WARNING
This guidance is under active development by NHS England and content may be added or updated on a regular basis.Task
The FHIR Task resource is used to manage the workflow for hub & spoke dispensing.
Tree View
| Task | C | DomainResource | Element idTaskShort description A task to be performed DefinitionA task to be performed.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idTask.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idTask.metaShort description Metadata about the resource DefinitionThe 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idTask.implicitRulesShort description A set of rules under which this content was created DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idTask.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idTask.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idTask.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idTask.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idTask.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. 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
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| identifier | 0..* | Identifier | Element idTask.identifierShort description Task Instance Identifier DefinitionThe business identifier for this task. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| instantiatesCanonical | Σ | 0..1 | canonical(ActivityDefinition) | Element idTask.instantiatesCanonicalShort description Formal definition of task DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Task. Enables a formal definition of how he task is to be performed, enabling automation. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| instantiatesUri | Σ | 0..1 | uri | Element idTask.instantiatesUriShort description Formal definition of task DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Task. Enables a formal definition of how he task is to be performed (e.g. using BPMN, BPEL, XPDL or other formal notation to be associated with a task), enabling automation. see http://en.wikipedia.org/wiki/Uniform_resource_identifier The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| basedOn | Σ C | 0..* | Reference(Resource) | Element idTask.basedOnShort description Request fulfilled by this task DefinitionBasedOn refers to a higher-level authorization that triggered the creation of the task. It references a "request" resource such as a ServiceRequest, MedicationRequest, ServiceRequest, CarePlan, etc. which is distinct from the "request" resource the task is seeking to fulfill. This latter resource is referenced by FocusOn. For example, based on a ServiceRequest (= BasedOn), a task is created to fulfill a procedureRequest ( = FocusOn ) to collect a specimen from a patient. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| groupIdentifier | Σ | 0..1 | Identifier | Element idTask.groupIdentifierShort description Requisition or grouper id DefinitionAn identifier that links together multiple tasks and other requests that were created in the same context. Billing and/or reporting can be linked to whether multiple requests were created as a single unit. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| partOf | Σ C | 0..* | Reference(Task) | Element idTask.partOfShort description Composite task DefinitionTask that this particular task is part of. Allows tasks to be broken down into sub-steps (and this division can occur independent of the original task). This should usually be 0..1. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| status | Σ ?! | 1..1 | codeBinding | Element idTask.statusShort description draft | requested | received | accepted | + DefinitionThe current status of the task. These states enable coordination of task status with off-the-shelf workflow solutions that support automation of tasks. Note that FHIR strings SHALL NOT exceed 1MB in size The current status of the task. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| statusReason | Σ | 0..1 | CodeableConcept | Element idTask.statusReasonShort description Reason for current status DefinitionAn explanation as to why this task is held, failed, was refused, etc. This applies to the current status. Look at the history of the task to see reasons for past statuses. Codes to identify the reason for current status. These will typically be specific to a particular workflow. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| businessStatus | Σ | 0..1 | CodeableConcept | Element idTask.businessStatusShort description E.g. "Specimen collected", "IV prepped" DefinitionContains business-specific nuances of the business state. There's often a need to track substates of a task - this is often variable by specific workflow implementation. 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. The domain-specific business-contextual sub-state of the task. For example: "Blood drawn", "IV inserted", "Awaiting physician signature", etc. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| intent | Σ | 1..1 | codeBinding | Element idTask.intentShort description unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option DefinitionIndicates the "level" of actionability associated with the Task, i.e. i+R[9]Cs this a proposed task, a planned task, an actionable task, etc. This element is immutable. Proposed tasks, planned tasks, etc. must be distinct instances. In most cases, Tasks will have an intent of "order". Distinguishes whether the task is a proposal, plan or full order. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| priority | 0..1 | codeBinding | Element idTask.priorityShort description routine | urgent | asap | stat DefinitionIndicates how quickly the Task should be addressed with respect to other requests. Used to identify the service level expected while performing a task. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority The task's priority. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| code | Σ | 0..1 | CodeableConcept | Element idTask.codeShort description Task Type DefinitionA name or code (or both) briefly describing what the task involves. The title (eg "My Tasks", "Outstanding Tasks for Patient X") should go into the code. Codes to identify what the task involves. These will typically be specific to a particular workflow. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| description | Σ | 0..1 | string | Element idTask.descriptionShort description Human-readable explanation of task DefinitionA free-text description of what is to be performed. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| focus | Σ C | 0..1 | Reference(Resource) | Element idTask.focusShort description What task is acting on DefinitionThe request being actioned or the resource being manipulated by this task. Used to identify the thing to be done. If multiple resources need to be manipulated, use sub-tasks. (This ensures that status can be tracked independently for each referenced resource.). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| for | Σ C | 0..1 | Reference(Resource) | Element idTask.forShort description Beneficiary of the Task Alternate namesPatient DefinitionThe entity who benefits from the performance of the service specified in the task (e.g., the patient). Used to track tasks outstanding for a beneficiary. Do not use to track the task owner or creator (see owner and creator respectively). This can also affect access control. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| encounter | Σ C | 0..1 | Reference(Encounter) | Element idTask.encounterShort description Healthcare event during which this task originated DefinitionThe healthcare event (e.g. a patient and healthcare provider interaction) during which this task was created. For some tasks it may be important to know the link between the encounter the task originated within. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| executionPeriod | Σ C | 0..1 | Period | Element idTask.executionPeriodShort description Start and end time of execution DefinitionIdentifies the time action was first taken against the task (start) and/or the time final action was taken against the task prior to marking it as completed (end). 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| authoredOn | C | 0..1 | dateTime | Element idTask.authoredOnShort description Task Creation Date Alternate namesCreated Date DefinitionThe date and time this task was created. Most often used along with lastUpdated to track duration of task to supporting monitoring and management. The cardinality or value of this element may be affected by these constraints: ele-1, inv-1 Constraints
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| lastModified | Σ C | 0..1 | dateTime | Element idTask.lastModifiedShort description Task Last Modified Date Alternate namesUpdate Date DefinitionThe date and time of last modification to this task. Used along with history to track task activity and time in a particular task state. This enables monitoring and management. The cardinality or value of this element may be affected by these constraints: ele-1, inv-1 Constraints
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| requester | Σ C | 0..1 | Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | Element idTask.requesterShort description Who is asking for task to be done DefinitionThe creator of the task. Identifies who created this task. May be used by access control mechanisms (e.g., to ensure that only the creator can cancel a task). 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. Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| performerType | 0..* | CodeableConceptBinding | Element idTask.performerTypeShort description Requested performer DefinitionThe kind of participant that should perform the task. Use to distinguish tasks on different activity queues. 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. The type(s) of task performers allowed. ProcedurePerformerRoleCodes (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| owner | Σ C | 0..1 | Reference(CareTeam | Device | HealthcareService | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | Element idTask.ownerShort description Responsible individual Alternate namesPerformer, Executer DefinitionIndividual organization or Device currently responsible for task execution. Identifies who is expected to perform this task. Tasks may be created with an owner not yet identified. Reference(CareTeam | Device | HealthcareService | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| location | Σ C | 0..1 | Reference(Location) | Element idTask.locationShort description Where task occurs DefinitionPrincipal physical location where the this task is performed. Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| reasonCode | 0..1 | CodeableConcept | Element idTask.reasonCodeShort description Why task is needed DefinitionA description or code indicating why this task needs to be performed. This should only be included if there is no focus or if it differs from the reason indicated on the focus. Indicates why the task is needed. E.g. Suspended because patient admitted to hospital. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| reasonReference | C | 0..1 | Reference(Resource) | Element idTask.reasonReferenceShort description Why task is needed DefinitionA resource reference indicating why this task needs to be performed. Tasks might be justified based on an Observation, a Condition, a past or planned procedure, etc. This should only be included if there is no focus or if it differs from the reason indicated on the focus. Use the CodeableConcept text element in The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| insurance | C | 0..