Specialty Patient Enrollment for Pharmacies

Resource Profile: MedicationRequest_Prescription

This MedicationRequest profile sets the expectations for the SRxDataResponse message. It identifies the mandatory core elements, extensions, vocabularies, and value sets which SHALL be present in the MedicationRequest as well as optional elements when using this profile.

Example

*See MedicationRequest_Prescription resource in SRxDataResponse Example

Formal View of Profile Content

Note: Description of Profiles, Differentials, and Snapshots

This profile builds on the core FHIR R4 MessageRequest resource. For additional information on the table definitions shown below, see the Logical Table section on the Resource Formats page.

Notes: Click the tabs below to see the different views for the profile:

The Full View shows all the base resource element information for the profile plus the Surescripts requirements.
The Hybrid View shows all the element information, but the unchanged information from the base resource is greyed out.
The Differential View only shows the changes made to the base resource (i.e., the Surescripts requirements).

Full View

MedicationRequest_Prescription (MedicationRequest)

MedicationRequest

There are no (further) constraints on this element

Element id

MedicationRequest

Short description

Ordering of medication for patient or group

Alternate names

Prescription, Order

Definition

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

Data type

MedicationRequest

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Request
script10.6: Message/Body/NewRx
rim: CombinedMedicationRequest

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

Meta

There are no (further) constraints on this element

Element id

MedicationRequest.meta

Short description

Metadata about the resource

Definition

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

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationRequest.implicitRules

Short description

A set of rules under which this content was created

Definition

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

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

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

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationRequest.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

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

Comments

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

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationRequest.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

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

Comments

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

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

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

Comments

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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

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

Requirements

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

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

Element id

MedicationRequest.identifier

Short description

External ids for this request

Definition

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

Comments

For provider-initiated transactions, the provider (placer) order number (PON) is desired.

For pharmacy-initiated transactions, the pharmacy prescription ID (aka filler order number) is desired.

Both of these identifiers are specified with the MedicationRequest.identifier.type property. In both cases, the system value is "http://terminology.hl7.org/CodeSystem/v2-0203”.

The associated code values (MedicationRequest.identifier.type.code) for these two identifiers are "PLAC" (for the PON), and "FILL" for the pharmacy prescription ID.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Request.identifier
script10.6: Message/Header/PrescriberOrderNumber
w5: FiveWs.identifier
v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim: .id

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.status

Short description

Definition

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

Comments

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

Data type

code

Binding

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

medicationrequest Status (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.status
script10.6: no mapping
w5: FiveWs.status
rim: .statusCode

statusReason

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.statusReason

Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationRequest.

Comments

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

Data type

CodeableConcept

Binding

Identifies the reasons for a given status.

medicationRequest Status Reason Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.statusReason
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

intent

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.intent

Short description

Definition

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

Comments

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

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

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

Data type

code

Binding

The kind of medication order.

medicationRequest Intent (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.intent
w5: FiveWs.class
rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

category

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.category

Short description

Type of medication usage

Definition

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

Comments

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

Data type

CodeableConcept

Binding

A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

medicationRequest Category Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
w5: FiveWs.class
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

priority

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.priority

Short description

routine | urgent | asap | stat

Definition

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Binding

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

RequestPriority (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.priority
w5: FiveWs.grade
rim: .priorityCode

doNotPerform

Σ ?!

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationRequest.doNotPerform

Short description

True if request is prohibiting action

Definition

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

Comments

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

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: SubstanceAdministration.actionNegationInd

reported[x]

0..1

There are no (further) constraints on this element

Element id

MedicationRequest.reported[x]

Short description

Reported rather than primary record

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .participation[typeCode=INF].role

reportedBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

reportedReference

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

There are no (further) constraints on this element

Data type

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

medication[x]

1..1

Element id

MedicationRequest.medication[x]

Short description

Medication to be taken

Definition

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

Comments

Includes NDC-11, which is specified in a Coding structure of the medicationCodeableConcept or Medication.code (for the Medication specified by the medicationReference). An NDC is specified by a Coding whose system is "http://hl7.org/fhir/sid/ndc".

Binding

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

SNOMEDCTMedicationCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.code
script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
w5: FiveWs.what[x]
v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
rim: consumable.administrableMedication

medicationCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

medicationReference

Reference(Medication)

There are no (further) constraints on this element

Data type

Reference(Medication)

subject

Σ C

1..1

Reference(Patient)

Element id

MedicationRequest.subject

Short description

Who the medication request is for

Definition

A link to a resource representing the person to whom the medication will be given.

