Copy of 'GP Connect Data Model | FHIR STU3 Representation'

Notice: This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Profile: CareConnect-GPC-MedicationRequest-1

idΣ0..1id
id0..1string
extensionC0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileΣ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueUnsignedIntunsignedInt
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueUnsignedIntunsignedInt
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueDateTimedateTime
url1..1uriFixed Value
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueCodeableConceptCodeableConcept
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueDateTimedateTime
url1..1uriFixed Value
prescriptionTypeS C0..1Extension(CodeableConcept)
modifierExtension?! C0..*Extension
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(Organization)
statusΣ ?!1..1codeBinding
statusReason0..1CodeableConcept
intentΣ ?!1..1codeBinding
category0..*CodeableConcept
priorityΣ0..1codeBinding
doNotPerformΣ ?!0..1boolean
reportedBooleanboolean
reportedReferenceReference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
medicationCodeableConceptCodeableConcept
medicationReferenceReference(Medication)
subjectΣ C1..1Reference(Group | Patient)
encounterC0..1Reference(Encounter)
supportingInformationC0..*Reference(Resource)
authoredOnΣ0..1dateTime
requesterΣ C0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
performerC0..1Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
performerTypeΣ0..1CodeableConcept
recorderC0..1Reference(Practitioner | PractitionerRole)
reasonCode0..*CodeableConcept
reasonReferenceC0..*Reference(Condition | Observation)
instantiatesCanonicalΣ0..*canonical
instantiatesUriΣ0..*uri
basedOnS Σ C0..*Reference(CarePlan) | Reference(http://hl7.org/fhir/StructureDefinition/ProcedureRequest) | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest) | Reference(CareConnect-GPC-MedicationRequest-1)
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(CareConnect-GPC-Organization-1)
courseOfTherapyType0..1CodeableConcept
insuranceC0..*Reference(ClaimResponse | Coverage)
id0..1string
extensionC0..*Extension
authorReferenceReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
sequenceΣ0..1integer
textΣ1..1string
id0..1string
extensionC0..*Extension
id0..1string
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueIdid
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..1boolean
textΣ0..1string
patientInstructionS Σ0..1string
timingΣ0..1Timing
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
siteΣ0..1CodeableConcept
id0..1string
extensionC0..*Extension
id0..1string
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueIdid
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..1boolean
textΣ0..1string
methodΣ0..1CodeableConcept
id0..1string
extensionC0..*Extension
typeΣ0..1CodeableConcept
doseQuantitySimpleQuantity
doseRangeRange
rateQuantitySimpleQuantity
rateRangeRange
rateRatioRatio
maxDosePerPeriodΣ C0..1Ratio
maxDosePerAdministrationΣ C0..1SimpleQuantity
maxDosePerLifetimeΣ C0..1SimpleQuantity
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
quantityC0..1SimpleQuantity
durationC0..1Duration
dispenseIntervalC0..1Duration
id0..1string
extensionC0..*Extension
startΣ C1..1dateTime
endΣ C0..1dateTime
numberOfRepeatsAllowed0..1unsignedInt
id0..1string
quantityTextS C0..1Extension(string)
valueΣ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemΣ C0..1uri
codeΣ0..1code
id0..1string
extensionC0..*Extension
valueΣ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemΣ C1..1uriFixed Value
codeΣ1..1codeBinding
performerS C0..1Reference(CareConnect-GPC-Organization-1)
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
allowedBooleanboolean
allowedCodeableConceptCodeableConcept
reason0..1CodeableConcept
priorPrescriptionC0..1Reference(CareConnect-GPC-MedicationRequest-1)
detectedIssueS C0..*Reference(DetectedIssue)
eventHistoryC0..*Reference(Provenance)
status1..
medicationCodeableConceptCodeableConcept
medicationReferenceReference(CareConnect-GPC-Medication-1)
subjectC0..*Reference(Group) | Reference(CareConnect-GPC-Patient-1)
contextS C0..*Reference(EpisodeOfCare) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)
authoredOn1..
requesterS
recorderC1..*Reference(CareConnect-GPC-Practitioner-1)
reasonReferenceC0..*Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1)
MedicationRequestC
ShortOrdering of medication for patient or group
Definition

An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

Cardinality0..*
AliasPrescription, Order
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Request
  • script10.6: Message/Body/NewRx
  • rim: CombinedMedicationRequest
MedicationRequest.idΣ
ShortLogical id of this artifact
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Cardinality0..1
Typeid
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.metaΣ
ShortMetadata about the resource
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.meta.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.meta.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.meta.versionIdΣ
ShortVersion specific identifier
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Cardinality0..1
Typeid
SummaryTrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.lastUpdatedΣ
ShortWhen the resource version last changed
Definition

When the resource last changed - e.g. when the version changed.

Cardinality0..1
Typeinstant
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.sourceΣ
ShortIdentifies where the resource comes from
Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Cardinality0..1
Typeuri
SummaryTrue
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.profileΣ
ShortProfiles this resource claims to conform to
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Cardinality1..*
Typecanonical(StructureDefinition)
SummaryTrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.securityΣ
ShortSecurity Labels applied to this resource
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Cardinality0..*
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

AllSecurityLabels (extensible)

SummaryTrue
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
MedicationRequest.meta.tagΣ
ShortTags applied to this resource
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Cardinality0..*
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
MedicationRequest.implicitRulesΣ ?!
ShortA set of rules under which this content was created
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
MaxValueSetAllLanguages
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.text
ShortText summary of the resource, for human interpretation
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
MedicationRequest.contained
ShortContained, inline Resources
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
MedicationRequest.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformationC
ShortMedication repeat information
Definition

Medication repeat information.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:repeatInformation.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality1..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowedS C
ShortNumber of repeat prescriptions authorised
Definition

Number of repeat prescriptions authorised.

Cardinality0..1
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
numberOfRepeatPrescriptionsAllowed
Mappings
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed.value[x]
ShortNumber of issues authorised
Definition

Number of issues authorised.

Cardinality1..1
TypeunsignedInt
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssuedC
ShortNumber of repeat prescriptions issued
Definition

Number of repeat prescriptions issued.

Cardinality1..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
numberOfRepeatPrescriptionsIssued
Mappings
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued.value[x]
ShortNumber of issues issued
Definition

Number of issues issued.

Cardinality0..1
TypeunsignedInt
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDateS C
ShortRepeat prescription review date
Definition

Repeat prescription review date.

Cardinality0..1
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDate.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDate.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDate.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
authorisationExpiryDate
Mappings
  • rim: N/A
MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDate.value[x]
ShortRepeat review date
Definition

Repeat review date.

Cardinality0..1
TypedateTime
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:repeatInformation.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationRepeatInformation-1
Mappings
  • rim: N/A
MedicationRequest.extension:repeatInformation.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | canonical | code | CodeableConcept | Coding | ContactDetail | ContactPoint | Contributor | Count | DataRequirement | date | dateTime | decimal | Distance | Dosage | Duration | Expression | HumanName | id | Identifier | instant | integer | markdown | Meta | Money | oid | ParameterDefinition | Period | positiveInt | Quantity | Range | Ratio | Reference | RelatedArtifact | SampledData | Signature | string | time | Timing | TriggerDefinition | unsignedInt | uri | url | UsageContext | uuid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReasonS C
ShortTo record the reason the medication (plan or order) was stopped and the date this occurred
Definition

To record the reason the medication (plan or order) was stopped and the date this occurred.

Cardinality0..1
TypeExtension(Complex)
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:statusReason.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality2..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusReasonC
ShortReason for current status
Definition

Reason for current status.

Cardinality1..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusReason.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:statusReason.extension:statusReason.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusReason.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
statusReason
Mappings
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusReason.value[x]
ShortTo record the reason the medication (plan or order) was stopped
Definition

To record the reason the medication (plan or order) was stopped.

Cardinality0..1
TypeCodeableConcept
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusChangeDateC
ShortTo record the date this occurred
Definition

To record the date this occurred.