* | Reference(ClaimResponse | Coverage) | Element idTask.insuranceShort description Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be relevant to the Task. 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. Reference(ClaimResponse | Coverage) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| note | 0..* | Annotation | Element idTask.noteShort description Comments made about the task DefinitionFree-text information captured about the task as it progresses. 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). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| relevantHistory | C | 0..* | Reference(Provenance) | Element idTask.relevantHistoryShort description Key events in history of the Task Alternate namesStatus History DefinitionLinks to Provenance records for past versions of this Task that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the task. This element does not point to the Provenance associated with the current version of the resource - as it would be created after this version existed. The Provenance for the current version can be retrieved with a _revinclude. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| restriction | 0..1 | BackboneElement | Element idTask.restrictionShort description Constraints on fulfillment tasks DefinitionIf the Task.focus is a request resource and the task is seeking fulfillment (i.e. is asking for the request to be actioned), this element identifies any limitations on what parts of the referenced request should be actioned. Sometimes when fulfillment is sought, you don't want full fulfillment. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idTask.restriction.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idTask.restriction.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idTask.restriction.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| repetitions | 0..1 | positiveInt | Element idTask.restriction.repetitionsShort description How many times to repeat DefinitionIndicates the number of times the requested action should occur. E.g. order that requests monthly lab tests, fulfillment is sought for 1. 32 bit number; for values larger than this, use decimal The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| period | C | 0..1 | Period | Element idTask.restriction.periodShort description When fulfillment sought DefinitionOver what time-period is fulfillment sought. E.g. order that authorizes 1 year's services. Fulfillment is sought for next 3 months. Note that period.high is the due date representing the time by which the task should be completed. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| recipient | C | 0..* | Reference(Group | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | Element idTask.restriction.recipientShort description For whom is fulfillment sought? DefinitionFor requests that are targeted to more than on potential recipient/target, for whom is fulfillment sought? 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. Reference(Group | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| input | 0..* | BackboneElement | Element idTask.inputShort description Information used to perform task Alternate namesSupporting Information DefinitionAdditional information that may be needed in the execution of the task. Resources and data used to perform the task. This data is used in the business logic of task execution, and is stored separately because it varies between workflows. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idTask.input.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idTask.input.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idTask.input.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| type | 1..1 | CodeableConcept | Element idTask.input.typeShort description Label for the input Alternate namesName DefinitionA code or description indicating how the input is intended to be used as part of the task execution. Inputs are named to enable task automation to bind data and pass it from one task to the next. If referencing a BPMN workflow or Protocol, the "system" is the URL for the workflow definition and the code is the "name" of the required input. Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| value[x] | 1..1 | Element idTask.input.value[x]Short description Content to use in performing the task DefinitionThe value of the input parameter as a basic type. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| valueAddress | Address | Data type | ||||
| valueAge | Age | Data type | ||||
| valueAnnotation | Annotation | Data type | ||||
| valueAttachment | Attachment | Data type | ||||
| valueBase64Binary | base64Binary | Data type | ||||
| valueBoolean | boolean | Data type | ||||
| valueCanonical | canonical | Data type | ||||
| valueCode | code | Data type | ||||
| valueCodeableConcept | CodeableConcept | Data type | ||||
| valueCoding | Coding | Data type | ||||
| valueContactDetail | ContactDetail | Data type | ||||
| valueContactPoint | ContactPoint | Data type | ||||
| valueContributor | Contributor | Data type | ||||
| valueCount | Count | Data type | ||||
| valueDataRequirement | DataRequirement | Data type | ||||
| valueDate | date | Data type | ||||
| valueDateTime | dateTime | Data type | ||||
| valueDecimal | decimal | Data type | ||||
| valueDistance | Distance | Data type | ||||
| valueDosage | Dosage | Data type | ||||
| valueDuration | Duration | Data type | ||||
| valueExpression | Expression | Data type | ||||
| valueHumanName | HumanName | Data type | ||||
| valueId | id | Data type | ||||
| valueIdentifier | Identifier | Data type | ||||
| valueInstant | instant | Data type | ||||
| valueInteger | integer | Data type | ||||
| valueMarkdown | markdown | Data type | ||||
| valueMeta | Meta | Data type | ||||
| valueMoney | Money | Data type | ||||
| valueOid | oid | Data type | ||||
| valueParameterDefinition | ParameterDefinition | Data type | ||||
| valuePeriod | Period | Data type | ||||
| valuePositiveInt | positiveInt | Data type | ||||
| valueQuantity | Quantity | Data type | ||||
| valueRange | Range | Data type | ||||
| valueRatio | Ratio | Data type | ||||
| valueReference | Reference | Data type | ||||
| valueRelatedArtifact | RelatedArtifact | Data type | ||||
| valueSampledData | SampledData | Data type | ||||
| valueSignature | Signature | Data type | ||||
| valueString | string | Data type | ||||
| valueTime | time | Data type | ||||
| valueTiming | Timing | Data type | ||||
| valueTriggerDefinition | TriggerDefinition | Data type | ||||
| valueUnsignedInt | unsignedInt | Data type | ||||
| valueUri | uri | Data type | ||||
| valueUrl | url | Data type | ||||
| valueUsageContext | UsageContext | Data type | ||||
| valueUuid | uuid | Data type | ||||
| output | 0..* | BackboneElement | Element idTask.outputShort description Information produced as part of task DefinitionOutputs produced by the Task. Resources and data produced during the execution the task. This data is generated by the business logic of task execution, and is stored separately because it varies between workflows. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idTask.output.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idTask.output.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idTask.output.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | 1..1 | CodeableConcept | Element idTask.output.typeShort description Label for output Alternate namesName DefinitionThe name of the Output parameter. Outputs are named to enable task automation to bind data and pass it from one task to the next. 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. Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| value[x] | 1..1 | Element idTask.output.value[x]Short description Result of output DefinitionThe value of the Output parameter as a basic type. Task outputs can take any form. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||||
| valueAddress | Address | Data type | ||||
| valueAge | Age | Data type | ||||
| valueAnnotation | Annotation | Data type | ||||
| valueAttachment | Attachment | Data type | ||||
| valueBase64Binary | base64Binary | Data type | ||||
| valueBoolean | boolean | Data type | ||||
| valueCanonical | canonical | Data type | ||||
| valueCode | code | Data type | ||||
| valueCodeableConcept | CodeableConcept | Data type | ||||
| valueCoding | Coding | Data type | ||||
| valueContactDetail | ContactDetail | Data type | ||||
| valueContactPoint | ContactPoint | Data type | ||||
| valueContributor | Contributor | Data type | ||||
| valueCount | Count | Data type | ||||
| valueDataRequirement | DataRequirement | Data type | ||||
| valueDate | date | Data type | ||||
| valueDateTime | dateTime | Data type | ||||
| valueDecimal | decimal | Data type | ||||
| valueDistance | Distance | Data type | ||||
| valueDosage | Dosage | Data type | ||||
| valueDuration | Duration | Data type | ||||
| valueExpression | Expression | Data type | ||||
| valueHumanName | HumanName | Data type | ||||
| valueId | id | Data type | ||||
| valueIdentifier | Identifier | Data type | ||||
| valueInstant | instant | Data type | ||||
| valueInteger | integer | Data type | ||||
| valueMarkdown | markdown | Data type | ||||
| valueMeta | Meta | Data type | ||||
| valueMoney | Money | Data type | ||||
| valueOid | oid | Data type | ||||
| valueParameterDefinition | ParameterDefinition | Data type | ||||
| valuePeriod | Period | Data type | ||||
| valuePositiveInt | positiveInt | Data type | ||||
| valueQuantity | Quantity | Data type | ||||
| valueRange | Range | Data type | ||||
| valueRatio | Ratio | Data type | ||||
| valueReference | Reference | Data type | ||||
| valueRelatedArtifact | RelatedArtifact | Data type | ||||
| valueSampledData | SampledData | Data type | ||||
| valueSignature | Signature | Data type | ||||
| valueString | string | Data type | ||||
| valueTime | time | Data type | ||||
| valueTiming | Timing | Data type | ||||
| valueTriggerDefinition | TriggerDefinition | Data type | ||||
| valueUnsignedInt | unsignedInt | Data type | ||||
| valueUri | uri | Data type | ||||
| valueUrl | url | Data type | ||||
| valueUsageContext | UsageContext | Data type | ||||
| valueUuid | uuid | Data type |
Examples
Task POST Creation
In this example there are 2 x MedicationRequest resources referenced by the Task.input. The Task will be included within the Bundle for the PharmacySpokeToHub FHIR Transaction.
{
"resourceType": "Task",
"meta": {
"profile": [
"https://hl7.org/fhir/r4/StructureDefinition/Task"
]
},
"id": "ae92a488-92a1-42e0-a1c7-e61f6beb8c78",
"status": "requested",
"intent": "order",
"requester": {
"reference": "urn:uuid:a5acefc1-f8ca-4989-a5ac-34ae36741466"
},
"input": [
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/resource-types",
"code": "MedicationRequest",
"display": "MedicationRequest"
}
]
},
"valueReference": {
"reference": "urn:uuid:29356196-1c07-4057-a7f3-e8d9b7e20926",
"type": "MedicationRequest"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/resource-types",
"code": "MedicationRequest",
"display": "MedicationRequest"
}
]
},
"valueReference": {
"reference": "urn:uuid:0b7497d3-5489-45fc-bd82-4d58a393f010",
"type": "MedicationRequest"
}
},
]
}
Task PATCH (Accepted)
PATCH https://{base}/Task/{TaskID}
Content-type: application/fhir+json
{
"resourceType": "Parameters",
"parameter": [
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "replace"
},
{
"name": "path",
"valueString": "Task.status"
},
{
"name": "value",
"valueString": "accepted"
}
]
}
]
}
Task PATCH (Completed)
In this example there is a single MedicationDispense resource referenced by the Task.output. The update to complete the Task will be included within the Bundle for the PharmacyHubToSpoke FHIR Transaction.
