New Zealand Rheumatic Fever FHIR Implementation Guide
1.0.0 - draft

New Zealand Rheumatic Fever FHIR Implementation Guide, published by Te Whatu Ora. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/fhir-rheumatic-fever/ and changes regularly. See the Directory of published versions

Resource Profile: Rheumatic Fever Medication Request

Official URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/nz-rheumaticfever-medicationrequest Version: 1.0.0
Draft as of 2024-09-26 Computable Name: RheumaticFeverMedicationRequest

Describes medication planned for a rheumatic fever patient over a period of time. Referenced as an activity in rheumatic fever care plans. Includes an extension defining the medication frequency which determines the scheduling intervals for Appointments.

Controls values of medication frequency (secondary prophylaxis appointments) to a set of standard frequency intervals used in NZ RF care.

Usage:

Formal Views of Profile Content

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

This structure is derived from NzMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest NzMedicationRequest
... meta C 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... Slices for extension Content/Rules for all slices
.... medicationFrequency 0..1 Coding Sets a standard interval between RF secondary prophylaxis medication appointments.
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-medicationrequest-medicationfrequency
Binding: Rheumatic fever planned medication frequency codes (required)
... dosageInstruction
.... extension 0..0
.... modifierExtension 0..0
.... sequence 0..0
.... asNeeded[x] 0..0
.... site 0..1 CodeableConcept Body site to administer to
.... route 0..1 CodeableConcept How drug should enter body
.... method 0..0

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
RFNZTagConstrainterrorMedicationRequest.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* NzMedicationRequest Ordering of medication for patient or group
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... nzeps-long-term-medication 0..1 boolean NZePS Long Term Medication Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-long-term-medication
.... nzeps-supply-period-reason 0..1 string NZePS Supply Period Reason
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-supply-period-reason
.... nzeps-unusual-dose-quantity 0..1 boolean NZePS Unusual Dose Quantity Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-unusual-dose-quantity
.... medicationFrequency 0..1 Coding Sets a standard interval between RF secondary prophylaxis medication appointments.
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-medicationrequest-medicationfrequency
Binding: Rheumatic fever planned medication frequency codes (required)
... status ?!Σ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... intent ?!Σ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... Slices for medication[x] Σ 1..1 Medication to be taken
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
.... medication[x]:medicationCodeableConcept Σ 0..1 CodeableConcept Medication to be taken
Binding: http://nzmt.org.nz/vs (preferred)
... subject Σ 1..1 Reference(Patient | Group) Who or group medication request is for

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]exampleSNOMEDCTMedicationCodes
http://hl7.org/fhir/ValueSet/medication-codes
from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConceptpreferredhttp://nzmt.org.nz/vs
http://nzmt.org.nz/vs

Constraints

IdGradePath(s)DetailsRequirements
RFNZTagConstrainterrorMedicationRequest.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* NzMedicationRequest Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... nzeps-long-term-medication 0..1 boolean NZePS Long Term Medication Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-long-term-medication
.... nzeps-supply-period-reason 0..1 string NZePS Supply Period Reason
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-supply-period-reason
.... nzeps-unusual-dose-quantity 0..1 boolean NZePS Unusual Dose Quantity Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-unusual-dose-quantity
.... medicationFrequency 0..1 Coding Sets a standard interval between RF secondary prophylaxis medication appointments.
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-medicationrequest-medicationfrequency
Binding: Rheumatic fever planned medication frequency codes (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External ids for this request
... status ?!Σ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!Σ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... Slices for medication[x] Σ 1..1 Medication to be taken
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
.... medication[x]:medicationCodeableConcept Σ 0..1 CodeableConcept Medication to be taken
Binding: http://nzmt.org.nz/vs (preferred)
... subject Σ 1..1 Reference(Patient | Group) Who or group medication request is for
... encounter 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn Σ 0..1 dateTime When request was initially authored
... requester Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... 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 0..* Annotation Information about the prescription
... dosageInstruction 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..0
.... text Σ 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 Σ 0..1 Timing When medication should be administered
.... 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 Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