Cardinality1..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusChangeDate.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:statusReason.extension:statusChangeDate.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusChangeDate.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
statusChangeDate
Mappings
  • rim: N/A
MedicationRequest.extension:statusReason.extension:statusChangeDate.value[x]
ShortTo record the date this occurred
Definition

To record the date this occurred.

Cardinality0..1
TypedateTime
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:statusReason.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatusReason-1
Mappings
  • rim: N/A
MedicationRequest.extension:statusReason.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | canonical | code | CodeableConcept | Coding | ContactDetail | ContactPoint | Contributor | Count | DataRequirement | date | dateTime | decimal | Distance | Dosage | Duration | Expression | HumanName | id | Identifier | instant | integer | markdown | Meta | Money | oid | ParameterDefinition | Period | positiveInt | Quantity | Range | Ratio | Reference | RelatedArtifact | SampledData | Signature | string | time | Timing | TriggerDefinition | unsignedInt | uri | url | UsageContext | uuid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:prescriptionTypeS C
ShortTo record the type of prescription
Definition

To record the type of prescription.

Cardinality0..1
TypeExtension(CodeableConcept)
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.modifierExtension?! C
ShortExtensions that cannot be ignored
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.identifier
ShortExternal ids for this request
Definition

Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

Cardinality1..*
TypeIdentifier
Comments

This is a business identifier, not a resource identifier.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • script10.6: Message/Header/PrescriberOrderNumber
  • w5: FiveWs.identifier
  • v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
  • rim: .id
MedicationRequest.identifier.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.identifier.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.identifier.useΣ ?!
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
MedicationRequest.identifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
MedicationRequest.identifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
MedicationRequest.identifier.valueΣ
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality1..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
MedicationRequest.identifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
MedicationRequest.identifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
MedicationRequest.statusΣ ?!
Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Definition

A code specifying the current state of the order. Generally, this will be active or completed state.

Cardinality1..1
Typecode
Binding

A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

medicationrequest Status (required)

ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.status
  • script10.6: no mapping
  • w5: FiveWs.status
  • rim: .statusCode
MedicationRequest.statusReason
ShortReason for current status
Definition

Captures the reason for the current state of the MedicationRequest.

Cardinality0..1
TypeCodeableConcept
Binding

Identifies the reasons for a given status.

MedicationRequestStatusReasonCodes (example)

Comments

This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.statusReason
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
MedicationRequest.intentΣ ?!
Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Definition

Whether the request is a proposal, plan, or an original order.

Cardinality1..1
Typecode
Binding

The kind of medication order.

medicationRequest Intent (required)

ModifierTrue
SummaryTrue
Comments

It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.intent
  • w5: FiveWs.class
  • rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
MedicationRequest.category
ShortType of medication usage
Definition

Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

Cardinality0..*
TypeCodeableConcept
Binding

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.

medicationRequest Category Codes (example)

Comments

The category can be used to include where the medication is expected to be consumed or other types of requests.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
  • w5: FiveWs.class
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
MedicationRequest.priorityΣ
Shortroutine | urgent | asap | stat
Definition

Indicates how quickly the Medication Request should be addressed with respect to other requests.

Cardinality0..1
Typecode
Binding

Identifies the level of importance to be assigned to actioning the request.

RequestPriority (required)

SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.priority
  • w5: FiveWs.grade
  • rim: .priorityCode
MedicationRequest.doNotPerformΣ ?!
ShortTrue if request is prohibiting action
Definition

If true indicates that the provider is asking for the medication request not to occur.

Cardinality0..1
Typeboolean
ModifierTrue
SummaryTrue
Comments

If do not perform is not specified, the request is a positive request e.g. "do perform".

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: SubstanceAdministration.actionNegationInd
MedicationRequest.reported[x]Σ
ShortReported rather than primary record
Definition

Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

Cardinality0..1
Typeboolean | Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .participation[typeCode=INF].role
MedicationRequest.medication[x]Σ
ShortMedication to be taken
Definition

Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

Cardinality1..1
TypeCodeableConcept | Reference(Medication)
Binding

A coded concept identifying substance or product that can be ordered.

SNOMEDCTMedicationCodes (example)

SummaryTrue
Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.code
  • script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
  • w5: FiveWs.what[x]
  • v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
  • rim: consumable.administrableMedication
MedicationRequest.subjectΣ C
ShortWho or group medication request is for
Definition

A link to a resource representing the person or set of individuals to whom the medication will be given.

Cardinality1..1
TypeReference(Group | Patient)
SummaryTrue
Comments

The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
  • w5: FiveWs.subject[x]
  • v2: PID-3-Patient ID List
  • rim: .participation[typeCode=AUT].role
  • w5: FiveWs.subject
MedicationRequest.encounterC
ShortEncounter created as part of encounter/admission/stay
Definition

The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

Cardinality0..1
TypeReference(Encounter)
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.context
  • script10.6: no mapping
  • w5: FiveWs.context
  • v2: PV1-19-Visit Number
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
MedicationRequest.supportingInformationC
ShortInformation to support ordering of the medication
Definition

Include additional information (for example, patient height and weight) that supports the ordering of the medication.

Cardinality0..*
TypeReference(Resource)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
  • w5: FiveWs.context
  • rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
MedicationRequest.authoredOnΣ
ShortWhen request was initially authored
Definition

The date (and perhaps time) when the prescription was initially written or authored on.

Cardinality0..1
TypedateTime
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
  • w5: FiveWs.recorded
  • v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
  • rim: author.time
MedicationRequest.requesterΣ C
ShortWho/What requested the Request
Definition

The individual, organization, or device that initiated the request and has responsibility for its activation.

Cardinality0..1
TypeReference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.requester
  • w5: FiveWs.author
  • rim: .participation[typeCode=AUT].role
MedicationRequest.performerC
ShortIntended performer of administration
Definition

The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

Cardinality0..1
TypeReference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.performer
  • w5: FiveWs.actor
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
MedicationRequest.performerTypeΣ
ShortDesired kind of performer of the medication administration
Definition

Indicates the type of performer of the administration of the medication.

Cardinality0..1
TypeCodeableConcept
Binding

Identifies the type of individual that is desired to administer the medication.

ProcedurePerformerRoleCodes (example)

SummaryTrue
Comments

If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.performerType
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
MedicationRequest.recorderC
ShortPerson who entered the request
Definition

The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

Cardinality0..1
TypeReference(Practitioner | PractitionerRole)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.who
  • rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
MedicationRequest.reasonCode
ShortReason or indication for ordering or not ordering the medication
Definition

The reason or the indication for ordering or not ordering the medication.

Cardinality0..*
TypeCodeableConcept
Binding

A coded concept indicating why the medication was ordered.

ConditionProblemDiagnosisCodes (example)

Comments

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.reasonCode
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
  • w5: FiveWs.why[x]
  • v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
  • rim: reason.observation.reasonCode
MedicationRequest.reasonReferenceC
ShortCondition or observation that supports why the prescription is being written
Definition

Condition or observation that supports why the medication was ordered.

Cardinality0..*
TypeReference(Condition | Observation)
Comments

This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.reasonReference
  • script10.6: no mapping
  • w5: FiveWs.why[x]
  • rim: reason.observation[code=ASSERTION].value
MedicationRequest.instantiatesCanonicalΣ
ShortInstantiates FHIR protocol or definition
Definition

The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

Cardinality0..*
Typecanonical
SummaryTrue
Comments
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiates
  • rim: .outboundRelationship[typeCode=DEFN].target
MedicationRequest.instantiatesUriΣ
ShortInstantiates external protocol or definition
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

Cardinality0..*
Typeuri
SummaryTrue
Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=DEFN].target
MedicationRequest.basedOnS Σ C
ShortWhat request fulfills
Definition

A plan or request that is fulfilled in whole or in part by this medication request.