{
"resourceType": "Parameters",
"parameter": [
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "replace"
},
{
"name": "path",
"valueString": "Task.status"
},
{
"name": "value",
"valueString": "completed"
}
]
},
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "add"
},
{
"name": "path",
"valueString": "Task.output[0].type"
},
{
"name": "value",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/resource-types",
"code": "MedicationDispense",
"display": "MedicationDispense"
}
]
}
}
]
},
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "add"
},
{
"name": "path",
"valueString": "Task.output[0].valueReference"
},
{
"name": "value",
"valueReference": {
"reference": "urn:uuid:312d757e-21f1-4f10-9f02-1746768bc31d"
}
}
]
}
]
}
Required / Minimum Dataset
The required fields that represent the minimum dataset to be shared with the spoke pharmacy (the requester) for medication assembled, labelled and shipped to the spoke pharmacy are as follows.
| Element | Implementation Requirements |
|---|---|
id |
A locally generated UUID. |
status |
See note below. |
intent |
Fixed value of order. |
requester |
A reference to a UKCore-Organization resource for the spoke pharmacy. |
input |
Reference to any number of UKCore-MedicationRequest resources. It is an implementation decision for the relationship between a Task and a MedicationRequest. There may be a 1-to-1 relationship where each Task relates to a single MedicationRequest. There may be a 1-to-many relationship where a Task relates to multiple MedicationRequests, which can either be for the same patient or different patients. |
output |
Omitted by the spoke (requestor) pharmacy. The hub (provider) pharmacy updates with references to any number of UKCore-MedicationDispense resources. The number of referenced MedicationDispenses will depend on how many MedicationRequests were an input for the Task. |
Note: Use of Task.status
The Task.status element is key to managing the workflow for hub & spoke dispensing.
The Task is created and persisted by the requestor with the status set to requested when the PharmacySpokeToHub FHIR Transaction is posted to the performer.
The performer uses an HTTP PATCH to amend the Task setting the status to either accepted or rejected. If rejected, the spoke pharmacy needs to find an alternative assembly solution.
Optionally the performer may use an HTTP PATCH to amend the Task status to in-progress once the assembly process has started.
Optionally the performer may use an HTTP PATCH to amend the Task status to on-hold if the assembly process pauses, for example, if stock is temporarily unavailable, or there are clinical queries that need to be discussed with the spoke pharmacy.
The performer uses an HTTP POST containing a PharmacyHubToSpoke FHIR Transaction to the requestor. Within this will be an HTTP PATCH for amend the Task resource to a status of completed.
The performer would use an HTTP PATCH to amend the Task status to failed if the assembly process cannot be completed, meaning no medication will be shipped and the spoke needs to find an alternative assembly solution.
Implementation of HTTP PATCH
The FHIR standard support various way to PATCH a resource. Using a FHIRPath with a Parameters resource is preferred over using a JSONPatch, as the latter requires the content to be base64 encoded when used within a Bundle. The examples above include those for a PATCH operation.
UKCore-MedicationRequest
Tree View
| UKCoreMedicationRequest (MedicationRequest) | C | MedicationRequest | There are no (further) constraints on this element Element idMedicationRequestShort description Ordering of medication for patient or group Alternate namesPrescription, Order DefinitionAn 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.
| |||
| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationRequest.metaShort description Metadata about the resource DefinitionThe 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationRequest.implicitRulesShort description A set of rules under which this content was created DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| text | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationRequest.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationRequest.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| medicationRepeatInformation | C | 0..1 | Extension(Complex) | Element idMedicationRequest.extension:medicationRepeatInformationShort description Allows the resource to be referenced within / by other resources. Alternate namesextensions, user content DefinitionMedication repeat information. 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. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. 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
| ||
| identifier | S | 0..* | Identifier | Element idMedicationRequest.identifierShort description Allows the resource to be referenced within / by other resources. DefinitionIdentifiers 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. This is a business identifier, not a resource identifier. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| status | S Σ ?! | 1..1 | codeBinding | Element idMedicationRequest.statusShort description A code specifying the current state of the order. DefinitionA code specifying the current state of the order. Generally, this will be active or completed state. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. medicationrequest Status (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| statusReason | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.statusReasonShort description Reason for current status DefinitionCaptures the reason for the current state of the MedicationRequest. 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. Identifies the reasons for a given status. medicationRequest Status Reason Codes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| intent | S Σ ?! | 1..1 | codeBinding | Element idMedicationRequest.intentShort description Whether the request is a proposal, plan, or an original order. DefinitionWhether the request is a proposal, plan, or an original order. 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. The kind of medication order. medicationRequest Intent (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| category | S | 0..* | CodeableConceptBinding | Element idMedicationRequest.categoryShort description Provides the business context for the relevant dispensing processes. DefinitionIndicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). The category can be used to include where the medication is expected to be consumed or other types of requests. 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. UKCoreMedicationRequestCategory (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| priority | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.priorityShort description routine | urgent | asap | stat DefinitionIndicates how quickly the Medication Request should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size Identifies the level of importance to be assigned to actioning the request. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.doNotPerformShort description True if request is prohibiting action DefinitionIf true indicates that the provider is asking for the medication request not to occur. If do not perform is not specified, the request is a positive request e.g. "do perform". The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| reported[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationRequest.reported[x]Short description Reported rather than primary record DefinitionIndicates 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| reportedBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| reportedReference | Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | There are no (further) constraints on this element Data typeReference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | ||||
| medication[x] | S Σ | 1..1 | Binding | Element idMedicationRequest.medication[x]Short description Identifies the medication being requested. DefinitionIdentifies 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. 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. A coded concept identifying substance or product that can be ordered. UKCoreMedicationCode (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| medicationCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||||
| medicationReference | Reference(Medication) | There are no (further) constraints on this element Data type | ||||
| subject | S Σ C | 1..1 | Reference(Group | Patient) | Element idMedicationRequest.subjectShort description Who the medication request is for. DefinitionA link to a resource representing the person or set of individuals to whom the medication will be given. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| encounter | C | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idMedicationRequest.encounterShort description Encounter created as part of encounter/admission/stay DefinitionThe Encounter during which this [x] was created or to which the creation of this record is tightly associated. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| supportingInformation | C | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationRequest.supportingInformationShort description Information to support ordering of the medication DefinitionInclude additional information (for example, patient height and weight) that supports the ordering of the medication. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| authoredOn | S Σ | 0..1 | dateTime | Element idMedicationRequest.authoredOnShort description The date / time that the medication request was initially authored. DefinitionThe date (and perhaps time) when the prescription was initially written or authored on. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| requester | S Σ C | 0..1 | Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | Element idMedicationRequest.requesterShort description Who is requesting the medication. DefinitionThe individual, organization, or device that initiated the request and has responsibility for its activation. 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. Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| performer | C | 0..1 | Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | There are no (further) constraints on this element Element idMedicationRequest.performerShort description Intended performer of administration DefinitionThe specified desired performer of the medication treatment (e.g. the performer of the medication administration). 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. Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.performerTypeShort description Desired kind of performer of the medication administration DefinitionIndicates the type of performer of the administration of the medication. 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. Identifies the type of individual that is desired to administer the medication. ProcedurePerformerRoleCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| recorder | C | 0..1 | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idMedicationRequest.recorderShort description Person who entered the request DefinitionThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. 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. Reference(Practitioner | PractitionerRole) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.reasonCodeShort description Reason or indication for ordering or not ordering the medication DefinitionThe reason or the indication for ordering or not ordering the medication. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. A coded concept indicating why the medication was ordered. Condition/Problem/DiagnosisCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| reasonReference | C | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationRequest.reasonReferenceShort description Condition or observation that supports why the prescription is being written DefinitionCondition or observation that supports why the medication was ordered. This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Reference(Condition | Observation) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| instantiatesCanonical | Σ | 0..