Comments

The subject on a medication request is mandatory, and must be a Patient. That resource will always be present in the SRxDataResponse bundle.

Data type

Reference(Patient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.subject
script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=AUT].role
w5: FiveWs.subject

encounter

0..1

Reference(Encounter)

There are no (further) constraints on this element

Element id

MedicationRequest.encounter

Short description

Encounter created as part of encounter/admission/stay

Definition

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

Comments

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

Data type

Reference(Encounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.context
script10.6: no mapping
w5: FiveWs.context
v2: PV1-19-Visit Number
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationRequest.supportingInformation

Short description

Information to support ordering of the medication

Definition

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

Comments

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

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.supportingInfo
w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

authoredOn

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationRequest.authoredOn

Short description

When request was initially authored

Definition

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

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.authoredOn
script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
w5: FiveWs.recorded
v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
rim: author.time

requester

Σ C

0..1

Reference(Practitioner_Prescriber)

Element id

MedicationRequest.requester

Short description

Who/What requested the Request

Definition

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

Comments

Data type

Reference(Practitioner_Prescriber)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.requester
w5: FiveWs.author
rim: .participation[typeCode=AUT].role

performer

0..1

There are no (further) constraints on this element

Element id

MedicationRequest.performer

Short description

Intended performer of administration

Definition

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

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.performer
w5: FiveWs.actor
rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

performerType

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.performerType

Short description

Desired kind of performer of the medication administration

Definition

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

Comments

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

Data type

CodeableConcept

Binding

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

ProcedurePerformerRoleCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.performerType
rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code

recorder

0..1

Reference(Practitioner | PractitionerRole)

There are no (further) constraints on this element

Element id

MedicationRequest.recorder

Short description

Person who entered the request

Definition

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

Comments

Data type

Reference(Practitioner | PractitionerRole)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.who
rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.reasonCode

Short description

Reason or indication for ordering or not ordering the medication

Definition

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

Comments

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

Data type

CodeableConcept

Binding

A coded concept indicating why the medication was ordered.

Condition/Problem/DiagnosisCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.reasonCode
script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
w5: FiveWs.why[x]
v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
rim: reason.observation.reasonCode

reasonReference

0..*

Reference(Condition | Observation)

There are no (further) constraints on this element

Element id

MedicationRequest.reasonReference

Short description

Condition or observation that supports why the prescription is being written

Definition

Condition or observation that supports why the medication was ordered.

Comments

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

Data type

Reference(Condition | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.reasonReference
script10.6: no mapping
w5: FiveWs.why[x]
rim: reason.observation[code=ASSERTION].value

instantiatesCanonical

0..*

canonical

There are no (further) constraints on this element

Element id

MedicationRequest.instantiatesCanonical

Short description

Instantiates FHIR protocol or definition

Definition

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

Comments

see Canonical References

Data type

canonical

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.instantiates
rim: .outboundRelationship[typeCode=DEFN].target

instantiatesUri

0..*

uri

There are no (further) constraints on this element

Element id

MedicationRequest.instantiatesUri

Short description

Instantiates external protocol or definition

Definition

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

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=DEFN].target

basedOn

Σ C

0..*

Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)

There are no (further) constraints on this element

Element id

MedicationRequest.basedOn

Short description

What request fulfills

Definition

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

Comments

Data type

Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.basedOn
rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

groupIdentifier

0..1

Identifier

There are no (further) constraints on this element

Element id

MedicationRequest.groupIdentifier

Short description

Composite request this is part of

Definition

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

Requirements

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

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Request.groupIdentifier
rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id

courseOfTherapyType

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.courseOfTherapyType

Short description

Overall pattern of medication administration

Definition

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

Comments

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

Data type

CodeableConcept

Binding

Identifies the overall pattern of medication administratio.

medicationRequest Course of Therapy Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: Act.code where classCode = LIST and moodCode = EVN

insurance

0..*

Reference(ClaimResponse | Coverage)

There are no (further) constraints on this element

Element id

MedicationRequest.insurance

Short description

Associated insurance coverage

Definition

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

Comments

Data type

Reference(ClaimResponse | Coverage)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.insurance
rim: .outboundRelationship[typeCode=COVBY].target