Cardinality0..*
TypeReference(CarePlan) | Reference(http://hl7.org/fhir/StructureDefinition/ProcedureRequest) | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest) | Reference(CareConnect-GPC-MedicationRequest-1)
Must SupportTrue
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.basedOn
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
MedicationRequest.groupIdentifierS Σ
ShortComposite request this is part of
Definition

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

Cardinality0..1
TypeIdentifier
Must SupportTrue
SummaryTrue
Requirements

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.groupIdentifier
  • rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
MedicationRequest.groupIdentifier.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.groupIdentifier.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.groupIdentifier.useΣ ?!
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
MedicationRequest.groupIdentifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
MedicationRequest.groupIdentifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality0..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
MedicationRequest.groupIdentifier.valueΣ
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality0..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
MedicationRequest.groupIdentifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
MedicationRequest.groupIdentifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(CareConnect-GPC-Organization-1)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
MedicationRequest.courseOfTherapyType
ShortOverall pattern of medication administration
Definition

The description of the overall patte3rn of the administration of the medication to the patient.

Cardinality0..1
TypeCodeableConcept
Binding

Identifies the overall pattern of medication administratio.

MedicationRequestCourseOfTherapyCodes (example)

Comments

This attribute should not be confused with the protocol of the medication.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: Act.code where classCode = LIST and moodCode = EVN
MedicationRequest.insuranceC
ShortAssociated insurance coverage
Definition

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

Cardinality0..*
TypeReference(ClaimResponse | Coverage)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.insurance
  • rim: .outboundRelationship[typeCode=COVBY].target
MedicationRequest.noteS
ShortInformation about the prescription
Definition

Extra information about the prescription that could not be conveyed by the other attributes.

Cardinality0..*
TypeAnnotation
Must SupportTrue
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Note
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationRequest.note.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.note.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.note.author[x]Σ
ShortIndividual responsible for the annotation
Definition

The individual responsible for making the annotation.

Cardinality0..1
TypeReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1) | string
SummaryTrue
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
MedicationRequest.note.timeΣ
ShortWhen the annotation was made
Definition

Indicates when this particular annotation was made.

Cardinality0..1
TypedateTime
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
MedicationRequest.note.textΣ
ShortThe annotation - text content (as markdown)
Definition

The text of the annotation in markdown format.

Cardinality1..1
Typemarkdown
SummaryTrue
Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
MedicationRequest.dosageInstruction
ShortHow the medication should be taken
Definition

Indicates how the medication is to be used by the patient.

Cardinality1..*
TypeDosage
Comments

There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • workflow: Request.occurrence[x]
  • rim: see dosageInstruction mapping
MedicationRequest.dosageInstruction.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.sequenceΣ
ShortThe order of the dosage instructions
Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Cardinality0..1
Typeinteger
SummaryTrue
Requirements

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

32 bit number; for values larger than this, use decimal

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-1
  • rim: .text
MedicationRequest.dosageInstruction.textΣ
ShortFree text dosage instructions e.g. SIG
Definition

Free text dosage instructions e.g. SIG.

Cardinality1..1
Typestring
SummaryTrue
Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-6; RXE-21
  • rim: .text
MedicationRequest.dosageInstruction.additionalInstructionΣ
ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Cardinality0..*
TypeCodeableConcept
Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)

SummaryTrue
Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-7
  • rim: .text
MedicationRequest.dosageInstruction.additionalInstruction.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.additionalInstruction.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCTΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..1
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionIDC
ShortThe SNOMED CT Description ID for the display
Definition

The SNOMED CT Description ID for the display.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality1..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionIdC
ShortThe SNOMED CT Description ID
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality1..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionId
Mappings
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]
ShortThe SNOMED CT Description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typeid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplayC
ShortThe SNOMED CT display for the description ID
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionDisplay
Mappings
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]
ShortThe SNOMED CT display for the description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid
Mappings
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
http://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.versionΣ
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.codeΣ
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality1..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.userSelectedΣ
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationRequest.dosageInstruction.additionalInstruction.textΣ
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MedicationRequest.dosageInstruction.patientInstructionS Σ
ShortPatient or consumer oriented instructions
Definition

Instructions in terms that are understood by the patient or consumer.

Cardinality0..1
Typestring
Must SupportTrue
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-7
  • rim: .text
MedicationRequest.dosageInstruction.timingΣ
ShortWhen medication should be administered
Definition

When medication should be administered.

Cardinality0..1
TypeTiming
SummaryTrue
Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: QSET<TS> (GTS)
  • rim: .effectiveTime
MedicationRequest.dosageInstruction.asNeeded[x]Σ
ShortTake "as needed" (for x)
Definition

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Cardinality0..1
Typeboolean | CodeableConcept
Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

SNOMEDCTMedicationAsNeededReasonCodes (example)

SummaryTrue
Comments

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-9
  • rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
MedicationRequest.dosageInstruction.siteΣ
ShortBody site to administer to
Definition

Body site to administer to.

Cardinality0..1
TypeCodeableConcept
Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureAdministrationSites (example)

SummaryTrue
Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-2
  • rim: .approachSiteCode
MedicationRequest.dosageInstruction.routeΣ
ShortHow drug should enter body
Definition

How drug should enter body.

Cardinality0..1
TypeCodeableConcept
Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMEDCTRouteCodes (example)

SummaryTrue
Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-1
  • rim: .routeCode
MedicationRequest.dosageInstruction.route.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.route.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationRequest.dosageInstruction.route.coding:snomedCTΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..1
TypeCoding
Binding

A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

(unbound) (preferred)

SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationRequest.dosageInstruction.route.coding:snomedCT.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.route.coding:snomedCT.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionIDC
ShortThe SNOMED CT Description ID for the display
Definition

The SNOMED CT Description ID for the display.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality1..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionIdC
ShortThe SNOMED CT Description ID
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality1..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionId
Mappings
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]
ShortThe SNOMED CT Description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typeid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplayC
ShortThe SNOMED CT display for the description ID
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..1
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionDisplay
Mappings
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]
ShortThe SNOMED CT display for the description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid
Mappings
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.route.coding:snomedCT.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
http://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationRequest.dosageInstruction.route.coding:snomedCT.versionΣ
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationRequest.dosageInstruction.route.coding:snomedCT.codeΣ
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationRequest.dosageInstruction.route.coding:snomedCT.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality1..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationRequest.dosageInstruction.route.coding:snomedCT.userSelectedΣ
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationRequest.dosageInstruction.route.textΣ
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MedicationRequest.dosageInstruction.methodΣ
ShortTechnique for administering medication
Definition

Technique for administering medication.

Cardinality0..1
TypeCodeableConcept
Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)

SummaryTrue
Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-4
  • rim: .doseQuantity
MedicationRequest.dosageInstruction.doseAndRateΣ
ShortAmount of medication administered
Definition

The amount of medication administered.

Cardinality0..*
TypeElement
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-2
MedicationRequest.dosageInstruction.doseAndRate.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.doseAndRate.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.doseAndRate.typeΣ
ShortThe kind of dose or rate specified
Definition

The kind of dose or rate specified, for example, ordered or calculated.

Cardinality0..1
TypeCodeableConcept
Binding

The kind of dose or rate specified.

DoseAndRateType (example)

SummaryTrue
Requirements

If the type is not populated, assume to be "ordered".

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-21; RXE-23
MedicationRequest.dosageInstruction.doseAndRate.dose[x]Σ
ShortAmount of medication per dose
Definition

Amount of medication per dose.

Cardinality0..1
TypeSimpleQuantity | Range
SummaryTrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
MedicationRequest.dosageInstruction.doseAndRate.rate[x]Σ
ShortAmount of medication per unit of time
Definition

Amount of medication per unit of time.

Cardinality0..1
TypeSimpleQuantity | Range | Ratio
SummaryTrue
Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXE22, RXE23, RXE-24
  • rim: .rateQuantity
MedicationRequest.dosageInstruction.maxDosePerPeriodΣ C
ShortUpper limit on medication per unit of time
Definition

Upper limit on medication per unit of time.

Cardinality0..1
TypeRatio
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
    (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: RTO
  • v2: RXO-23, RXE-19
  • rim: .maxDoseQuantity
MedicationRequest.dosageInstruction.maxDosePerAdministrationΣ C
ShortUpper limit on medication per administration
Definition

Upper limit on medication per administration.

Cardinality0..1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
MedicationRequest.dosageInstruction.maxDosePerLifetimeΣ C
ShortUpper limit on medication per lifetime of the patient
Definition

Upper limit on medication per lifetime of the patient.