* | canonical | There are no (further) constraints on this element Element idMedicationRequest.instantiatesCanonicalShort description Instantiates FHIR protocol or definition DefinitionThe URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element idMedicationRequest.instantiatesUriShort description Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. see http://en.wikipedia.org/wiki/Uniform_resource_identifier The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| basedOn | Σ C | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest) | There are no (further) constraints on this element Element idMedicationRequest.basedOnShort description What request fulfills DefinitionA plan or request that is fulfilled in whole or in part by this medication request. 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. Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| groupIdentifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationRequest.groupIdentifierShort description Composite request this is part of DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| courseOfTherapyType | 0..1 | CodeableConceptBinding | Element idMedicationRequest.courseOfTherapyTypeShort description A course of therapy for a medication request DefinitionThe description of the course of therapy for a medication request. This attribute should not be confused with the protocol of the medication. Identifies the overall pattern of medication administratio. UKCoreMedicationRequestCourseOfTherapy (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| insurance | C | 0..* | Reference(ClaimResponse | Coverage) | There are no (further) constraints on this element Element idMedicationRequest.insuranceShort description Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. 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. Reference(ClaimResponse | Coverage) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationRequest.noteShort description Information about the prescription DefinitionExtra information about the prescription that could not be conveyed by the other attributes. 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). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| dosageInstruction | S | 0..* | Dosage | Element idMedicationRequest.dosageInstructionShort description Dosage instructions for the medication. DefinitionIndicates how the medication is to be used by the patient. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| sequence | Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.sequenceShort description The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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. 32 bit number; for values larger than this, use decimal The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | S Σ | 0..1 | string | Element idMedicationRequest.dosageInstruction.textShort description Free text dosage instructions. DefinitionFree text dosage instructions e.g. SIG. 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. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.additionalInstructionShort description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" DefinitionSupplemental 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"). 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. 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. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.patientInstructionShort description Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| timing | S Σ | 0..1 | Timing | Element idMedicationRequest.dosageInstruction.timingShort description When the medication should be administered. DefinitionWhen medication should be administered. 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| asNeeded[x] | Σ | 0..1 | Binding | Element idMedicationRequest.dosageInstruction.asNeeded[x]Short description Take "as needed" (for x) DefinitionIndicates 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). 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". 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 (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||||
| site | Σ | 0..1 | CodeableConceptBinding | Element idMedicationRequest.dosageInstruction.siteShort description Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| route | Σ | 0..1 | CodeableConceptBinding | Element idMedicationRequest.dosageInstruction.routeShort description How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. 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. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. UKCoreSubstanceOrProductAdministrationRoute (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| method | Σ | 0..1 | CodeableConceptBinding | Element idMedicationRequest.dosageInstruction.methodShort description Technique for administering medication DefinitionTechnique for administering medication. 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. UKCoreMedicationDosageMethod (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| doseAndRate | S Σ | 0..* | Element | Element idMedicationRequest.dosageInstruction.doseAndRateShort description Dosage instructions for the requested medication. DefinitionThe amount of medication administered. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.typeShort description The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". 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. The kind of dose or rate specified. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| dose[x] | S Σ | 0..1 | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]Short description Quantity of requested medication to be administered. DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||||
| doseRange | Range | There are no (further) constraints on this element Data type | ||||
| rate[x] | S Σ | 0..1 | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]Short description Rate at which the requested medication is to be administered. DefinitionAmount of medication per unit of time. 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||||
| rateRange | Range | There are no (further) constraints on this element Data type | ||||
| rateRatio | Ratio | There are no (further) constraints on this element Data type | ||||
| maxDosePerPeriod | Σ C | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriodShort description Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. 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". The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| maxDosePerAdministration | Σ C | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministrationShort description Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| maxDosePerLifetime | Σ C | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerLifetimeShort description Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| dispenseRequest | S | 0..1 | BackboneElement | Element idMedicationRequest.dispenseRequestShort description Specific dispensing quantity instructions. DefinitionIndicates 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| initialFill | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFillShort description First fill details DefinitionIndicates the quantity or duration for the first dispense of the medication. If populating this element, either the quantity or the duration must be included. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| quantity | C | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.quantityShort description First fill quantity DefinitionThe amount or quantity to provide as part of the first dispense. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| duration | C | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.durationShort description First fill duration DefinitionThe length of time that the first dispense is expected to last. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| dispenseInterval | C | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.dispenseIntervalShort description Minimum period of time between dispenses DefinitionThe minimum period of time that must occur between dispenses of the medication. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| validityPeriod | C | 0..1 | Period | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.validityPeriodShort description Time period supply is authorized for DefinitionThis indicates the validity period of a prescription (stale dating the Prescription). Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| numberOfRepeatsAllowed | 0..1 | unsignedInt | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.numberOfRepeatsAllowedShort description Number of refills authorized DefinitionAn 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. If displaying "number of authorized fills", add 1 to this number. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| quantity | S C | 0..1 | SimpleQuantity | Element idMedicationRequest.dispenseRequest.quantityShort description >Amount of medication to supply per dispense. DefinitionThe amount that is to be dispensed for one fill. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| expectedSupplyDuration | C | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.expectedSupplyDurationShort description Number of days supply per dispense DefinitionIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| performer | C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.performerShort description Intended dispenser DefinitionIndicates the intended dispensing Organization specified by the prescriber. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| substitution | S | 1..1 | BackboneElement | Element idMedicationRequest.substitutionShort description Any restrictions on medication substitution. DefinitionIndicates 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.substitution.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| allowed[x] | 1..1 | Element idMedicationRequest.substitution.allowed[x]Short description Whether substitution is allowed or not DefinitionThe purpose of this element is to allow the prescriber to dispense a different drug from what was prescribed. This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Identifies the type of substitution allowed. v3.ActSubstanceAdminSubstitutionCode (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||||
| allowedBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| allowedCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||||
| reason | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.substitution.reasonShort description Why should (not) substitution be made DefinitionIndicates the reason for the substitution, or why substitution must or must not be performed. 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. A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| priorPrescription | C | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationRequest.priorPrescriptionShort description An order/prescription that is being replaced DefinitionA link to a resource representing an earlier order related order or prescription. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| detectedIssue | C | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element idMedicationRequest.detectedIssueShort description Clinical Issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| eventHistory | C | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationRequest.eventHistoryShort description A list of events of interest in the lifecycle DefinitionLinks 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. 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.). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
|
Example
{
"resourceType": "MedicationRequest",
"meta": {
"profile": [
"https://fhir.nhs.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"id": "29356196-1c07-4057-a7f3-e8d9b7e20926",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
"value": "7dc0390a-f416-4d8a-9751-257bfa6294cd"
}
],
"status": "active",
"intent": "order",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://dmd.nhs.uk",
"code": "39720311000001101",
"display": "Paracetamol 500mg soluble tablets"
}
]
},
"subject": {
"reference": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2"
},
"authoredOn": "2025-09-08T09:00:00+00:00",
"requester": {
"reference": "urn:uuid:a5acefc1-f8ca-4989-a5ac-34ae36741466"
},
"dosageInstruction": [
{
"patientInstruction": "Take 2 tablets - 3 times a day - for 1 week"
}
],
"dispenseRequest": {
"quantity": {
"value": 60,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
},
"performer": {
"reference": "urn:uuid:89d46cf0-94a6-4ec4-97e1-2bdfca664b77"
}
}
}
}
Required / Minimum Dataset
The required fields that represent the minimum dataset to be shared with the hub pharmacy (the performer) for the purposes of hub pharmacy dispensing are as follows.