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationRequest.note

Short description

Information about the prescription

Definition

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

Comments

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

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: Request.note
script10.6: Message/Body/NewRx/MedicationPrescribed/Note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

dosageInstruction

0..*

Dosage

There are no (further) constraints on this element

Element id

MedicationRequest.dosageInstruction

Short description

How the medication should be taken

Definition

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

Comments

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

Data type

Dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
workflow: Request.occurrence[x]
rim: see dosageInstruction mapping

dispenseRequest

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest

Short description

Medication supply authorization

Definition

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

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
rim: component.supplyEvent

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

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

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

initialFill

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill

Short description

First fill details

Definition

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

Comments

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

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

quantity

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.quantity

Short description

First fill quantity

Definition

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

Comments

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

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: Supply.quantity[moodCode=RQO]

duration

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.duration

Short description

First fill duration

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
rim: Supply.effectivetime[moodCode=RQO]

dispenseInterval

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.dispenseInterval

Short description

Minimum period of time between dispenses

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
rim: Supply.effectivetime[moodCode=RQO]

validityPeriod

0..1

Period

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.validityPeriod

Short description

Time period supply is authorized for

Definition

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

Requirements

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

Comments

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

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
rim: effectiveTime

numberOfRepeatsAllowed

0..1

unsignedInt

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.numberOfRepeatsAllowed

Short description

Number of refills authorized

Definition

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

Comments

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

Data type

unsignedInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
v2: RXE-12-Number of Refills
rim: repeatNumber

quantity

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.quantity

Short description

Amount of medication to supply per dispense

Definition

The amount that is to be dispensed for one fill.

Comments

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

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: quantity

expectedSupplyDuration

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.expectedSupplyDuration

Short description

Number of days supply per dispense

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
rim: expectedUseTime

performer

0..1

Reference(http://fhirdocs.surescripts.net/StructureDefinition/fhir/specialty/Organization_DispensingPharmacy)

Element id

MedicationRequest.dispenseRequest.performer

Short description

Intended dispenser

Definition

Indicates the intended dispensing Organization specified by the prescriber.

Comments

Data type

Reference(http://fhirdocs.surescripts.net/StructureDefinition/fhir/specialty/Organization_DispensingPharmacy)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.who
rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

substitution

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.substitution

Short description

Any restrictions on medication substitution

Definition

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

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
rim: subjectOf.substitutionPersmission

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

allowed[x]

1..1

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.allowed[x]

Short description

Whether substitution is allowed or not

Definition

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

Comments

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

Binding

Identifies the type of substitution allowed.

v3.ActSubstanceAdminSubstitutionCode (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: code

allowedBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

allowedCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

reason

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.reason

Short description

Why should (not) substitution be made

Definition

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

Comments

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

Data type

CodeableConcept

Binding

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

v3.SubstanceAdminSubstitutionReason (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6: not mapped
v2: RXE-9 Substition status
rim: reasonCode

priorPrescription

0..1

Reference(MedicationRequest)

There are no (further) constraints on this element

Element id

MedicationRequest.priorPrescription

Short description

An order/prescription that is being replaced

Definition

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

Comments

Data type

Reference(MedicationRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.replaces
script10.6: not mapped
rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]

detectedIssue

0..*

Reference(DetectedIssue)

There are no (further) constraints on this element

Element id

MedicationRequest.detectedIssue

Short description

Clinical Issue with action

Alternate names

Contraindication, Drug Utilization Review (DUR), Alert

Definition

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

Comments

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

Data type

Reference(DetectedIssue)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

eventHistory

0..*

Reference(Provenance)

There are no (further) constraints on this element

Element id

MedicationRequest.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

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

Comments

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

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.relevantHistory
rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Hybrid View

MedicationRequest_Prescription (MedicationRequest)

MedicationRequest

There are no (further) constraints on this element

Element id

MedicationRequest

Short description

Ordering of medication for patient or group

Alternate names

Prescription, Order

Definition

Data type

MedicationRequest

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Request
script10.6: Message/Body/NewRx
rim: CombinedMedicationRequest

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

Meta

There are no (further) constraints on this element

Element id

MedicationRequest.meta

Short description

Metadata about the resource

Definition

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

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationRequest.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationRequest.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationRequest.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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

Requirements

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

Element id

MedicationRequest.identifier

Short description

External ids for this request

Definition

Comments

For provider-initiated transactions, the provider (placer) order number (PON) is desired.