Cardinality0..1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
MedicationRequest.dispenseRequest
ShortMedication supply authorization
Definition

Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

Cardinality1..1
TypeBackboneElement
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
  • rim: component.supplyEvent
MedicationRequest.dispenseRequest.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.initialFill
ShortFirst fill details
Definition

Indicates the quantity or duration for the first dispense of the medication.

Cardinality0..1
TypeBackboneElement
Comments

If populating this element, either the quantity or the duration must be included.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
MedicationRequest.dispenseRequest.initialFill.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.initialFill.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.initialFill.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.initialFill.quantityC
ShortFirst fill quantity
Definition

The amount or quantity to provide as part of the first dispense.

Cardinality0..1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: Supply.quantity[moodCode=RQO]
MedicationRequest.dispenseRequest.initialFill.durationC
ShortFirst fill duration
Definition

The length of time that the first dispense is expected to last.

Cardinality0..1
TypeDuration
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • rim: Supply.effectivetime[moodCode=RQO]
MedicationRequest.dispenseRequest.dispenseIntervalC
ShortMinimum period of time between dispenses
Definition

The minimum period of time that must occur between dispenses of the medication.

Cardinality0..1
TypeDuration
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • rim: Supply.effectivetime[moodCode=RQO]
MedicationRequest.dispenseRequest.validityPeriodC
ShortTime period supply is authorized for
Definition

This indicates the validity period of a prescription (stale dating the Prescription).

Cardinality1..1
TypePeriod
Requirements

Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

Comments

It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
  • rim: effectiveTime
MedicationRequest.dispenseRequest.validityPeriod.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.validityPeriod.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.validityPeriod.startΣ C
ShortStarting time with inclusive boundary
Definition

The start of the period. The boundary is inclusive.

Cardinality1..1
TypedateTime
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, per-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
MedicationRequest.dispenseRequest.validityPeriod.endΣ C
ShortEnd time with inclusive boundary, if not ongoing
Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Cardinality0..1
TypedateTime
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, per-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
ShortNumber of refills authorized
Definition

An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

Cardinality0..1
TypeunsignedInt
Comments

If displaying "number of authorized fills", add 1 to this number.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
  • v2: RXE-12-Number of Refills
  • rim: repeatNumber
MedicationRequest.dispenseRequest.quantityS C
ShortAmount of medication to supply per dispense
Definition

The amount that is to be dispensed for one fill.

Cardinality0..1
TypeSimpleQuantity
Must SupportTrue
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
  • v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
  • rim: quantity
MedicationRequest.dispenseRequest.quantity.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.quantity.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.quantity.extension:quantityTextS C
ShortQuantity representation
Definition

Quantity representation.

Cardinality0..1
TypeExtension(string)
Must SupportTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.quantity.valueΣ
ShortNumerical value (with implicit precision)
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality0..1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationRequest.dispenseRequest.quantity.comparatorΣ ?!
Short< | <= | >= | > - how to understand the value
Definition

Not allowed to be used in this context

Cardinality0..0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationRequest.dispenseRequest.quantity.unitΣ
ShortUnit representation
Definition

A human-readable form of the unit.

Cardinality0..1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationRequest.dispenseRequest.quantity.systemΣ C
ShortSystem that defines coded unit form
Definition

The identification of the system that provides the coded form of the unit.

Cardinality0..1
Typeuri
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, qty-3
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationRequest.dispenseRequest.quantity.codeΣ
ShortCoded form of the unit
Definition

A computer processable form of the unit in some unit representation system.

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
MedicationRequest.dispenseRequest.expectedSupplyDurationS C
ShortNumber of days supply per dispense
Definition

Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

Cardinality0..1
TypeDuration
Must SupportTrue
Comments

In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim: expectedUseTime
MedicationRequest.dispenseRequest.expectedSupplyDuration.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.expectedSupplyDuration.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.expectedSupplyDuration.valueΣ
ShortNumerical value (with implicit precision)
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality1..1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparatorΣ ?!
Short< | <= | >= | > - how to understand the value
Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Cardinality0..0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationRequest.dispenseRequest.expectedSupplyDuration.unitΣ
ShortUnit representation
Definition

A human-readable form of the unit.

Cardinality0..1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationRequest.dispenseRequest.expectedSupplyDuration.systemΣ C
ShortSystem that defines coded unit form
Definition

The identification of the system that provides the coded form of the unit.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, qty-3
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
http://unitsofmeasure.org
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationRequest.dispenseRequest.expectedSupplyDuration.codeΣ
ShortCoded form of the unit
Definition

A computer processable form of the unit in some unit representation system.

Cardinality1..1
Typecode
Binding

A unit of time (units from UCUM).

(unbound) (required)

SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
MedicationRequest.dispenseRequest.performerS C
ShortIntended dispenser
Definition

Indicates the intended dispensing Organization specified by the prescriber.

Cardinality0..1
TypeReference(CareConnect-GPC-Organization-1)
Must SupportTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.who
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
MedicationRequest.substitution
ShortAny restrictions on medication substitution
Definition

Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

Cardinality0..1
TypeBackboneElement
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim: subjectOf.substitutionPersmission
MedicationRequest.substitution.id
ShortUnique id for inter-element referencing
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
MedicationRequest.substitution.extensionC
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.substitution.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.substitution.allowed[x]
ShortWhether substitution is allowed or not
Definition

True if the prescriber allows a different drug to be dispensed from what was prescribed.

Cardinality1..1
Typeboolean | CodeableConcept
Binding

Identifies the type of substitution allowed.

ActSubstanceAdminSubstitutionCode (example)

Comments

This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
  • rim: code
MedicationRequest.substitution.reason
ShortWhy should (not) substitution be made
Definition

Indicates the reason for the substitution, or why substitution must or must not be performed.

Cardinality0..1
TypeCodeableConcept
Binding

A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

SubstanceAdminSubstitutionReason (example)

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6: not mapped
  • v2: RXE-9 Substition status
  • rim: reasonCode
MedicationRequest.priorPrescriptionC
ShortAn order/prescription that is being replaced
Definition

A link to a resource representing an earlier order related order or prescription.

Cardinality0..1
TypeReference(CareConnect-GPC-MedicationRequest-1)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.replaces
  • script10.6: not mapped
  • rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
MedicationRequest.detectedIssueS C
ShortClinical Issue with action
Definition

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

Cardinality0..*
TypeReference(DetectedIssue)
Must SupportTrue
AliasContraindication, Drug Utilization Review (DUR), Alert
Comments

This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
MedicationRequest.eventHistoryC
ShortA list of events of interest in the lifecycle
Definition

Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

Cardinality0..*
TypeReference(Provenance)
Comments

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.relevantHistory
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
MedicationRequest.status
Cardinality1
MedicationRequest.medication[x]
ShortBase for all elements
Definition

Base definition for all elements in a resource.

Cardinality0..*
TypeCodeableConcept | Reference(CareConnect-GPC-Medication-1)
Binding

(unbound) (example)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.subjectC
ShortA reference from one resource to another
Definition

A reference from one resource to another.

Cardinality0..*
TypeReference(Group) | Reference(CareConnect-GPC-Patient-1)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
MedicationRequest.contextS C
ShortA reference from one resource to another
Definition

A reference from one resource to another.

Cardinality0..*
TypeReference(EpisodeOfCare) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)
Must SupportTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
MedicationRequest.authoredOn
Cardinality1
MedicationRequest.requesterS
Must SupportTrue
MedicationRequest.recorderC
ShortA reference from one resource to another
Definition

A reference from one resource to another.

Cardinality1..*
TypeReference(CareConnect-GPC-Practitioner-1)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
MedicationRequest.reasonReferenceC
ShortA reference from one resource to another
Definition

A reference from one resource to another.