| Element | Implementation Requirements |
|---|---|
id |
A locally generated UUID |
identifier |
Use as provided by EPS, or omit if a paper FP10 prescription |
status |
Fixed value of active |
intent |
Fixed value of order |
medicationCodeableConcept |
The dm+d code, display and system for the prescribed medication as provided by EPS. If received as a paper FP10 prescription and cannot be mapped to a valid dm+d concept then use .text. |
subject |
A reference of a UKCore-Patient resource. Where the NHS Number is not known, include a UUID or another suitably unique identifier within the Patient resource. |
authoredOn |
As provided by EPS, or prescription date as recorded within the pharmacy system for a paper FP10 prescription. |
dosageInstruction.patientInstruction |
String dosing instruction for the hub to use on the printed medication dispensing label. This may be as provided by the prescriber or may be an amended dosing instruction from the spoke pharmacy. |
dispenseRequest.quantity |
As provided by EPS, or prescribed quantity as recorded within the pharmacy system for a paper FP10 prescription. |
dispenseRequest.performer |
A reference to an UKCore-Organization resource for the spoke pharmacy. |
UKCore-MedicationDispense
Tree View
| UKCoreMedicationDispense (MedicationDispense) | C | MedicationDispense | There are no (further) constraints on this element Element idMedicationDispenseShort description Dispensing a medication to a named patient DefinitionIndicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
| |||
| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationDispense.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationDispense.metaShort description Metadata about the resource DefinitionThe 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationDispense.implicitRulesShort description A set of rules under which this content was created DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationDispense.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| text | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationDispense.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationDispense.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. 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
| ||
| identifier | S | 0..* | Identifier | Element idMedicationDispense.identifierShort description Allows the resource to be referenced within / by other resources. DefinitionIdentifiers associated with this Medication Dispense 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. This is a business identifier, not a resource identifier. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| partOf | C | 0..* | Reference(Procedure) | There are no (further) constraints on this element Element idMedicationDispense.partOfShort description Event that dispense is part of DefinitionThe procedure that trigger the dispense. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| status | S Σ ?! | 1..1 | codeBinding | Element idMedicationDispense.statusShort description A code that describes the status of the dispensing event. DefinitionA code specifying the state of the set of dispense events. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept specifying the state of the dispense event. MedicationDispense Status Codes (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| statusReason[x] | 0..1 | There are no (further) constraints on this element Element idMedicationDispense.statusReason[x]Short description Why a dispense was not performed DefinitionIndicates the reason why a dispense was not performed. A code describing why a dispense was not performed. MedicationDispense Status Reason Codes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||||
| statusReasonCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||||
| statusReasonReference | Reference(DetectedIssue) | There are no (further) constraints on this element Data type | ||||
| category | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationDispense.categoryShort description Type of medication dispense DefinitionIndicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind. A code describing where the dispensed medication is expected to be consumed or administered. MedicationDispense Category Codes (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| medication[x] | S Σ | 1..1 | Binding | Element idMedicationDispense.medication[x]Short description What medication was supplied. DefinitionIdentifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. 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, then you must reference the Medication resource. A coded concept identifying which substance or product can be dispensed. UKCoreMedicationCode (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| medicationCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||||
| medicationReference | Reference(Medication) | There are no (further) constraints on this element Data type | ||||
| subject | S Σ C | 0..1 | Reference(Group | Patient) | Element idMedicationDispense.subjectShort description Identifies the patient. DefinitionA link to a resource representing the person or the group to whom the medication will be given. SubstanceAdministration->subject->Patient. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| context | C | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationDispense.contextShort description Encounter / Episode associated with event DefinitionThe encounter or episode of care that establishes the context for this event. 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. Reference(Encounter | EpisodeOfCare) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| supportingInformation | C | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationDispense.supportingInformationShort description Information that supports the dispensing of the medication DefinitionAdditional information that supports the medication being dispensed. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| performer | S | 0..* | BackboneElement | Element idMedicationDispense.performerShort description Who or what performed the dispensing event. DefinitionIndicates who or what performed the event. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationDispense.performer.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.performer.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.performer.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.performer.functionShort description Who performed the dispense and what they did DefinitionDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. Allows disambiguation of the types of involvement of different performers. 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. A code describing the role an individual played in dispensing a medication. MedicationDispense Performer Function Codes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| actor | C | 1..1 | Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | There are no (further) constraints on this element Element idMedicationDispense.performer.actorShort description Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. 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. Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| location | C | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idMedicationDispense.locationShort description Where the dispense occurred DefinitionThe principal physical location where the dispense was performed. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| authorizingPrescription | C | 0..* | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationDispense.authorizingPrescriptionShort description Medication order that authorizes the dispense DefinitionIndicates the medication order that is being dispensed against. Maps to basedOn in Event logical model. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | 0..1 | CodeableConceptBinding | Element idMedicationDispense.typeShort description Trial fill, partial fill, emergency fill, etc. DefinitionIndicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. 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. Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. UKCoreMedicationSupplyType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| quantity | S C | 0..1 | SimpleQuantity | Element idMedicationDispense.quantityShort description Quantity of medication dispensed. DefinitionThe amount of medication that has been dispensed. Includes unit of measure. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| daysSupply | C | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationDispense.daysSupplyShort description Amount of medication expressed as a timing amount DefinitionThe amount of medication expressed as a timing amount. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| whenPrepared | S Σ | 0..1 | dateTime | Element idMedicationDispense.whenPreparedShort description Timestamp for when the medication was prepared. DefinitionThe time when the dispensed product was packaged and reviewed. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| whenHandedOver | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationDispense.whenHandedOverShort description When product was given out DefinitionThe time the dispensed product was provided to the patient or their representative. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| destination | C | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idMedicationDispense.destinationShort description Where the medication was sent DefinitionIdentification of the facility/location where the medication was shipped to, as part of the dispense event. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| receiver | C | 0..* | Reference(Patient | Practitioner) | There are no (further) constraints on this element Element idMedicationDispense.receiverShort description Who collected the medication DefinitionIdentifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. 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. Reference(Patient | Practitioner) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationDispense.noteShort description Information about the dispense DefinitionExtra information about the dispense that could not be conveyed in the other attributes. 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). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| dosageInstruction | S | 0..* | Dosage | Element idMedicationDispense.dosageInstructionShort description Dosage instruction for the dispensed medication. DefinitionIndicates how the medication is to be used by the patient. When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| sequence | Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.sequenceShort description The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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. 32 bit number; for values larger than this, use decimal The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| text | S Σ | 0..1 | string | Element idMedicationDispense.dosageInstruction.textShort description Free text dosage instructions. DefinitionFree text dosage instructions e.g. SIG. 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. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.additionalInstructionShort description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" DefinitionSupplemental 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"). 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. 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. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.patientInstructionShort description Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| timing | S Σ | 0..1 | Timing | Element idMedicationDispense.dosageInstruction.timingShort description When medication should be administered. DefinitionWhen medication should be administered. 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| asNeeded[x] | Σ | 0..1 | Binding | Element idMedicationDispense.dosageInstruction.asNeeded[x]Short description Take "as needed" (for x) DefinitionIndicates 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). 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". 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 (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||||
| site | Σ | 0..1 | CodeableConceptBinding | Element idMedicationDispense.dosageInstruction.siteShort description Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| route | Σ | 0..1 | CodeableConceptBinding | Element idMedicationDispense.dosageInstruction.routeShort description How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. 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. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. UKCoreSubstanceOrProductAdministrationRoute (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| method | Σ | 0..1 | CodeableConceptBinding | Element idMedicationDispense.dosageInstruction.methodShort description Technique for administering medication DefinitionTechnique for administering medication. 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. UKCoreMedicationDosageMethod (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| doseAndRate | S Σ | 0..* | Element | Element idMedicationDispense.dosageInstruction.doseAndRateShort description Dosage instructions for the medication. DefinitionThe amount of medication administered. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.doseAndRate.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.doseAndRate.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.doseAndRate.typeShort description The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". 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. The kind of dose or rate specified. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| dose[x] | S Σ | 0..1 | Element idMedicationDispense.dosageInstruction.doseAndRate.dose[x]Short description Quantity of medication administered. DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||||
| doseRange | Range | There are no (further) constraints on this element Data type | ||||
| rate[x] | S Σ | 0..1 | Element idMedicationDispense.dosageInstruction.doseAndRate.rate[x]Short description Rate at which the medication is to be administered. DefinitionAmount of medication per unit of time. 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||||
| rateRange | Range | There are no (further) constraints on this element Data type | ||||
| rateRatio | Ratio | There are no (further) constraints on this element Data type | ||||
| maxDosePerPeriod | Σ C | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.maxDosePerPeriodShort description Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. 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". The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| maxDosePerAdministration | Σ C | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.maxDosePerAdministrationShort description Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| maxDosePerLifetime | Σ C | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction.maxDosePerLifetimeShort description Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| substitution | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationDispense.substitutionShort description Whether a substitution was performed on the dispense DefinitionIndicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idMedicationDispense.substitution.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.substitution.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.substitution.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| wasSubstituted | 1..1 | boolean | There are no (further) constraints on this element Element idMedicationDispense.substitution.wasSubstitutedShort description Whether a substitution was or was not performed on the dispense DefinitionTrue if the dispenser dispensed a different drug or product from what was prescribed. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.substitution.typeShort description Code signifying whether a different drug was dispensed from what was prescribed DefinitionA code signifying whether a different drug was dispensed from what was prescribed. 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. A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. v3.ActSubstanceAdminSubstitutionCode (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| reason | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.substitution.reasonShort description Why was substitution made DefinitionIndicates the reason for the substitution (or lack of substitution) from what was prescribed. 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. A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| responsibleParty | C | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idMedicationDispense.substitution.responsiblePartyShort description Who is responsible for the substitution DefinitionThe person or organization that has primary responsibility for the substitution. 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. Reference(Practitioner | PractitionerRole) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| detectedIssue | C | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element idMedicationDispense.detectedIssueShort description Clinical issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| eventHistory | C | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationDispense.eventHistoryShort description A list of relevant lifecycle events DefinitionA summary of the events of interest that have occurred, such as when the dispense was verified. 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.). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
|
Example - Completed Dispensing
{
"resource": {
"resourceType": "MedicationDispense",
"meta": {
"profile": [
"https://fhir.nhs.uk/StructureDefinition/UKCore-MedicationDispense"
]
},
"id": "312d757e-21f1-4f10-9f02-1746768bc31d",
"status": "completed",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://dmd-nhs.uk",
"code": "42234211000001100",
"display": "ProSource 20 liquid red berry (Nutrinovo Ltd)"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449304130"
},
"display": "Mr Michael Mouser"
},
"performer": [
{
"actor": {
"reference": "urn:uuid:7535862a-d46b-43a3-9d7f-2f489861e24c"
}
}
],
"authorizingPrescription": [
{
"reference": "urn:uuid:7dc0390a-f416-4d8a-9751-257bfa6294cd"
}
],
"quantity": {
"value": 60,
"unit": "tablets",
"system": "http://snomed.info/sct",
"code": "428673006"
},
"whenPrepared": "2025-11-07T11:45:00+00:00",
"dosageInstruction": [
{
"text": "Swallow 2 tablets - 3 times a day - for 1 week"
}
]
}
}
Example - Stopped / Non-Dispensing
{
"resource": {
"resourceType": "MedicationDispense",
"meta": {
"profile": [
"https://fhir.nhs.uk/StructureDefinition/UKCore-MedicationDispense"
]
},
"id": "312d757e-21f1-4f10-9f02-1746768bc31d",
"status": "stopped",
"statusReasonCodeableConcept": {
"text": "Cannot be hub assembled as per regulations as a Controlled Drug medication"
},
"medicationCodeableConcept": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "not-applicable"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449304130"
},
"display": "Mr Michael Mouser"
},
"performer": [
{
"actor": {
"reference": "urn:uuid:7535862a-d46b-43a3-9d7f-2f489861e24c"
}
}
],
"authorizingPrescription": [
{
"reference": "urn:uuid:7dc0390a-f416-4d8a-9751-257bfa6294cd"
}
]
}
}
Required / Minimum Dataset
The required fields that represent the minimum dataset to be shared with the spoke pharmacy (the requester) for medication assembled, labelled and shipped to the spoke pharmacy are as follows.