For pharmacy-initiated transactions, the pharmacy prescription ID (aka filler order number) is desired.

Both of these identifiers are specified with the MedicationRequest.identifier.type property. In both cases, the system value is "http://terminology.hl7.org/CodeSystem/v2-0203”.

The associated code values (MedicationRequest.identifier.type.code) for these two identifiers are "PLAC" (for the PON), and "FILL" for the pharmacy prescription ID.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Request.identifier
script10.6: Message/Header/PrescriberOrderNumber
w5: FiveWs.identifier
v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim: .id

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.status

Short description

Definition

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

Comments

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

Data type

code

Binding

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

medicationrequest Status (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.status
script10.6: no mapping
w5: FiveWs.status
rim: .statusCode

statusReason

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.statusReason

Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationRequest.

Comments

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

Data type

CodeableConcept

Binding

Identifies the reasons for a given status.

medicationRequest Status Reason Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.statusReason
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

intent

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.intent

Short description

Definition

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

Comments

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.

Data type

code

Binding

The kind of medication order.

medicationRequest Intent (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.intent
w5: FiveWs.class
rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

category

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.category

Short description

Type of medication usage

Definition

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

Comments

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

Data type

CodeableConcept

Binding

A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

medicationRequest Category Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
w5: FiveWs.class
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

priority

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.priority

Short description

routine | urgent | asap | stat

Definition

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Binding

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

RequestPriority (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.priority
w5: FiveWs.grade
rim: .priorityCode

doNotPerform

Σ ?!

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationRequest.doNotPerform

Short description

True if request is prohibiting action

Definition

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

Comments

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

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: SubstanceAdministration.actionNegationInd

reported[x]

0..1

There are no (further) constraints on this element

Element id

MedicationRequest.reported[x]

Short description

Reported rather than primary record

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .participation[typeCode=INF].role

reportedBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

reportedReference

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

There are no (further) constraints on this element

Data type

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

medication[x]

1..1

Element id

MedicationRequest.medication[x]

Short description

Medication to be taken

Definition

Comments

Binding

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

SNOMEDCTMedicationCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.code
script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
w5: FiveWs.what[x]
v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
rim: consumable.administrableMedication

medicationCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

medicationReference

Reference(Medication)

There are no (further) constraints on this element

Data type

Reference(Medication)

subject

Σ C

1..1

Reference(Patient)

Element id

MedicationRequest.subject

Short description

Who the medication request is for

Definition

A link to a resource representing the person to whom the medication will be given.

Comments

The subject on a medication request is mandatory, and must be a Patient. That resource will always be present in the SRxDataResponse bundle.

Data type

Reference(Patient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.subject
script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=AUT].role
w5: FiveWs.subject

encounter

0..1

Reference(Encounter)

There are no (further) constraints on this element

Element id

MedicationRequest.encounter

Short description

Encounter created as part of encounter/admission/stay

Definition

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

Comments

Data type

Reference(Encounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.context
script10.6: no mapping
w5: FiveWs.context
v2: PV1-19-Visit Number
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationRequest.supportingInformation

Short description

Information to support ordering of the medication

Definition

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

Comments

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.supportingInfo
w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

authoredOn

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationRequest.authoredOn

Short description

When request was initially authored

Definition

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

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.authoredOn
script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
w5: FiveWs.recorded
v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
rim: author.time

requester

Σ C

0..1

Reference(Practitioner_Prescriber)

Element id

MedicationRequest.requester

Short description

Who/What requested the Request

Definition

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

Comments

Data type

Reference(Practitioner_Prescriber)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.requester
w5: FiveWs.author
rim: .participation[typeCode=AUT].role

performer

0..1

There are no (further) constraints on this element

Element id

MedicationRequest.performer

Short description

Intended performer of administration

Definition

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

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.performer
w5: FiveWs.actor
rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

performerType

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.performerType

Short description

Desired kind of performer of the medication administration

Definition

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

Comments

Data type

CodeableConcept

Binding

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

ProcedurePerformerRoleCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.performerType
rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code

recorder

0..1

Reference(Practitioner | PractitionerRole)

There are no (further) constraints on this element

Element id

MedicationRequest.recorder

Short description

Person who entered the request

Definition

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

Comments

Data type

Reference(Practitioner | PractitionerRole)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.who
rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.reasonCode

Short description

Reason or indication for ordering or not ordering the medication

Definition

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

Comments

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

Data type

CodeableConcept

Binding

A coded concept indicating why the medication was ordered.