Cardinality0..*
TypeReference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
<StructureDefinition xmlns="http://hl7.org/fhir">
<lastUpdated value="2026-10-29T16:52:26.8579644+00:00" />
</meta>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="phx" />
</extension>
<url value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
<version value="1.7.0" />
<name value="CareConnect-GPC-MedicationRequest-1" />
<status value="active" />
<date value="2023-07-23" />
<publisher value="HL7 UK" />
<description value="This MedicationRequest Resource represents an order for both supply of the medication and the instructions for administration of the medication to a patient." />
<copyright value="Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html" />
<fhirVersion value="3.0.2" />
<kind value="resource" />
<abstract value="false" />
<type value="MedicationRequest" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
<derivation value="constraint" />
<element id="MedicationRequest.meta">
<path value="MedicationRequest.meta" />
</element>
<element id="MedicationRequest.meta.profile">
<path value="MedicationRequest.meta.profile" />
<min value="1" />
</element>
<element id="MedicationRequest.extension:repeatInformation">
<path value="MedicationRequest.extension" />
<sliceName value="repeatInformation" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationRepeatInformation-1" />
</type>
</element>
<element id="MedicationRequest.extension:repeatInformation.extension">
<path value="MedicationRequest.extension.extension" />
<min value="1" />
</element>
<element id="MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed">
<path value="MedicationRequest.extension.extension" />
<sliceName value="numberOfRepeatPrescriptionsAllowed" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued">
<path value="MedicationRequest.extension.extension" />
<sliceName value="numberOfRepeatPrescriptionsIssued" />
<mustSupport value="false" />
</element>
<element id="MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDate">
<path value="MedicationRequest.extension.extension" />
<sliceName value="authorisationExpiryDate" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.extension:statusReason">
<path value="MedicationRequest.extension" />
<sliceName value="statusReason" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatusReason-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationRequest.extension:statusReason.extension">
<path value="MedicationRequest.extension.extension" />
<min value="2" />
</element>
<element id="MedicationRequest.extension:prescriptionType">
<path value="MedicationRequest.extension" />
<sliceName value="prescriptionType" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescriptionType-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationRequest.identifier">
<path value="MedicationRequest.identifier" />
<min value="1" />
</element>
<element id="MedicationRequest.identifier.system">
<path value="MedicationRequest.identifier.system" />
<min value="1" />
</element>
<element id="MedicationRequest.identifier.value">
<path value="MedicationRequest.identifier.value" />
<min value="1" />
</element>
<element id="MedicationRequest.basedOn">
<path value="MedicationRequest.basedOn" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
</type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest" />
</type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationRequest.groupIdentifier">
<path value="MedicationRequest.groupIdentifier" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.groupIdentifier.assigner">
<path value="MedicationRequest.groupIdentifier.assigner" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
</element>
<element id="MedicationRequest.status">
<path value="MedicationRequest.status" />
<min value="1" />
</element>
<element id="MedicationRequest.medication[x]">
<path value="MedicationRequest.medication[x]" />
<code value="CodeableConcept" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Medication-1" />
</type>
<strength value="example" />
</binding>
</element>
<element id="MedicationRequest.subject">
<path value="MedicationRequest.subject" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
</element>
<element id="MedicationRequest.context">
<path value="MedicationRequest.context" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationRequest.authoredOn">
<path value="MedicationRequest.authoredOn" />
<min value="1" />
</element>
<element id="MedicationRequest.requester">
<path value="MedicationRequest.requester" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.requester.agent">
<path value="MedicationRequest.requester.agent" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="MedicationRequest.requester.onBehalfOf">
<path value="MedicationRequest.requester.onBehalfOf" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
</element>
<element id="MedicationRequest.recorder">
<path value="MedicationRequest.recorder" />
<min value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="MedicationRequest.reasonReference">
<path value="MedicationRequest.reasonReference" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1" />
</type>
</element>
<element id="MedicationRequest.note">
<path value="MedicationRequest.note" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.note.author[x]">
<path value="MedicationRequest.note.author[x]" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<code value="string" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="MedicationRequest.dosageInstruction">
<path value="MedicationRequest.dosageInstruction" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.text">
<path value="MedicationRequest.dosageInstruction.text" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding" />
<sliceName value="snomedCT" />
<max value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding.extension.extension" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.system">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.version">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding.version" />
<max value="0" />
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.code">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding.code" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.display">
<path value="MedicationRequest.dosageInstruction.additionalInstruction.coding.display" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.patientInstruction">
<path value="MedicationRequest.dosageInstruction.patientInstruction" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.dosageInstruction.route.coding">
<path value="MedicationRequest.dosageInstruction.route.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT">
<path value="MedicationRequest.dosageInstruction.route.coding" />
<sliceName value="snomedCT" />
<max value="1" />
<strength value="preferred" />
<description value="A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration." />
</binding>
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID">
<path value="MedicationRequest.dosageInstruction.route.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension">
<path value="MedicationRequest.dosageInstruction.route.coding.extension.extension" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT.system">
<path value="MedicationRequest.dosageInstruction.route.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT.version">
<path value="MedicationRequest.dosageInstruction.route.coding.version" />
<max value="0" />
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT.code">
<path value="MedicationRequest.dosageInstruction.route.coding.code" />
<min value="1" />
</element>
<element id="MedicationRequest.dosageInstruction.route.coding:snomedCT.display">
<path value="MedicationRequest.dosageInstruction.route.coding.display" />
<min value="1" />
</element>
<element id="MedicationRequest.dispenseRequest">
<path value="MedicationRequest.dispenseRequest" />
<min value="1" />
</element>
<element id="MedicationRequest.dispenseRequest.validityPeriod">
<path value="MedicationRequest.dispenseRequest.validityPeriod" />
<min value="1" />
</element>
<element id="MedicationRequest.dispenseRequest.validityPeriod.start">
<path value="MedicationRequest.dispenseRequest.validityPeriod.start" />
<min value="1" />
</element>
<element id="MedicationRequest.dispenseRequest.quantity">
<path value="MedicationRequest.dispenseRequest.quantity" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.dispenseRequest.quantity.extension:quantityText">
<path value="MedicationRequest.dispenseRequest.quantity.extension" />
<sliceName value="quantityText" />
<max value="1" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationQuantityText-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationRequest.dispenseRequest.expectedSupplyDuration">
<path value="MedicationRequest.dispenseRequest.expectedSupplyDuration" />
<mustSupport value="true" />
</element>
<element id="MedicationRequest.dispenseRequest.expectedSupplyDuration.value">
<path value="MedicationRequest.dispenseRequest.expectedSupplyDuration.value" />
<min value="1" />
</element>
<element id="MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator">
<path value="MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator" />
<max value="0" />
</element>
<element id="MedicationRequest.dispenseRequest.expectedSupplyDuration.system">
<path value="MedicationRequest.dispenseRequest.expectedSupplyDuration.system" />
<min value="1" />
<fixedUri value="http://unitsofmeasure.org" />
</element>
<element id="MedicationRequest.dispenseRequest.expectedSupplyDuration.code">
<path value="MedicationRequest.dispenseRequest.expectedSupplyDuration.code" />
<min value="1" />
<strength value="required" />
<description value="A unit of time (units from UCUM)." />
</binding>
</element>
<element id="MedicationRequest.dispenseRequest.performer">
<path value="MedicationRequest.dispenseRequest.performer" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationRequest.priorPrescription">
<path value="MedicationRequest.priorPrescription" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
</type>
</element>
<element id="MedicationRequest.detectedIssue">
<path value="MedicationRequest.detectedIssue" />
<mustSupport value="true" />
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"meta": {
"lastUpdated": "2026-10-29T16:52:26.8579644+00:00"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "phx"
}
],
"url": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1",
"version": "1.7.0",
"name": "CareConnect-GPC-MedicationRequest-1",
"status": "active",
"date": "2023-07-23",
"publisher": "HL7 UK",
"description": "This MedicationRequest Resource represents an order for both supply of the medication and the instructions for administration of the medication to a patient.",
"copyright": "Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html",
"fhirVersion": "3.0.2",
"kind": "resource",
"abstract": false,
"type": "MedicationRequest",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"derivation": "constraint",
"element": [
{
"id": "MedicationRequest.meta",
"path": "MedicationRequest.meta"
},
{
"id": "MedicationRequest.meta.profile",
"path": "MedicationRequest.meta.profile",
"min": 1
},
{
"id": "MedicationRequest.extension:repeatInformation",
"path": "MedicationRequest.extension",
"sliceName": "repeatInformation",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationRepeatInformation-1"
]
}
]
},
{
"id": "MedicationRequest.extension:repeatInformation.extension",
"path": "MedicationRequest.extension.extension",
"min": 1
},
{
"id": "MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed",
"path": "MedicationRequest.extension.extension",
"sliceName": "numberOfRepeatPrescriptionsAllowed",
"mustSupport": true
},
{
"id": "MedicationRequest.extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued",
"path": "MedicationRequest.extension.extension",
"sliceName": "numberOfRepeatPrescriptionsIssued",
"mustSupport": false
},
{
"id": "MedicationRequest.extension:repeatInformation.extension:authorisationExpiryDate",
"path": "MedicationRequest.extension.extension",
"sliceName": "authorisationExpiryDate",
"mustSupport": true
},
{
"id": "MedicationRequest.extension:statusReason",
"path": "MedicationRequest.extension",
"sliceName": "statusReason",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatusReason-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationRequest.extension:statusReason.extension",
"path": "MedicationRequest.extension.extension",
"min": 2
},
{
"id": "MedicationRequest.extension:prescriptionType",
"path": "MedicationRequest.extension",
"sliceName": "prescriptionType",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescriptionType-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationRequest.identifier",
"path": "MedicationRequest.identifier",
"min": 1
},
{
"id": "MedicationRequest.identifier.system",
"path": "MedicationRequest.identifier.system",
"min": 1
},
{
"id": "MedicationRequest.identifier.value",
"path": "MedicationRequest.identifier.value",
"min": 1
},
{
"id": "MedicationRequest.basedOn",
"path": "MedicationRequest.basedOn",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/CarePlan"
]
},
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
]
},
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/ReferralRequest"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationRequest.groupIdentifier",
"path": "MedicationRequest.groupIdentifier",
"mustSupport": true
},
{
"id": "MedicationRequest.groupIdentifier.assigner",
"path": "MedicationRequest.groupIdentifier.assigner",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
}
]
},
{
"id": "MedicationRequest.status",
"path": "MedicationRequest.status",
"min": 1
},
{
"id": "MedicationRequest.medication[x]",
"path": "MedicationRequest.medication[x]",
"type": [
{
"code": "CodeableConcept"
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Medication-1"
]
}
],
"binding": {
"valueSetUri": "http://hl7.org/fhir/ValueSet/medication-codes",
"strength": "example"
}
},
{
"id": "MedicationRequest.subject",
"path": "MedicationRequest.subject",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Group"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
}
]
},
{
"id": "MedicationRequest.context",
"path": "MedicationRequest.context",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
]
},
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationRequest.authoredOn",
"path": "MedicationRequest.authoredOn",
"min": 1
},
{
"id": "MedicationRequest.requester",
"path": "MedicationRequest.requester",
"mustSupport": true
},
{
"id": "MedicationRequest.requester.agent",
"path": "MedicationRequest.requester.agent",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Device"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "MedicationRequest.requester.onBehalfOf",
"path": "MedicationRequest.requester.onBehalfOf",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
}
]
},
{
"id": "MedicationRequest.recorder",
"path": "MedicationRequest.recorder",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "MedicationRequest.reasonReference",
"path": "MedicationRequest.reasonReference",
"type": [
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1"
]
},
{
"code": "Reference",
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1"
]
}
]
},
{
"id": "MedicationRequest.note",
"path": "MedicationRequest.note",
"mustSupport": true
},
{
"id": "MedicationRequest.note.author[x]",
"path": "MedicationRequest.note.author[x]",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "string"
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "MedicationRequest.dosageInstruction",
"path": "MedicationRequest.dosageInstruction",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.text",
"path": "MedicationRequest.dosageInstruction.text",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"sliceName": "snomedCT",
"max": "1"
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID.extension",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.extension.extension",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.system",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.version",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.version",
"max": "0"
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.code",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.display",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.display",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.patientInstruction",
"path": "MedicationRequest.dosageInstruction.patientInstruction",
"mustSupport": true
},
{
"id": "MedicationRequest.dosageInstruction.route.coding",
"path": "MedicationRequest.dosageInstruction.route.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT",
"path": "MedicationRequest.dosageInstruction.route.coding",
"sliceName": "snomedCT",
"max": "1",
"binding": {
"reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-MedicationDosageRoute-1"
},
"strength": "preferred",
"description": "A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration."
}
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID",
"path": "MedicationRequest.dosageInstruction.route.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID.extension",
"path": "MedicationRequest.dosageInstruction.route.coding.extension.extension",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT.system",
"path": "MedicationRequest.dosageInstruction.route.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT.version",
"path": "MedicationRequest.dosageInstruction.route.coding.version",
"max": "0"
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT.code",
"path": "MedicationRequest.dosageInstruction.route.coding.code",
"min": 1
},
{
"id": "MedicationRequest.dosageInstruction.route.coding:snomedCT.display",
"path": "MedicationRequest.dosageInstruction.route.coding.display",
"min": 1
},
{
"id": "MedicationRequest.dispenseRequest",
"path": "MedicationRequest.dispenseRequest",
"min": 1
},
{
"id": "MedicationRequest.dispenseRequest.validityPeriod",
"path": "MedicationRequest.dispenseRequest.validityPeriod",
"min": 1
},
{
"id": "MedicationRequest.dispenseRequest.validityPeriod.start",
"path": "MedicationRequest.dispenseRequest.validityPeriod.start",
"min": 1
},
{
"id": "MedicationRequest.dispenseRequest.quantity",
"path": "MedicationRequest.dispenseRequest.quantity",
"mustSupport": true
},
{
"id": "MedicationRequest.dispenseRequest.quantity.extension:quantityText",
"path": "MedicationRequest.dispenseRequest.quantity.extension",
"sliceName": "quantityText",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationQuantityText-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"mustSupport": true
},
{
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"min": 1
},
{
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator",
"max": "0"
},
{
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"min": 1,
"fixedUri": "http://unitsofmeasure.org"
},
{
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"min": 1,
"binding": {
"reference": "http://hl7.org/fhir/ValueSet/units-of-time"
},
"strength": "required",
"description": "A unit of time (units from UCUM)."
}
},
{
"id": "MedicationRequest.dispenseRequest.performer",
"path": "MedicationRequest.dispenseRequest.performer",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationRequest.priorPrescription",
"path": "MedicationRequest.priorPrescription",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1"
]
}
]
},
{
"id": "MedicationRequest.detectedIssue",
"path": "MedicationRequest.detectedIssue",
"mustSupport": true
}
]
}
}
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Reference

