventHistory		0..*	HIEReference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationRequest.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
MedicationRequest.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
MedicationRequest.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
MedicationRequest.status	Base	required	medicationrequest Status	📍4.3.0	FHIR Std.
MedicationRequest.statusReason	Base	example	medicationRequest Status Reason Codes	📍4.3.0	FHIR Std.
MedicationRequest.intent	Base	required	medicationRequest Intent	📍4.3.0	FHIR Std.
MedicationRequest.category	Base	example	medicationRequest Category Codes	📍4.3.0	FHIR Std.
MedicationRequest.priority	Base	required	RequestPriority	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.medication[x]:medicationCodeableConcept	Base	example	SNOMED CT Medication Codes	📍4.3.0	FHIR Std.
MedicationRequest.performerType	Base	example	Procedure Performer Role Codes	📍4.3.0	FHIR Std.
MedicationRequest.reasonCode	Base	example	Condition/Problem/Diagnosis Codes	📍4.3.0	FHIR Std.
MedicationRequest.courseOfTherapyType	Base	example	medicationRequest Course of Therapy Codes	📍4.3.0	FHIR Std.
MedicationRequest.substitution.​allowed[x]	Base	example	ActSubstanceAdminSubstitutionCode	📦3.0.0	THO v7.4
MedicationRequest.substitution.​allowed[x]:allowedCodeableConcept	Base	example	ActSubstanceAdminSubstitutionCode	📦3.0.0	THO v7.4
MedicationRequest.substitution.​reason	Base	example	SubstanceAdminSubstitutionReason	📦3.0.0	THO v7.4

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	MedicationRequest.identifier.type, MedicationRequest.category, MedicationRequest.medication[x]:medicationCodeableConcept, MedicationRequest.performerType, MedicationRequest.reasonCode, MedicationRequest.courseOfTherapyType, MedicationRequest.substitution.allowed[x]:allowedCodeableConcept, MedicationRequest.substitution.reason	Text is optional, coding is required	coding.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.exists() and ('#'+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(uri) = '#').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()
dom-r4b	warning	MedicationRequest.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()
sqty-1	error	MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.quantity	The comparator is not used on a SimpleQuantity	comparator.empty()

This structure is derived from MedicationRequest

Summary

Mandatory: 9 elements(4 nested mandatory elements)
Must-Support: 12 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)
• HIE Encounter (https://nshr.dha.go.ke/fhir/StructureDefinition/encounter)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)
• HIE PractitionerRole (https://nshr.dha.go.ke/fhir/StructureDefinition/practitionerrole)
• HIE Condition (https://nshr.dha.go.ke/fhir/StructureDefinition/condition)
• HIE Observation (https://nshr.dha.go.ke/fhir/StructureDefinition/observation)
• HIE MedicationRequest (https://nshr.dha.go.ke/fhir/StructureDefinition/medicationrequest)
• HIE ServiceRequest (https://nshr.dha.go.ke/fhir/StructureDefinition/servicerequest)
• HIE ClaimResponse (https://nshr.dha.go.ke/fhir/StructureDefinition/claimresponse)
• HIE Annotation (https://nshr.dha.go.ke/fhir/StructureDefinition/annotation)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.medication[x]
• The element 1 is sliced based on the value of MedicationRequest.substitution.allowed[x]

Other representations of profile: CSV, Excel, Schematron