Condition/Problem/DiagnosisCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.reasonCode
script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
w5: FiveWs.why[x]
v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
rim: reason.observation.reasonCode

reasonReference

0..*

Reference(Condition | Observation)

There are no (further) constraints on this element

Element id

MedicationRequest.reasonReference

Short description

Condition or observation that supports why the prescription is being written

Definition

Condition or observation that supports why the medication was ordered.

Comments

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

Data type

Reference(Condition | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.reasonReference
script10.6: no mapping
w5: FiveWs.why[x]
rim: reason.observation[code=ASSERTION].value

instantiatesCanonical

0..*

canonical

There are no (further) constraints on this element

Element id

MedicationRequest.instantiatesCanonical

Short description

Instantiates FHIR protocol or definition

Definition

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

Comments

see Canonical References

Data type

canonical

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.instantiates
rim: .outboundRelationship[typeCode=DEFN].target

instantiatesUri

0..*

uri

There are no (further) constraints on this element

Element id

MedicationRequest.instantiatesUri

Short description

Instantiates external protocol or definition

Definition

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

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=DEFN].target

basedOn

Σ C

0..*

Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)

There are no (further) constraints on this element

Element id

MedicationRequest.basedOn

Short description

What request fulfills

Definition

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

Comments

Data type

Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.basedOn
rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

groupIdentifier

0..1

Identifier

There are no (further) constraints on this element

Element id

MedicationRequest.groupIdentifier

Short description

Composite request this is part of

Definition

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

Requirements

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Request.groupIdentifier
rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id

courseOfTherapyType

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.courseOfTherapyType

Short description

Overall pattern of medication administration

Definition

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

Comments

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

Data type

CodeableConcept

Binding

Identifies the overall pattern of medication administratio.

medicationRequest Course of Therapy Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: Act.code where classCode = LIST and moodCode = EVN

insurance

0..*

Reference(ClaimResponse | Coverage)

There are no (further) constraints on this element

Element id

MedicationRequest.insurance

Short description

Associated insurance coverage

Definition

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

Comments

Data type

Reference(ClaimResponse | Coverage)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.insurance
rim: .outboundRelationship[typeCode=COVBY].target

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationRequest.note

Short description

Information about the prescription

Definition

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

Comments

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: Request.note
script10.6: Message/Body/NewRx/MedicationPrescribed/Note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

dosageInstruction

0..*

Dosage

There are no (further) constraints on this element

Element id

MedicationRequest.dosageInstruction

Short description

How the medication should be taken

Definition

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

Comments

Data type

Dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
workflow: Request.occurrence[x]
rim: see dosageInstruction mapping

dispenseRequest

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest

Short description

Medication supply authorization

Definition

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
rim: component.supplyEvent

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

initialFill

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill

Short description

First fill details

Definition

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

Comments

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

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

quantity

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.quantity

Short description

First fill quantity

Definition

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

Comments

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

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: Supply.quantity[moodCode=RQO]

duration

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.duration

Short description

First fill duration

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
rim: Supply.effectivetime[moodCode=RQO]

dispenseInterval

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.dispenseInterval

Short description

Minimum period of time between dispenses

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
rim: Supply.effectivetime[moodCode=RQO]

validityPeriod

0..1

Period

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.validityPeriod

Short description

Time period supply is authorized for

Definition

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

Requirements

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

Comments

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
rim: effectiveTime

numberOfRepeatsAllowed

0..1

unsignedInt

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.numberOfRepeatsAllowed

Short description

Number of refills authorized

Definition

Comments

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

Data type

unsignedInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
v2: RXE-12-Number of Refills
rim: repeatNumber

quantity

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.quantity

Short description

Amount of medication to supply per dispense

Definition

The amount that is to be dispensed for one fill.

Comments

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

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: quantity

expectedSupplyDuration

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.expectedSupplyDuration

Short description

Number of days supply per dispense

Definition

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

Comments

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
rim: expectedUseTime

performer

0..1

Reference(http://fhirdocs.surescripts.net/StructureDefinition/fhir/specialty/Organization_DispensingPharmacy)

Element id

MedicationRequest.dispenseRequest.performer

Short description

Intended dispenser

Definition

Indicates the intended dispensing Organization specified by the prescriber.