Canonical URI: https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1

The canonical URI is the stable FHIR identifier for this profile and is not currently available as a browsable web page.

Overarching principles

When populating the MedicationRequest profile it may appear that fields are duplicated in other associated resources. This is by design and has two benefits:

  • provides context for each individual resource
  • enables consumers to know that if no data has been populated it was because no data was available

This leads to the following two principles that MUST be applied when populating MedicationRequest profiles:

  1. All mandatory fields MUST be populated.
  2. Required fields MUST be populated where the data exists in the system

Data model element usage

Element Use CareConnect (STU3) UK Core (R4)
id
meta.versionId
meta.lastUpdated
meta.profile
meta.security
meta.tag
extension(repeatInformation)
extension(statusReason)
extension(prescriptionType)
identifier
definition
basedOn
groupIdentifier
status
intent
category
priority
medication
subject
context
supportingInformation
authoredOn
requester
recorder
reasonCode
note
dosageInstruction
dispenseRequest.validityPeriod
dispenseRequest.numberOfRepeatsAllowed
dispenseRequest.quantity
dispenseRequest.performer
substitution
priorPrescription
detectedIssue
eventHistory

id

Usage

Optional

Guidance

The id is the logical identifier for the CareConnect-GPC-MedicationRequest-1 profile.

Example
<id value="5b23906c-22b7-47dd-810b-5cbaab16a8cc" />


meta.profile

Usage

Mandatory

Guidance

The meta.profile contains a fixed value of the URL for the CareConnect-GPC-MedicationRequest-1 profile.