| Element | Implementation Requirements |
|---|---|
id |
A locally generated UUID |
status |
Fixed value completed |
medicationCodeableConcept |
The dm+d code, display and system for the dispensed medication. If the dispensed medication cannot be mapped to a valid dm+d concept then use .text. |
subject |
An identifier for the patient using NHS Number. Where NHS Number is not known use the unique identifier as provided by the requestor. |
performer |
A reference to an Organization resource for the hub pharmacy. |
authorizingPrescription |
A reference to the UKCore-MedicationRequest that is being dispensed against. |
quantity |
The quantity of medication dispensed. |
whenPrepared |
Date and time of medication assembly and labelling. |
dosageInstruction.patientInstruction |
The dosing instruction as printed on the medication dispensing label. |
Failed / Non-Dispensing
If the hub dispensing process has failed and no medication is to be shipped to the spoke pharmacy then a MedicationDispense resource should still be posted to the spoke pharmacy with the following data.
| Element | Implementation Requirements |
|---|---|
id |
A locally generated UUID |
status |
Fixed value stopped |
statusReasonCodeableConcept.text |
The reason the medication could not be assembled by the hub pharmacy. |
medicationCodeableConcept |
A mandatory element within the UKCore profile so populate with the extension data-absent-reason. |
subject |
An identifier for the patient using NHS Number. Where NHS Number is not known use the unique identifier as provided by the requestor. |
performer |
A reference to an Organization resource for the hub pharmacy. |
authorizingPrescription |
A reference to the UKCore-MedicationRequest that is being dispensed against. |
UKCore-Organization
Tree View
| UKCoreOrganization (Organization) | C | Organization | There are no (further) constraints on this element Element idOrganizationShort description A grouping of people or organizations with a common purpose DefinitionA formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.
| |||
| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idOrganization.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idOrganization.metaShort description Metadata about the resource DefinitionThe 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idOrganization.implicitRulesShort description A set of rules under which this content was created DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idOrganization.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| text | 0..1 | Narrative | There are no (further) constraints on this element Element idOrganization.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| contained | 0..* | Resource | There are no (further) constraints on this element Element idOrganization.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idOrganization.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| mainLocation | C | 0..1 | Extension(Reference(Location)) | Element idOrganization.extension:mainLocationShort description The main location of the organisation. Alternate namesextensions, user content DefinitionThe main location of the organisation. 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. Extension(Reference(Location)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MainLocation ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| organizationPeriod | C | 0..1 | Extension(Period) | Element idOrganization.extension:organizationPeriodShort description The date range that this organization SHOULD be considered available. Alternate namesextensions, user content DefinitionThe date range that this organization SHOULD be considered available. 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. http://hl7.org/fhir/StructureDefinition/organization-period ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idOrganization.extension:organizationPeriod.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idOrganization.extension:organizationPeriod.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idOrganization.extension:organizationPeriod.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/organization-periodMappings
| |||
| value[x] | 1..1 | Element idOrganization.extension:organizationPeriod.value[x]Short description The date range that this organization SHOULD be considered available. DefinitionThe date range that this organization SHOULD be considered available. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||||
| valuePeriod | Period | There are no (further) constraints on this element Data type | ||||
| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idOrganization.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. 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
| ||
| identifier | S Σ C | 0..* | Identifier | Element idOrganization.identifierShort description Identifies this organization across multiple systems. DefinitionIdentifier for the organization that is used to identify the organization across multiple disparate systems. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unordered, Open, by system(Value) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, org-1 Constraints
| ||
| odsOrganisationCode | Σ C | 0..1 | Identifier | Element idOrganization.identifier:odsOrganisationCodeShort description Organisation Data Service code DefinitionIdentifier code supplier by the Organisation Data Service. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. The cardinality or value of this element may be affected by these constraints: ele-1, org-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.useShort description usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.typeShort description Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| system | Σ | 1..1 | uriFixed Value | Element idOrganization.identifier:odsOrganisationCode.systemShort description The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
https://fhir.nhs.uk/Id/ods-organization-codeExamples General http://www.acme.com/identifiers/patientMappings
| ||
| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.valueShort description The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 123456Mappings
| ||
| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.periodShort description Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idOrganization.identifier:odsOrganisationCode.assignerShort description Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| odsSiteCode | Σ C | 0..1 | Identifier | Element idOrganization.identifier:odsSiteCodeShort description ODS Site code to identify the organisation at site level DefinitionODS Site code to identify the organisation at site level. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. The cardinality or value of this element may be affected by these constraints: ele-1, org-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.useShort description usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.typeShort description Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| system | Σ | 1..1 | uriFixed Value | Element idOrganization.identifier:odsSiteCode.systemShort description The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
https://fhir.nhs.uk/Id/ods-site-codeExamples General http://www.acme.com/identifiers/patientMappings
| ||
| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.valueShort description The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 123456Mappings
| ||
| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.periodShort description Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idOrganization.identifier:odsSiteCode.assignerShort description Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| active | S Σ ?! | 0..1 | boolean | Element idOrganization.activeShort description Identifies this organization across multiple systems. DefinitionWhether the organization's record is still in active use. Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI. This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used. This element is labeled as a modifier because it may be used to mark that the resource was created in error. This resource is generally assumed to be active if no value is provided for the active element The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | Σ | 0..* | CodeableConceptBinding | Element idOrganization.typeShort description Kind of organization DefinitionThe kind(s) of organization that this is. Need to be able to track the kind of organization that this is - different organization types have different uses. Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center. We expect that some jurisdictions will profile this optionality to be a single cardinality. A set of concepts indicating the organisation type, derived from the base CodeSystem, and Genomics specific concepts UKCoreOrganizationType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| name | S Σ C | 0..1 | string | Element idOrganization.nameShort description A name associated with the organization. DefinitionA name associated with the organization. Need to use the name as the label of the organization. If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches. The cardinality or value of this element may be affected by these constraints: ele-1, org-1 Constraints
| ||
| alias | 0..* | string | There are no (further) constraints on this element Element idOrganization.aliasShort description A list of alternate names that the organization is known as, or was known as in the past DefinitionA list of alternate names that the organization is known as, or was known as in the past. Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the organization was known by can be very useful. There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| telecom | S C | 0..* | ContactPoint | Element idOrganization.telecomShort description Contact details for the organization. DefinitionA contact detail for the organization. Human contact for the organization. The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself. The cardinality or value of this element may be affected by these constraints: ele-1, org-3 Constraints
| ||
| address | S C | 0..* | Address | Element idOrganization.addressShort description An address for the organization. DefinitionAn address for the organization. May need to keep track of the organization's addresses for contacting, billing or reporting requirements. Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used. The cardinality or value of this element may be affected by these constraints: ele-1, org-2 Constraints
| ||
| partOf | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idOrganization.partOfShort description The organization of which this organization forms a part DefinitionThe organization of which this organization forms a part. Need to be able to track the hierarchy of organizations within an organization. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| contact | 0..* | BackboneElement | There are no (further) constraints on this element Element idOrganization.contactShort description Contact for the organization for a certain purpose DefinitionContact for the organization for a certain purpose. Need to keep track of assigned contact points within bigger organization. Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idOrganization.contact.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idOrganization.contact.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idOrganization.contact.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| purpose | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idOrganization.contact.purposeShort description The type of contact DefinitionIndicates a purpose for which the contact can be reached. Need to distinguish between multiple contact persons. 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. The purpose for which you would contact a contact party. ContactEntityType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| name | 0..1 | HumanName | There are no (further) constraints on this element Element idOrganization.contact.nameShort description A name associated with the contact DefinitionA name associated with the contact. Need to be able to track the person by name. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| telecom | C | 0..* | ContactPoint | There are no (further) constraints on this element Element idOrganization.contact.telecomShort description Contact details (telephone, email, etc.) for a contact DefinitionA contact detail (e.g. a telephone number or an email address) by which the party may be contacted. People have (primary) ways to contact them in some way such as phone, email. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| address | 0..1 | Address | There are no (further) constraints on this element Element idOrganization.contact.addressShort description Visiting or postal addresses for the contact DefinitionVisiting or postal addresses for the contact. May need to keep track of a contact party's address for contacting, billing or reporting requirements. Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| endpoint | C | 0..* | Reference(Endpoint) | There are no (further) constraints on this element Element idOrganization.endpointShort description Technical endpoints providing access to services operated for the organization DefinitionTechnical endpoints providing access to services operated for the organization. Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
|
Example
{
"resourceType": "Organization",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "VNE51"
}
],
"address": [
{
"city": "West Yorkshire",
"use": "work",
"line": [
"17 Austhorpe Road",
"Crossgates",
"Leeds"
],
"postalCode": "LS15 8BA"
}
],
"name": "The Simple Pharmacy",
"telecom": [
{
"system": "phone",
"use": "work",
"value": "0113 3180277"
}
]
}
Required / Minimum Dataset
The required fields that represent the minimum dataset to be shared between hub and spoke pharmacies are as follows.