Comments

Data type

Reference(http://fhirdocs.surescripts.net/StructureDefinition/fhir/specialty/Organization_DispensingPharmacy)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.who
rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

substitution

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.substitution

Short description

Any restrictions on medication substitution

Definition

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
rim: subjectOf.substitutionPersmission

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

allowed[x]

1..1

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.allowed[x]

Short description

Whether substitution is allowed or not

Definition

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

Comments

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

Binding

Identifies the type of substitution allowed.

v3.ActSubstanceAdminSubstitutionCode (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: code

allowedBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

allowedCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

reason

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.reason

Short description

Why should (not) substitution be made

Definition

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

Comments

Data type

CodeableConcept

Binding

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

v3.SubstanceAdminSubstitutionReason (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6: not mapped
v2: RXE-9 Substition status
rim: reasonCode

priorPrescription

0..1

Reference(MedicationRequest)

There are no (further) constraints on this element

Element id

MedicationRequest.priorPrescription

Short description

An order/prescription that is being replaced

Definition

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

Comments

Data type

Reference(MedicationRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.replaces
script10.6: not mapped
rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]

detectedIssue

0..*

Reference(DetectedIssue)

There are no (further) constraints on this element

Element id

MedicationRequest.detectedIssue

Short description

Clinical Issue with action

Alternate names

Contraindication, Drug Utilization Review (DUR), Alert

Definition

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

Comments

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

Data type

Reference(DetectedIssue)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

eventHistory

0..*

Reference(Provenance)

There are no (further) constraints on this element

Element id

MedicationRequest.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

Comments

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.relevantHistory
rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Differential View

MedicationRequest_Prescription (MedicationRequest)

MedicationRequest

There are no (further) constraints on this element

Element id

MedicationRequest

Short description

Ordering of medication for patient or group

Alternate names

Prescription, Order

Definition

Data type

MedicationRequest

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Request
script10.6: Message/Body/NewRx
rim: CombinedMedicationRequest

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

Meta

There are no (further) constraints on this element

Element id

MedicationRequest.meta

Short description

Metadata about the resource

Definition

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

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationRequest.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationRequest.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationRequest.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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

Requirements

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

Element id

MedicationRequest.identifier

Short description

External ids for this request

Definition

Comments

For provider-initiated transactions, the provider (placer) order number (PON) is desired.

For pharmacy-initiated transactions, the pharmacy prescription ID (aka filler order number) is desired.

Both of these identifiers are specified with the MedicationRequest.identifier.type property. In both cases, the system value is "http://terminology.hl7.org/CodeSystem/v2-0203”.

The associated code values (MedicationRequest.identifier.type.code) for these two identifiers are "PLAC" (for the PON), and "FILL" for the pharmacy prescription ID.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Request.identifier
script10.6: Message/Header/PrescriberOrderNumber
w5: FiveWs.identifier
v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim: .id

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.status

Short description

Definition

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

Comments

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

Data type

code

Binding

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

medicationrequest Status (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.status
script10.6: no mapping
w5: FiveWs.status
rim: .statusCode

statusReason

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.statusReason

Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationRequest.

Comments

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

Data type

CodeableConcept

Binding

Identifies the reasons for a given status.

medicationRequest Status Reason Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.statusReason
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

intent

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.intent

Short description

Definition

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

Comments

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.

Data type

code

Binding

The kind of medication order.

medicationRequest Intent (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.intent
w5: FiveWs.class
rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

category

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.category

Short description

Type of medication usage

Definition

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

Comments

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

Data type

CodeableConcept

Binding

A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

medicationRequest Category Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
w5: FiveWs.class
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

priority

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationRequest.priority

Short description

routine | urgent | asap | stat

Definition

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Binding

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

RequestPriority (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.priority
w5: FiveWs.grade
rim: .priorityCode

doNotPerform

Σ ?!