Example
<meta>
    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
</meta>


meta.security

Usage

Optional

Guidance

The security label(s) applicable to the resource.

See Resources not to be disclosed to a patient for more details on how to populate the element.

Example
<meta>
    <security>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="NOPAT"/>
        <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/>
    </security>
</meta>


meta.tag

Usage

Optional

Guidance

A use-case for the meta.tag element within GP Connect has not been defined.

Example
<meta>
    <tag>
        <coding>
            <system value="http://hl7.org/fhir/common-tags" />
            <code value="actionable" />
            <display value="Actionable" />
        </coding>
    </tag>
</meta>


extension(repeatInformation)

Usage

Required

Guidance

Only populate for a medication request with an intent that has been set to plan.

Note: For a medication request with an intent of order, then none of the repeatInformation fields are populated.

numberOfRepeatPrescriptionsAllowed

The number of repeat issues authorised if specified.

  • This MUST be present where a repeat is authorised for a defined number of issues.
  • It MUST NOT be specified for acute prescriptions or where the number of repeat issues has not been defined. There is no concept of an initial dispense in GP Connect usage. Therefore, the numberOfRepeats allowed is the total number of allowed issues.

numberOfRepeatPrescriptionsIssued

Running total of number of issues made against a repeat authorisation.

  • This MUST be zero, if not yet issued.

authorisationExpiryDate

The date a repeat prescription authorisation will expire.

  • Only populate for a medication request with an intent set to plan.
<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationRepeatInformation-1" />
    <!-- number of repeat Rx allowed -->
    <extension>
        <url value="numberOfRepeatPrescriptionsAllowed" />
        <valuePositiveInt value="3">
    </extension>
    <!-- number of repeat Rx issued -->
    <extension>
        <url value="numberOfRepeatPrescriptionsIssued" />
        <valuePositiveInt value="0" />
    </extension>
    <!-- authorisation expiry date -->
    <extension>
        <url value="authorisationExpiryDate" />
        <valueDateTime value="2023-01-13T00:00:00Z" />
    </extension>
</extension>


extension(statusReason)

Usage

Required

Guidance

A coded reason for the current state of the medication request.

Should only be populated when the status is on-hold, cancelled or stopped and when the medication request intent is set to plan.

Example
<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatusReason-1" />
    <extension>
        <url value="statusReason" />
        <valueCodeableConcept>
            <coding value="salg" />
            <text value="Allergy" />
        </valueCodeableConcept>
    </extension>
</extension>


extension(prescriptionType)

Usage

Required

Guidance
Note: The value set for this STU3 extension aligns with the legacy HL7v3 PrescriptionTreatmentType vocabulary.
  • acute
  • repeat
  • repeat dispensing
  • delayed prescribing.

If UK Core R4 is extended to support this type of data then the extension name should ideally not be called prescriptionType as it confused with a different legacy HL7v3 vocabulary for prescriptionType which serves a different purpose.

This element provides an explicit repeat/acute flag rather than deriving it from presence of extension elements or repeatNumber.

In exceptional cases where for legacy data there is no prescriptionType recorded in the system then this MUST not populate the element and the consumer SHOULD use the text No information available.

Example
<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescriptionType-1" />
    <valueCodeableConcept>
        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-PrescriptionType-1" />
        <code value="acute" />
    </valueCodeableConcept>
</extension>


identifier

Usage

Mandatory

Guidance

This identifier element MUST be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data). This MUST be scoped by a provider specific namespace for the identifier.

Where consuming systems are integrating data from this resource to their local system, they MUST also persist this identifier at the same time.

If the EPS identifier is present then the identifier.value is where the EPS ID SHOULD also be added. The codeSystem for this identifier is https://fhir.nhs.uk/Id/prescription-order-item-number

Example
<identifier>
    <system value="https://fhir.nhs.uk/Id/prescription-order-item-number" />
    <value value="9b4ecfde-124e-4e25-8606-a36385ce1ecc" />
</identifier>


basedOn

Usage

Required

Guidance

This field is used to create the links between MedicationRequest profiles to represent the medication ordering process as described here.

This MUST be used when a profile has an intent element that is set to order and is basedOn a MedicationRequest profile that has an intent set to plan.

Warning: DO NOT USE for authorisations - that is, for a MedicationRequest with intent of plan.
Example
<basedOn>
    <reference value="medication-request-5485984" />
</basedOn>


groupIdentifier

Usage

Required

Guidance

This element SHOULD be populated if the medication request has been prescribed via the Electronic Prescription Service (EPS).

If the EPS identifier is present then the identifier.value is where the EPS ID SHOULD also be added. The codeSystem for this identifier is https://fhir.nhs.uk/Id/prescription-order-item-number

Example
<groupIdentifier>
    <system value="https://fhir.nhs.uk/Id/prescription-order-item-number" />
    <value value="9b4ecfde-124e-4e25-8606-a36385ce1ecc" />
</groupIdentifier>


status

Usage

Mandatory

Guidance

The status of the authorisation within GP Connect will be one of active, completed or stopped:

  • active - representing an active authorisation - used for active medications/medical devices
  • completed - representing an authorisation which has run its course
  • stopped - representing an authorisation which has been discontinued, cancelled or stopped

For MedicationRequest instances where intent is set to plan:

  • For repeats and repeat dispensed the status refers to the status of the plan (the entire cycle of prescriptions)
  • For acutes the status refers to the status of the prescription issue

For MedicationRequest instances where intent is set to order:

  • The status refers to the status of the prescription issue
  • Where the plan has been discontinued then the status should not be updated to stopped

intent

Usage

Mandatory

Guidance

Used to distinguish between authorisations and issues.

Use one of plan or order:

  • plan represents an authorisation of a medication or medical device.
  • order represents a prescription or issue of a medication or medical device.
Example
<intent value="order" />


medication

Usage

Mandatory

Guidance

The medication or medical device the authorisation is for.

The Medication profile provides the coded representation of the medication or medical device.

Example
<medication>
    <coding>
        <system value="http://snomed.info/sct" />
        <code value="195967001" />
        <display value="Penicillin" />
    </coding>
</medication>


subject

Usage

Mandatory

Guidance

A reference to the patient who the medication or medical device is for - that is, to whom it will be administered.

Command 'pagelink' could not render: Page not found.

Example
 <subject>
    <identifier>
      <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1">
        <valueCodeableConcept>
          <coding>
            <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1" />
            <code value="01" />
            <display value="Number present and verified" />
          </coding>
          <text value="Number present and verified" />
        </valueCodeableConcept>
      </extension>
      <system value="https://fhir.nhs.uk/Id/nhs-number" />
      <value value="9989453456" />
    </identifier>
  </subject>


context

Usage

Required

Guidance
Note: This element has been removed from the FHIR R4 standard.

The consultation when the medication/medical device was authorised.

  • For a MedicationRequest with an intent = plan this is the consultation where the plan was authorised.
  • For a MedicationRequest with an intent = order this is the consultation where the specific issue was authorised
Example
<context>
    <identifier>
        <system value="https://hospital.example/visit-number" />
        <value value="visit-00425123" />
    </identifier>
</context>


authoredOn

Usage

Mandatory

Guidance

Authorisation date, when the medication or medical device was authorised.

Unless there is a distinct user-modifiable date and time for the authorisation, this is the audit trail dateTime for when the authorisation was entered.

Example
<authoredOn value="2022-10-13T16:59:00Z" />


requester

Usage

Required

Guidance

Person and their organization requesting authorisation for prescription.

May not always be the user who entered the record on the system but, where a system supports attribution to a responsible clinician, the attributed clinician MUST be referenced here.

If it was prescribed at another practice and has been imported via GP2GP. In that case, the onBehalfOf MUST be completed with a reference to the other organisation.

Command 'pagelink' could not render: Page not found.

Example
<requester>
    <agent>
        <identifier>
            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
            <value value="00143922" />
        </identifier>
    </agent>
</requester>


recorder

Usage

Mandatory

Guidance

The person who entered the record on the system. The table below outlines requester and recorder combinations for clarity.