| Element | Implementation Requirements |
|---|---|
identifier |
As per UKCore guidance. |
name |
As per UKCore guidance. |
telecom |
As per UKCore guidance. |
address |
The postal address for the pharmacy. For a spoke pharmacy, this must be the address where assembled medication is to be shipped to by the hub pharmacy. |
UKCore-Patient
Tree View
| UKCorePatient (Patient) | C | Patient | There are no (further) constraints on this element Element idPatientShort description Information about an individual or animal receiving health care services Alternate namesSubjectOfCare Client Resident DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idPatient.metaShort description Metadata about the resource DefinitionThe 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idPatient.implicitRulesShort description A set of rules under which this content was created DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idPatient.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idPatient.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| birthPlace | C | 0..1 | Extension(Address) | Element idPatient.extension:birthPlaceShort description The registered place of birth of the patient. Alternate namesextensions, user content DefinitionThe registered place of birth of the patient. 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. http://hl7.org/fhir/StructureDefinition/patient-birthPlace ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.extension:birthPlace.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.extension:birthPlace.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.extension:birthPlace.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/patient-birthPlaceMappings
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| value[x] | 1..1 | Element idPatient.extension:birthPlace.value[x]Short description The registered place of birth of the patient. DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| valueAddress | Address | There are no (further) constraints on this element Data type | ||||
| birthSex | C | 0..1 | Extension(CodeableConcept) | Element idPatient.extension:birthSexShort description The patient's phenotypic sex at birth. Alternate namesextensions, user content DefinitionThe patient's phenotypic sex at birth. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| cadavericDonor | C | 0..1 | Extension(boolean) | Element idPatient.extension:cadavericDonorShort description Post-mortem donor status. Alternate namesextensions, user content DefinitionFlag indicating whether the patient authorized the donation of body parts after death. 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. http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.extension:cadavericDonor.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.extension:cadavericDonor.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.extension:cadavericDonor.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/patient-cadavericDonorMappings
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| value[x] | 1..1 | Element idPatient.extension:cadavericDonor.value[x]Short description Post-mortem donor status. DefinitionFlag indicating whether the patient authorized the donation of body parts after death. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| valueBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| contactPreference | C | 0..1 | Extension(Complex) | Element idPatient.extension:contactPreferenceShort description The preferred method of contact, contact times and written communication format given by a Patient or Related Person. Alternate namesextensions, user content DefinitionThe preferred method of contact, contact times and written communication format given by a Patient or Related Person. 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. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| deathNotificationStatus | C | 0..1 | Extension(Complex) | Element idPatient.extension:deathNotificationStatusShort description The patient's death notification status. Alternate namesextensions, user content DefinitionThe patient's death notification status. 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. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| ethnicCategory | C | 0..1 | Extension(CodeableConcept) | Element idPatient.extension:ethnicCategoryShort description The ethnicity of the subject. Alternate namesextensions, user content DefinitionThe ethnicity of the subject. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| fetalStatus | C | 0..1 | Extension(code) | Element idPatient.extension:fetalStatusShort description An indicator on the fetal status of a baby. Alternate namesextensions, user content DefinitionTypically used in maternity where the patient record may be created before the birth of the baby. 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. http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| residentialStatus | C | 0..1 | Extension(CodeableConcept) | Element idPatient.extension:residentialStatusShort description The residential status of the patient. Alternate namesextensions, user content DefinitionThe residential status of the patient. For example if this patient is a UK resident. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| patientInterpreterRequired | C | 0..1 | Extension(boolean) | Element idPatient.extension:patientInterpreterRequiredShort description Indicator showing whether the patient needs an interpreter. Alternate namesextensions, user content DefinitionThis Patient requires an interpreter to communicate healthcare information to the practitioner. The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required. http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.extension:patientInterpreterRequired.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.extension:patientInterpreterRequired.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.extension:patientInterpreterRequired.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/patient-interpreterRequiredMappings
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| value[x] | 1..1 | Element idPatient.extension:patientInterpreterRequired.value[x]Short description Indicator showing whether the patient needs an interpreter DefinitionIndicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| valueBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| nhsNumberUnavailableReason | C | 0..1 | Extension(CodeableConcept) | Element idPatient.extension:nhsNumberUnavailableReasonShort description Reason why this Patient does not include an NHS Number identifier. Alternate namesextensions, user content DefinitionThe reason why a patient does not have an NHS Number. For example if this patient is an overseas patient. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. 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
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| identifier | S Σ | 0..* | Identifier | Element idPatient.identifierShort description An identifier for this patient. DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| nhsNumber | Σ | 0..1 | Identifier | Element idPatient.identifier:nhsNumberShort description The patient's NHS number. DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| nhsNumberVerificationStatus | C | 0..1 | Extension(CodeableConcept) | Element idPatient.identifier:nhsNumber.extension:nhsNumberVerificationStatusShort description NHS number verification status Alternate namesextensions, user content DefinitionThe verification/tracing status of the NHS number. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.useShort description usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.typeShort description Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| system | Σ | 1..1 | uriFixed Value | Element idPatient.identifier:nhsNumber.systemShort description The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
https://fhir.nhs.uk/Id/nhs-numberExamples General http://www.acme.com/identifiers/patientMappings
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| value | Σ | 1..1 | string | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.valueShort description The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 123456Mappings
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| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.periodShort description Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.identifier:nhsNumber.assignerShort description Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| active | S Σ ?! | 0..1 | boolean | Element idPatient.activeShort description Whether this patient's record is in active use. DefinitionWhether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| name | S Σ | 0..* | HumanName | Element idPatient.nameShort description A name associated with the patient. DefinitionA name associated with the individual. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| telecom | S Σ C | 0..* | ContactPoint | Element idPatient.telecomShort description A contact detail for the individual. DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.telecom.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.telecom.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| system | Σ C | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.telecom.systemShort description phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. The cardinality or value of this element may be affected by these constraints: ele-1, cpt-2 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.telecom.system.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.telecom.system.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| otherContactSystem | C | 0..1 | Extension(CodeableConcept) | Element idPatient.telecom.system.extension:otherContactSystemShort description Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`. Alternate namesextensions, user content DefinitionOther contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| value | 0..1 | System.String | There are no (further) constraints on this element Element idPatient.telecom.system.valueShort description Primitive value for code DefinitionPrimitive value for code System.String Maximum string length1048576 | |||
| value | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.telecom.valueShort description The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.telecom.useShort description home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idPatient.telecom.rankShort description Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idPatient.telecom.periodShort description Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| gender | S Σ | 0..1 | codeBinding | Element idPatient.genderShort description The gender that the patient is considered to have for administration and record keeping purposes. DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. AdministrativeGender (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| birthDate | S Σ | 0..1 | date | Element idPatient.birthDateShort description The date of birth for the individual. DefinitionThe date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.birthDate.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.birthDate.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| birthTime | C | 0..1 | Extension(dateTime) | Element idPatient.birthDate.extension:birthTimeShort description The time of day that the patient was born. This SHOULD be included when the birth time is relevant. Alternate namesextensions, user content DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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. http://hl7.org/fhir/StructureDefinition/patient-birthTime ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.birthDate.extension:birthTime.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.birthDate.extension:birthTime.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.birthDate.extension:birthTime.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/patient-birthTimeMappings
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| value[x] | 1..1 | Element idPatient.birthDate.extension:birthTime.value[x]Short description Time of day of birth. DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| valueDateTime | dateTime | There are no (further) constraints on this element Data type | ||||
| value | 0..1 | System.Date | There are no (further) constraints on this element Element idPatient.birthDate.valueShort description Primitive value for date DefinitionPrimitive value for date System.Date | |||
| deceased[x] | Σ ?! | 0..1 | There are no (further) constraints on this element Element idPatient.deceased[x]Short description Indicates if the individual is deceased or not DefinitionIndicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| deceasedBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| deceasedDateTime | dateTime | There are no (further) constraints on this element Data type | ||||
| address | S Σ | 0..* | Address | There are no (further) constraints on this element Element idPatient.addressShort description An address for the individual DefinitionAn address for the individual. May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.address.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| addressKey | C | 0..* | Extension(Complex) | Element idPatient.address.extension:addressKeyShort description A patient's address key and type Alternate namesextensions, user content DefinitionA patient's address key and type. 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. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.address.useShort description home | work | temp | old | billing - purpose of this address DefinitionThe purpose of this address. Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General homeMappings
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| type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.address.typeShort description postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General bothMappings