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationRequest.doNotPerform

Short description

True if request is prohibiting action

Definition

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

Comments

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

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: SubstanceAdministration.actionNegationInd

reported[x]

0..1

There are no (further) constraints on this element

Element id

MedicationRequest.reported[x]

Short description

Reported rather than primary record

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .participation[typeCode=INF].role

reportedBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

reportedReference

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

There are no (further) constraints on this element

Data type

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

medication[x]

1..1

Element id

MedicationRequest.medication[x]

Short description

Medication to be taken

Definition

Comments

Binding

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

SNOMEDCTMedicationCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.code
script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
w5: FiveWs.what[x]
v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
rim: consumable.administrableMedication

medicationCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

medicationReference

Reference(Medication)

There are no (further) constraints on this element

Data type

Reference(Medication)

subject

Σ C

1..1

Reference(Patient)

Element id

MedicationRequest.subject

Short description

Who the medication request is for

Definition

A link to a resource representing the person to whom the medication will be given.

Comments

The subject on a medication request is mandatory, and must be a Patient. That resource will always be present in the SRxDataResponse bundle.

Data type

Reference(Patient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.subject
script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=AUT].role
w5: FiveWs.subject

encounter

0..1

Reference(Encounter)

There are no (further) constraints on this element

Element id

MedicationRequest.encounter

Short description

Encounter created as part of encounter/admission/stay

Definition

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

Comments

Data type

Reference(Encounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.context
script10.6: no mapping
w5: FiveWs.context
v2: PV1-19-Visit Number
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationRequest.supportingInformation

Short description

Information to support ordering of the medication

Definition

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

Comments

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.supportingInfo
w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

authoredOn

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationRequest.authoredOn

Short description

When request was initially authored

Definition

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

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.authoredOn
script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
w5: FiveWs.recorded
v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
rim: author.time

requester

Σ C

0..1

Reference(Practitioner_Prescriber)

Element id

MedicationRequest.requester

Short description

Who/What requested the Request

Definition

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

Comments

Data type

Reference(Practitioner_Prescriber)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.requester
w5: FiveWs.author
rim: .participation[typeCode=AUT].role

performer

0..1

There are no (further) constraints on this element

Element id

MedicationRequest.performer

Short description

Intended performer of administration

Definition

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

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.performer
w5: FiveWs.actor
rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

performerType

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.performerType

Short description

Desired kind of performer of the medication administration

Definition

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

Comments

Data type

CodeableConcept

Binding

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

ProcedurePerformerRoleCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.performerType
rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code

recorder

0..1

Reference(Practitioner | PractitionerRole)

There are no (further) constraints on this element

Element id

MedicationRequest.recorder

Short description

Person who entered the request

Definition

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

Comments

Data type

Reference(Practitioner | PractitionerRole)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.who
rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.reasonCode

Short description

Reason or indication for ordering or not ordering the medication

Definition

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

Comments

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

Data type

CodeableConcept

Binding

A coded concept indicating why the medication was ordered.

Condition/Problem/DiagnosisCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Request.reasonCode
script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
w5: FiveWs.why[x]
v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
rim: reason.observation.reasonCode

reasonReference

0..*

Reference(Condition | Observation)

There are no (further) constraints on this element

Element id

MedicationRequest.reasonReference

Short description

Condition or observation that supports why the prescription is being written

Definition

Condition or observation that supports why the medication was ordered.

Comments

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

Data type

Reference(Condition | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.reasonReference
script10.6: no mapping
w5: FiveWs.why[x]
rim: reason.observation[code=ASSERTION].value

instantiatesCanonical

0..*

canonical

There are no (further) constraints on this element

Element id

MedicationRequest.instantiatesCanonical

Short description

Instantiates FHIR protocol or definition

Definition

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

Comments

see Canonical References

Data type

canonical

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Request.instantiates
rim: .outboundRelationship[typeCode=DEFN].target

instantiatesUri

0..*

uri

There are no (further) constraints on this element

Element id

MedicationRequest.instantiatesUri

Short description

Instantiates external protocol or definition

Definition

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

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=DEFN].target

basedOn

Σ C

0..*

Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)

There are no (further) constraints on this element

Element id

MedicationRequest.basedOn

Short description

What request fulfills

Definition

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

Comments

Data type

Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.basedOn
rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

groupIdentifier

0..1

Identifier

There are no (further) constraints on this element

Element id

MedicationRequest.groupIdentifier

Short description

Composite request this is part of

Definition

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

Requirements

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Request.groupIdentifier
rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id

courseOfTherapyType

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.courseOfTherapyType

Short description

Overall pattern of medication administration

Definition

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

Comments

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

Data type

CodeableConcept

Binding

Identifies the overall pattern of medication administratio.

