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Example MedicationRequest/medrx0317 (JSON)

Pharmacy Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Encounter, Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Request for Intravenous Chemotherapy (inpatient order) - Alemtuzumab - completed with multiple dosageInstruction lines

{
  "resourceType" : "MedicationRequest",
  "id" : "medrx0317",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MedicationRequest</b><a name=\"medrx0317\"> </a><a name=\"hcmedrx0317\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest &quot;medrx0317&quot; </p></div><p><b>identifier</b>: <code>http://www.bmc.nl/portal/prescriptions</code>/12345689\u00a0(use:\u00a0OFFICIAL)</p><p><b>status</b>: completed</p><p><b>intent</b>: order</p><h3>Medications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Reference</b></td></tr><tr><td style=\"display: none\">*</td><td><a name=\"hcmed0303\"> </a><blockquote><p/><p><a name=\"med0303\"> </a></p><p><a name=\"hcmed0303\"> </a></p><p><b>code</b>: alemtuzumab 10 MG/ML [Lemtrada] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#1594660)</span></p></blockquote></td></tr></table><p><b>subject</b>: <a href=\"patient-example-a.html\">Patient/pat1: Donald Duck</a> &quot;Donald DUCK&quot;</p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a href=\"practitioner-example-f007-sh.html\">Practitioner/f007: Patrick Pump</a> &quot;Simone HEPS&quot;</p><h3>Reasons</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td>Chronic lymphoid leukemia, disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#92814006)</span></td></tr></table><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 1</p><p><b>text</b>: Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to 12 wk</p><p><b>additionalInstruction</b>: Rapidly increase dose until tolerated <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span>, Administer on alternate days <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>timing</b>: Duration 12weeks, 3 per 1 weeks</p><p><b>route</b>: Intravenous route <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#47625008)</span></p><p><b>method</b>: Inject - dosing instruction imperative (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#422145002)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote></blockquote><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 2</p><p><b>text</b>: Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to 12 wk</p><p><b>additionalInstruction</b>: Rapidly increase dose until tolerated <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span>, Administer on alternate days <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>timing</b>: Duration 12weeks, 3 per 1 weeks</p><p><b>route</b>: Intravenous route <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#47625008)</span></p><p><b>method</b>: Inject - dosing instruction imperative (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#422145002)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote></blockquote><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 3</p><p><b>text</b>: Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to 12 wk</p><p><b>additionalInstruction</b>: Rapidly increase dose until tolerated <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span>, Administer on alternate days <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>timing</b>: Duration 12weeks, 3 per 1 weeks</p><p><b>route</b>: Intravenous route <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#47625008)</span></p><p><b>method</b>: Inject - dosing instruction imperative (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#422145002)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Medication #med0303</b><a name=\"med0303\"> </a><a name=\"hcmed0303\"> </a></p><p><b>code</b>: alemtuzumab 10 MG/ML [Lemtrada] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#1594660)</span></p></blockquote></div>"
  },
  "contained" : [{
    "resourceType" : "Medication",
    "id" : "med0303",
    "code" : {
      "coding" : [{
        "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code" : "1594660",
        "display" : "alemtuzumab 10 MG/ML [Lemtrada]"
      }]
    }
  }],
  "identifier" : [{
    "use" : "official",
    "system" : "http://www.bmc.nl/portal/prescriptions",
    "value" : "12345689"
  }],
  "status" : "completed",
  "intent" : "order",
  "medication" : {
    "reference" : {
      "reference" : "#med0303"
    }
  },
  "subject" : {
    "reference" : "Patient/pat1",
    "display" : "Donald Duck"
  },
  "authoredOn" : "2015-01-15",
  "requester" : {
    "reference" : "Practitioner/f007",
    "display" : "Patrick Pump"
  },
  "reason" : [{
    "concept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "92814006",
        "display" : "Chronic lymphoid leukemia, disease (disorder)"
      }]
    }
  }],
  "dosageInstruction" : [{
    "sequence" : 1,
    "text" : "Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to 12 wk",
    "additionalInstruction" : [{
      "text" : "Rapidly increase dose until tolerated"
    },
    {
      "text" : "Administer on alternate days"
    }],
    "timing" : {
      "repeat" : {
        "duration" : 12,
        "durationUnit" : "wk",
        "frequency" : 3,
        "period" : 1,
        "periodUnit" : "wk"
      }
    },
    "route" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "47625008",
        "display" : "Intravenous route"
      }]
    },
    "method" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "422145002",
        "display" : "Inject - dosing instruction imperative (qualifier value)"
      }]
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]
      },
      "doseQuantity" : {
        "value" : 3,
        "unit" : "mg",
        "system" : "http://unitsofmeasure.org",
        "code" : "mg"
      }
    }]
  },
  {
    "sequence" : 2,
    "text" : "Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to 12 wk",
    "additionalInstruction" : [{
      "text" : "Rapidly increase dose until tolerated"
    },
    {
      "text" : "Administer on alternate days"
    }],
    "timing" : {
      "repeat" : {
        "duration" : 12,
        "durationUnit" : "wk",
        "frequency" : 3,
        "period" : 1,
        "periodUnit" : "wk"
      }
    },
    "route" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "47625008",
        "display" : "Intravenous route"
      }]
    },
    "method" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "422145002",
        "display" : "Inject - dosing instruction imperative (qualifier value)"
      }]
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]
      },
      "doseQuantity" : {
        "value" : 10,
        "unit" : "mg",
        "system" : "http://unitsofmeasure.org",
        "code" : "mg"
      }
    }]
  },
  {
    "sequence" : 3,
    "text" : "Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to 12 wk",
    "additionalInstruction" : [{
      "text" : "Rapidly increase dose until tolerated"
    },
    {
      "text" : "Administer on alternate days"
    }],
    "timing" : {
      "repeat" : {
        "duration" : 12,
        "durationUnit" : "wk",
        "frequency" : 3,
        "period" : 1,
        "periodUnit" : "wk"
      }
    },
    "route" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "47625008",
        "display" : "Intravenous route"
      }]
    },
    "method" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "422145002",
        "display" : "Inject - dosing instruction imperative (qualifier value)"
      }]
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]
      },
      "doseQuantity" : {
        "value" : 30,
        "unit" : "mg",
        "system" : "http://unitsofmeasure.org",
        "code" : "mg"
      }
    }]
  }]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.