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.textShort description Text representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 137 Nowhere Street, Erewhon 9132Mappings
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| line | Σ | 0..* | string | There are no (further) constraints on this element Element idPatient.address.lineShort description Street name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 137 Nowhere StreetMappings
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| city | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.cityShort description Name of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General ErewhonMappings
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| district | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.districtShort description District name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General MadisonMappings
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| state | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.stateShort description Sub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| postalCode | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.postalCodeShort description Postal code for area Alternate namesZip DefinitionA postal code designating a region defined by the postal service. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 9132Mappings
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| country | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.address.countryShort description Country (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idPatient.address.periodShort description Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General {
"start": "2010-03-23",
"end": "2010-07-01"
}Mappings
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| maritalStatus | 0..1 | CodeableConceptBinding | Element idPatient.maritalStatusShort description Marital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. 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. An indicator to identify the legal marital status of a person UKCorePersonMaritalStatusCode (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| multipleBirth[x] | 0..1 | There are no (further) constraints on this element Element idPatient.multipleBirth[x]Short description Whether patient is part of a multiple birth DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| multipleBirthBoolean | boolean | There are no (further) constraints on this element Data type | ||||
| multipleBirthInteger | integer | There are no (further) constraints on this element Data type | ||||
| photo | C | 0..* | Attachment | There are no (further) constraints on this element Element idPatient.photoShort description Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| contact | C | 0..* | BackboneElement | There are no (further) constraints on this element Element idPatient.contactShort description A contact party (e.g. guardian, partner, friend) for the patient DefinitionA contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| contactRank | C | 0..1 | Extension(positiveInt) | Element idPatient.contact.extension:contactRankShort description The preferred ranking or order of contact applied to a contact on a Patient's contact list. Alternate namesextensions, user content DefinitionThe preferred ranking or order of contact applied to a contact on a patient's contact list. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| copyCorrespondenceIndicator | C | 0..1 | Extension(boolean) | Element idPatient.contact.extension:copyCorrespondenceIndicatorShort description Indicates that a must be copied in to all related correspondence. Alternate namesextensions, user content DefinitionExtension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| relationship | 0..* | CodeableConceptBinding | Element idPatient.contact.relationshipShort description The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. 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. The nature of the relationship between a patient and a contact person for that patient. UKCorePersonRelationshipType (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| name | 0..1 | HumanName | There are no (further) constraints on this element Element idPatient.contact.nameShort description A name associated with the contact person DefinitionA name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| telecom | C | 0..* | ContactPoint | There are no (further) constraints on this element Element idPatient.contact.telecomShort description A contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.telecom.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.telecom.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| system | Σ C | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.telecom.systemShort description phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. The cardinality or value of this element may be affected by these constraints: ele-1, cpt-2 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.telecom.system.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.contact.telecom.system.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
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| otherContactSystem | C | 0..1 | Extension(CodeableConcept) | Element idPatient.contact.telecom.system.extension:otherContactSystemShort description Information about other contact methods which could be used in addition to those listed in `ContactPoint.system`. Alternate namesextensions, user content DefinitionOther contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| value | 0..1 | System.String | There are no (further) constraints on this element Element idPatient.contact.telecom.system.valueShort description Primitive value for code DefinitionPrimitive value for code System.String Maximum string length1048576 | |||
| value | Σ | 0..1 | string | There are no (further) constraints on this element Element idPatient.contact.telecom.valueShort description The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.telecom.useShort description home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idPatient.contact.telecom.rankShort description Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idPatient.contact.telecom.periodShort description Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| address | 0..1 | Address | There are no (further) constraints on this element Element idPatient.contact.addressShort description Address for the contact person DefinitionAddress for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| gender | 0..1 | codeBinding | There are no (further) constraints on this element Element idPatient.contact.genderShort description male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings SHALL NOT exceed 1MB in size The gender of a person used for administrative purposes. AdministrativeGender (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| organization | C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.contact.organizationShort description Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. 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. The cardinality or value of this element may be affected by these constraints: ele-1, pat-1 Constraints
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| period | C | 0..1 | Period | There are no (further) constraints on this element Element idPatient.contact.periodShort description The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| communication | 0..* | BackboneElement | There are no (further) constraints on this element Element idPatient.communicationShort description A language which may be used to communicate with the patient about his or her health DefinitionA language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| proficiency | C | 0..1 | Extension(Complex) | Element idPatient.communication.extension:proficiencyShort description The patient's proficiency level of the communication method. Alternate namesextensions, user content DefinitionProficiency level of the communication. 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. Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/patient-proficiency ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| level | C | 0..1 | Extension | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:levelShort description The proficiency level of the communication Alternate namesextensions, user content DefinitionHow well the patient can communicate this communication (good, poor, etc.). 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:level.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:level.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:level.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. levelMappings
| |||
| value[x] | 1..1 | Binding | Element idPatient.communication.extension:proficiency.extension:level.value[x]Short description The proficiency level for the communication DefinitionThe proficiency level for the communication. The proficiency level for the communication. v3.LanguageAbilityProficiency (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| valueCoding | Coding | There are no (further) constraints on this element Data type | ||||
| type | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:typeShort description The proficiency type of the communication Alternate namesextensions, user content DefinitionWhat type of communication for the proficiency (spoken, written, etc.). 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:type.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..0 | Extension | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:type.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.extension:type.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. typeMappings
| |||
| value[x] | 1..1 | Binding | Element idPatient.communication.extension:proficiency.extension:type.value[x]Short description The proficiency type for the communication DefinitionThe proficiency type for the communication. The proficiency type for the communication. v3.LanguageAbilityMode (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| valueCoding | Coding | There are no (further) constraints on this element Data type | ||||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.urlShort description identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/patient-proficiencyMappings
| |||
| value[x] | 0..0 | There are no (further) constraints on this element Element idPatient.communication.extension:proficiency.value[x]Short description Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.communication.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| language | 1..1 | CodeableConceptBinding | Element idPatient.communication.languageShort description A ValueSet that identifies the language used by a person. DefinitionA ValueSet that identifies the language used by a person. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A ValueSet that identifies the language used by a person.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| preferred | 0..1 | boolean | There are no (further) constraints on this element Element idPatient.communication.preferredShort description Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| generalPractitioner | C | 0..* | Reference(Organization | Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idPatient.generalPractitionerShort description Patient's nominated primary care provider Alternate namescareProvider DefinitionPatient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(Organization | Practitioner | PractitionerRole) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| managingOrganization | S Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idPatient.managingOrganizationShort description Organization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element idPatient.linkShort description Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple use cases:
There is no assumption that linked patient records have mutual links. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idPatient.link.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.link.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. 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
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idPatient.link.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| other | Σ C | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element idPatient.link.otherShort description The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(Patient | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idPatient.link.typeShort description replaced-by | replaces | refer | seealso DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings SHALL NOT exceed 1MB in size The type of link between this patient resource and another patient resource. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
|
Example
{
"fullUrl": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2",
"resource": {
"resourceType": "Patient",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
]
},
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449304130"
}
],
"name": [
{
"use": "usual",
"family": "Mouser",
"given": [
"Michael"
],
"prefix": [
"Mr"
]
}
],
"gender": "male",
"birthDate": "1932-01-06",
"address": [
{
"use": "home",
"line": [
"1 Trevelyan Square",
"Boar Lane",
"Leeds",
"West Yorkshire"
],
"postalCode": "LS1 6AE"
}
]
}
}
Required / Minimum Dataset
The required fields that represent the minimum dataset to be shared with the hub pharmacy (the performer) for the purposes of patient identification are as follows.
| Element | Implementation Requirements |
|---|---|
identifier |
As per UKCore guidance. |
name |
As per UKCore guidance. |
gender |
As per UKCore guidance. |
birthDate |
As per UKCore guidance. |
address |
The patient's home address, or as written on the prescription. |
See UKCore_Patient