medicationRequest Course of Therapy Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: Act.code where classCode = LIST and moodCode = EVN

insurance

0..*

Reference(ClaimResponse | Coverage)

There are no (further) constraints on this element

Element id

MedicationRequest.insurance

Short description

Associated insurance coverage

Definition

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

Comments

Data type

Reference(ClaimResponse | Coverage)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.insurance
rim: .outboundRelationship[typeCode=COVBY].target

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationRequest.note

Short description

Information about the prescription

Definition

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

Comments

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: Request.note
script10.6: Message/Body/NewRx/MedicationPrescribed/Note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

dosageInstruction

0..*

Dosage

There are no (further) constraints on this element

Element id

MedicationRequest.dosageInstruction

Short description

How the medication should be taken

Definition

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

Comments

Data type

Dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
workflow: Request.occurrence[x]
rim: see dosageInstruction mapping

dispenseRequest

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest

Short description

Medication supply authorization

Definition

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
rim: component.supplyEvent

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

initialFill

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill

Short description

First fill details

Definition

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

Comments

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

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

quantity

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.quantity

Short description

First fill quantity

Definition

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

Comments

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

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: Supply.quantity[moodCode=RQO]

duration

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.initialFill.duration

Short description

First fill duration

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
rim: Supply.effectivetime[moodCode=RQO]

dispenseInterval

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.dispenseInterval

Short description

Minimum period of time between dispenses

Definition

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

Comments

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

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
rim: Supply.effectivetime[moodCode=RQO]

validityPeriod

0..1

Period

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.validityPeriod

Short description

Time period supply is authorized for

Definition

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

Requirements

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

Comments

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
rim: effectiveTime

numberOfRepeatsAllowed

0..1

unsignedInt

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.numberOfRepeatsAllowed

Short description

Number of refills authorized

Definition

Comments

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

Data type

unsignedInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
v2: RXE-12-Number of Refills
rim: repeatNumber

quantity

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.quantity

Short description

Amount of medication to supply per dispense

Definition

The amount that is to be dispensed for one fill.

Comments

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

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: quantity

expectedSupplyDuration

0..1

Duration

There are no (further) constraints on this element

Element id

MedicationRequest.dispenseRequest.expectedSupplyDuration

Short description

Number of days supply per dispense

Definition

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

Comments

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
rim: expectedUseTime

performer

0..1

Reference(http://fhirdocs.surescripts.net/StructureDefinition/fhir/specialty/Organization_DispensingPharmacy)

Element id

MedicationRequest.dispenseRequest.performer

Short description

Intended dispenser

Definition

Indicates the intended dispensing Organization specified by the prescriber.

Comments

Data type

Reference(http://fhirdocs.surescripts.net/StructureDefinition/fhir/specialty/Organization_DispensingPharmacy)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.who
rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

substitution

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationRequest.substitution

Short description

Any restrictions on medication substitution

Definition

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
rim: subjectOf.substitutionPersmission

0..1

string

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

allowed[x]

1..1

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.allowed[x]

Short description

Whether substitution is allowed or not

Definition

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

Comments

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

Binding

Identifies the type of substitution allowed.

v3.ActSubstanceAdminSubstitutionCode (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: code

allowedBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

allowedCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

reason

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationRequest.substitution.reason

Short description

Why should (not) substitution be made

Definition

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

Comments

Data type

CodeableConcept

Binding

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

v3.SubstanceAdminSubstitutionReason (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6: not mapped
v2: RXE-9 Substition status
rim: reasonCode

priorPrescription

0..1

Reference(MedicationRequest)

There are no (further) constraints on this element

Element id

MedicationRequest.priorPrescription

Short description

An order/prescription that is being replaced

Definition

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

Comments

Data type

Reference(MedicationRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.replaces
script10.6: not mapped
rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]

detectedIssue

0..*

Reference(DetectedIssue)

There are no (further) constraints on this element

Element id

MedicationRequest.detectedIssue

Short description

Clinical Issue with action

Alternate names

Contraindication, Drug Utilization Review (DUR), Alert

Definition

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

Comments

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

Data type

Reference(DetectedIssue)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

eventHistory

0..*

Reference(Provenance)

There are no (further) constraints on this element

Element id

MedicationRequest.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

Comments

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Request.relevantHistory
rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]