Scenario Requester Recorder
Prescibing clinician Fred is requesting new medication Fred Fred
Prescibing clinician Fred is re-ordering previous medication he previously prescribed Fred Fred
Prescibing clinician Jane is re-ordering previous medication, without any clinical changes, that Fred previously prescribed Fred Jane
Prescibing clinician Jane is re-ordering previous medication that Fred previously prescribed, with clinical changes Jane Jane
Nurse Rodger is ordering medication prescribed by Fred Fred Rodger
Pharmacy technical Sally is re-ordering medication prescribed by Fred Fred Sally
Example
<recorder>
    <identifier>
        <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
        <value value="0054272" />
    </identifier>
 </recorder>


note

Usage

Required

Guidance

All notes that are associated with this medication/medical device record.

Sometimes labelled Pharmacy text or instructions for pharmacy.

Example
<note>
    <authorReference>
        <identifier>
            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
            <value value="00143922" />
        </identifier>
    </authorReference>
    <time value="2023-01-20T10:47:35.0536208+00:00" />
    <text value="Free text... R4 of the FHIR standard supports GitHub Flavoured Markdown (GFM)" />
</note>


dosageInstruction

Usage

Mandatory

Guidance

Complete dosage instructions as text.

Where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan append the following warning text to end of the dosage instructions:

WARNING – Dosage has changed during the effective period. The latest change was made on DD-Mmm-YYYY - where DD-Mmm-YYYY is the date the dosage was last changed.

In exceptional cases where for legacy data there is no dosage recorded in the system then this MUST be populated with the text: No information available.

The patientInstruction elemement MAY provide additional instructions to the patient, this is, RHS of the prescription label.

Important: The information standards notice (ISN): DAPB4013: Medicine and Allergy/Intolerance Data Transfer stipulates that structured dosage instructions should be sent.

GP Connect providers may uplift to the Information Standards Notice outlined above at different times so please account for both textual and structured representations.

See Medication and Medical Device interoperability for additional information.
Example

Legacy (free text):

<dosageInstruction>
    <text value="2 tablet - every 4 hours - up to a maximum of 6 dose in 24 hours - when migraine recurs" />
    <patientInstruction value="when migraine recurs" />
</dosageInstruction>

Structured dose syntax:

<dosageInstruction>
    <text value="2 tablet - every 4 hours - up to a maximum of 6 dose in 24 hours - when migraine recurs" />
    <patientInstruction value="when migraine recurs" />
    <timing>
        <repeat>
            <frequency value="1" />
            <period value="4" />
            <periodUnit value="h" />
        </repeat>
    </timing>
    <doseQuantity>
        <value value="2" />
        <unit value="tablet" />
        <system value="http://snomed.info/sct" />
        <code value="428673006" />
    </doseQuantity>
    <maxDosePerPeriod>
        <numerator>
            <value value="6" />
            <unit value="dose" />
            <system value="http://snomed.info/sct" />
            <code value="3317411000001100" />
        </numerator>
        <denominator>
            <value value="24" />
            <unit value="hour" />
            <system value="http://unitsofmeasure.org/" />
            <code value="h" />
        </denominator>
    </maxDosePerPeriod>
</dosageInstruction>


dispenseRequest.validityPeriod

Usage

Mandatory

Guidance

Prescription start and end dates.

Start date is mandatory. Where there is a defined expiry or end date the end date MUST be supplied.

For MedicationRequest instances where intent is set to plan:

  • This refers to the period that the medication/medical device plan is active.
  • This MUST mirror MedicationStatement.effective

For MedicationRequest instances where intent is set to order:

  • This refers to the period that the issued prescription is active

Period.start is MANDATORY

Use one of the following dates in order of descending preference:

  • The prescription issue date recorded in the patient record
  • The date the prescription was recorded.

Period.end is OPTIONAL

Use one of the following dates in order of descending preference:

  • The prescription end date recorded in the patient record
  • The prescription end date derived from Period.start and the duration
  • The Period.start date -- This option should only occur where data has been lost (for example, during the record transfer between two systems) and is used to ensure that an ended prescription will always have an end date.
Example
<dispenseRequest>
    ...
    <validityPeriod>
        <start value="2023-01-20" />
        <end value="2023-01-27" />
    </validityPeriod>
    ...
</dispenseRequest>

dispenseRequest.numberOfRepeatsAllowed

Usage

Optional

Guidance

An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets

Example
<numberOfRepeatsAllowed>
    <value value="7" />
</numberOfRepeatsAllowed>


dispenseRequest.quantity

Usage

Required

Guidance

The quantity to dispense.

When quantity to dispense is available as a numerical value dispenseRequest.quantity MUST be populated, in preference to dispenseRequest.quantityText.

Unit, system and code elements MUST be populated when information is available.

If quantity is a textual value, then the extension dispenseRequest.quantityText MUST be used for both value and units, leaving quantity element unpopulated.

When quantity to dispense is a textual value this field MUST contain both the value of the quantity to dispense and the unit e.g. ‘ten tablets’, ‘90 capsules’, ‘one dose’, ‘three millilitres’, ‘quantity varies dependent on schedule’. No information should be populated into dispenseRequest.quantity in this scenario.

Warning: The extension for `quantityText` is not currently within FHIR R4 / UK Core.
Example

Fully coded

<dispenseRequest>
    ...
    <quantity>
        <value value="14" />
        <unit value="capsule" />
        <system value="http://snomed.info/sct" />
        <code value="732937005" />
    </quantity>
    ...
</dispenseRequest>

Free text

<dispenseRequest>
    ...
    <quantity>
        <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationQuantityText-1">
            <valueString value="14 caspules" />
        </extension>
    </quantity>
    ...
</dispenseRequest>


dispenseRequest.expectedSupplyDuration

Usage

Required

Guidance

Number of days' supply per dispense.

Example
<dispenseRequest>
    ...
    <expectedSupplyDuration>
        <value value="7" />
        <unit value="d" />
        <system value="http://unitsofmeasure.org" />
        <code value="d" />
    </expectedSupplyDuration>
    ...
</dispenseRequest>


dispenseRequest.performer

Usage

Required

Guidance

The organisation that dispensed the issue. This element can only be completed where the provider organisation knows explicitly which organisation dispensed the issue.

  • It cannot be assumed to be the nominated pharmacy or appliance supplier
  • Only populate for a medication request with an intent which has the value of order
  • This field should not be populated when a medication request has intent with the value of plan
Example
<dispenseRequest>
    ...
    <performer>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
            <value value="RFR" />
        </identifier>
    </performer>
    ...
</dispenseRequest>


priorPrescription

Usage

Optional

Guidance

References prior prescription authorisation.

May be used, for example, to reference prior authorisation where prescription is re-authorised or where amendments have been made. May reference the previous authorisation before the amendment.

The published FHIR specifications described this element is slightly different ways in different parts of the FHIR specification:

  1. A link to a resource representing an earlier order related order or prescription.
  2. An order or prescription that is being replaced.

The following guidance applies to each use case.

Linking to an earlier request

A medication request that is a re-supply medication request based on a previous request referenced within priorPrescription. This would allow both the ePMA and pharmacy systems to logically link requests and add verification checks to flag any differences to the user.

Linking to an order that is being replaced

The medication request being replaced will be referenced within priorPrescription. It would be expected that the referenced resource would be updated with a status of cancelled, entered-in-error or stopped.

This will allow both the ePMA and pharmacy systems to make it clear to the human user that one medication request replaces another.

Example
<priorPrescription>
    <reference value="medicationrequest-00578231" />
</priorPrescription>


eventHistory

Usage

Optional

Guidance

A use-case for this element within the GP Connect Data model has not yet been defined.

Example
<eventHistory>
    <reference value="provenance-001243" />
</eventHistory>

MedicationRequest elements not in use

The following elements MUST NOT be populated:

meta.versionId

meta.lastUpdated

definition

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

category

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

priority

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

supportingInformation

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

reasonCode

This information is available via linking to a Problem record.

reasonReference

This information is available via linking to a Problem record.

substitution

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

detectedIssue

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

eventHistory

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

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