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

..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

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

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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]exampleSNOMEDCTMedicationCodes
http://hl7.org/fhir/ValueSet/medication-codes
from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConceptpreferredhttp://nzmt.org.nz/vs
http://nzmt.org.nz/vs
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
RFNZTagConstrainterrorMedicationRequest.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

This structure is derived from NzMedicationRequest

Summary

Prohibited: 5 elements

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from NzMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest NzMedicationRequest
... meta C 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... Slices for extension Content/Rules for all slices
.... medicationFrequency 0..1 Coding Sets a standard interval between RF secondary prophylaxis medication appointments.
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-medicationrequest-medicationfrequency
Binding: Rheumatic fever planned medication frequency codes (required)
... dosageInstruction
.... extension 0..0
.... modifierExtension 0..0
.... sequence 0..0
.... asNeeded[x] 0..0
.... site 0..1 CodeableConcept Body site to administer to
.... route 0..1 CodeableConcept How drug should enter body
.... method 0..0

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
RFNZTagConstrainterrorMedicationRequest.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* NzMedicationRequest Ordering of medication for patient or group
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... nzeps-long-term-medication 0..1 boolean NZePS Long Term Medication Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-long-term-medication
.... nzeps-supply-period-reason 0..1 string NZePS Supply Period Reason
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-supply-period-reason
.... nzeps-unusual-dose-quantity 0..1 boolean NZePS Unusual Dose Quantity Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-unusual-dose-quantity
.... medicationFrequency 0..1 Coding Sets a standard interval between RF secondary prophylaxis medication appointments.
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-medicationrequest-medicationfrequency
Binding: Rheumatic fever planned medication frequency codes (required)
... status ?!Σ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... intent ?!Σ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... Slices for medication[x] Σ 1..1 Medication to be taken
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
.... medication[x]:medicationCodeableConcept Σ 0..1 CodeableConcept Medication to be taken
Binding: http://nzmt.org.nz/vs (preferred)
... subject Σ 1..1 Reference(Patient | Group) Who or group medication request is for

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]exampleSNOMEDCTMedicationCodes
http://hl7.org/fhir/ValueSet/medication-codes
from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConceptpreferredhttp://nzmt.org.nz/vs
http://nzmt.org.nz/vs

Constraints

IdGradePath(s)DetailsRequirements
RFNZTagConstrainterrorMedicationRequest.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* NzMedicationRequest Ordering of medication for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta ΣC 0..1 Meta Metadata about the resource
RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... nzeps-long-term-medication 0..1 boolean NZePS Long Term Medication Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-long-term-medication
.... nzeps-supply-period-reason 0..1 string NZePS Supply Period Reason
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-supply-period-reason
.... nzeps-unusual-dose-quantity 0..1 boolean NZePS Unusual Dose Quantity Indicator
URL: http://hl7.org.nz/fhir/StructureDefinition/nzeps-unusual-dose-quantity
.... medicationFrequency 0..1 Coding Sets a standard interval between RF secondary prophylaxis medication appointments.
URL: https://fhir-ig.digital.health.nz/rheumatic-fever/StructureDefinition/rf-medicationrequest-medicationfrequency
Binding: Rheumatic fever planned medication frequency codes (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External ids for this request
... status ?!Σ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!Σ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... Slices for medication[x] Σ 1..1 Medication to be taken
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
.... medication[x]:medicationCodeableConcept Σ 0..1 CodeableConcept Medication to be taken
Binding: http://nzmt.org.nz/vs (preferred)
... subject Σ 1..1 Reference(Patient | Group) Who or group medication request is for
... encounter 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn Σ 0..1 dateTime When request was initially authored
... requester Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Who/What requested the Request
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... 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 0..* Annotation Information about the prescription
... dosageInstruction 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..0
.... text Σ 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 Σ 0..1 Timing When medication should be administered
.... 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 Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

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

..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

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

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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]exampleSNOMEDCTMedicationCodes
http://hl7.org/fhir/ValueSet/medication-codes
from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConceptpreferredhttp://nzmt.org.nz/vs
http://nzmt.org.nz/vs
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
RFNZTagConstrainterrorMedicationRequest.metaAll instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG)
: tag.code contains 'rf-nz'

This structure is derived from NzMedicationRequest

Summary

Prohibited: 5 elements

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron