DwMedicationRequestOrder
Purpose
The purpose of this resource is to request or order supply of medication and its instructions to the patient for administration. This resource covers the supply of all types of medication orders, example - inpatient, outpatient, community orders, over-the-counter medications, total parenteral nutrition, diet/ vitamin supplements and medication-related devices.
The resource cannot be rendered.
Usage note
extension.DispenserInstructions - For EMR's that have this information available this extension provides any additional instructions for the pharmacist about the prescription.
extension.NoRenewalsFlag - Reflects the EMR instruction to the pharmacist that the prescription should not be renewed.
extension.StatusChanged - This is a pre-adoption of an R5 data element, and reflects the dateTime that the status was changed https://build.fhir.org/medicationrequest-definitions.html#MedicationRequest.statusChanged
extension.RenderedDosageInstruction - Complete rendered dosage instructions for a medication as displayed on the EMR prescription.
status - Conformance Rule: Sending systems should set all orders should be set to completed
reported - In EMR's where the "external" prescription indicator is selected this will be considered as reported and value = true.
medication - Non-drug prescriptions such as prescriptions for devices will be provided as a medication codeableConcept. Medications will be provided as a Medication Reference.
supportingInformation For EMR's that reference the latest observations in the prescribing moduele. This will provide references to the supporting observations for weight, height, creatinine, eGFR.
medication In the case where the prescriber wants to send an Indication for Use that is not included in the value set the prescriber must be able to send a text value without a code.
reasonCode This could be a diagnosis code. If a full condition record exists it will be provided via reasonCode.
dosageInstruction.extension.effectivePeriod - The timeline or period for a specific dosage instruction applies to prescriptions for medications with tapering dose. In some cases, it could be same as a prescription.
dosageInstruction.sequence - This indicates the relationship between instruction line. If the sequence number of multiple dosages is the same, then it is implied that the instructions are to be treated as concurrent. This carries the meaning of AND. If the sequence number is different, then the Dosages are intended to be sequential. and carries a meaning of "THEN"..
dosageInstruction.patientInstruction - When the dosage is not populated in the discrete template in the EMR then text dosage instructions are provided as patientInstruction.
dispenseRequest.extension.TotalQuantity - It represents the total quantity prescribed
dispenseRequest.extension.DispenseTrial - Where an EMR has the ability to identify that the prescription is a trial supply.
Bundle
Example
{
"resource": {
"resourceType": "MedicationRequest",
"id": "ma-labtestsk1-MedicationRequest-2302754",
"meta": {
"lastUpdated": "2024-01-10T12:28:39+00:00",
"source": "urn:telus:emr:ma:labtestsk1",
"security": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
"code": "N",
"display": "normal"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"> "Text summary for human interpretation" </div>"
},
"extension": [
{
"url": "https://simplifier.net/telusdwgenericemrextract/rendereddosageinstruction",
"valueString": "AURO-CIPROFLOXACIN 500 MG TAB 35.0 Tablet(s) Once daily 10 Day"
},
{
"url": "https://simplifier.net/telusdwgenericemrextract/effectiveperiod",
"valuePeriod": {
"start": "2023-11-15T00:00:00+00:00",
"end": "2023-12-05T00:00:00+00:00"
}
}
],
"identifier": [
{
"system": "urn:telus:emr:ma:labtestsk1:MedicationRequest",
"value": "2302754"
}
],
"status": "completed",
"intent": "order",
"category": [
{
"coding": [
{
"system": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontype",
"code": "medication",
"display": "Medication",
"userSelected": true
}
],
"text": "Simple Rx"
}
],
"reportedBoolean": false,
"medicationReference": {
"reference": "Medication/ma-labtestsk1-Medication-DIN-02381923",
"type": "Medication",
"display": "AURO-CIPROFLOXACIN 500 MG TAB"
},
"subject": {
"reference": "Patient/ma-labtestsk1-Patient-17938",
"type": "Patient"
},
"authoredOn": "2023-10-12T03:31:42+00:00",
"requester": {
"reference": "Practitioner/ma-labtestsk1-Practitioner-594",
"type": "Practitioner",
"display": "Evan EVB Blue"
},
"courseOfTherapyType": {
"coding": [
{
"system": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontreatmentcategory",
"code": "CHRON",
"display": "Continuous/chronic"
}
],
"text": "Continuous"
},
"dosageInstruction": [
{
"sequence": 0,
"text": "AURO-CIPROFLOXACIN 500 MG TAB 35.0 Tablet(s) Once daily 10 Day",
"timing": {
"repeat": {
"frequency": 1,
"period": 1.0,
"periodUnit": "d"
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/v3/GTSAbbreviation",
"code": "QD",
"display": "Once daily"
}
],
"text": "Once daily"
}
},
"asNeededBoolean": false,
"route": {
"coding": [
{
"system": "urn:telus:emr:ma:*:medication-route",
"code": "PO",
"display": "Oral",
"userSelected": true
},
{
"system": "http://snomed.info/sct",
"version": "20220930",
"code": "26643006",
"display": "Oral route",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "voie orale"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"userSelected": false
},
{
"system": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration",
"version": "20190415",
"code": "26643006",
"display": "Oral route",
"userSelected": false
}
],
"text": "Oral"
},
"doseAndRate": [
{
"doseQuantity": {
"value": 35.0,
"unit": "Tablet(s)",
"system": "urn:telus:emr:ma:*:medication-dose-unit",
"code": "TAB"
}
}
]
}
],
"dispenseRequest": {
"extension": [
{
"url": "https://simplifier.net/telusdwgenericemrextract/totalquantity",
"valueQuantity": {
"value": 350.0
}
},
{
"url": "https://simplifier.net/telusdwgenericemrextract/dispensetrial",
"valueBoolean": false
}
],
"initialFill": {
"quantity": {
"value": 350.0,
"unit": "TAB"
},
"duration": {
"value": 0.0
}
},
"dispenseInterval": {
"value": 0.0
},
"validityPeriod": {
"start": "2023-10-11T00:00:00+00:00",
"end": "2024-10-10T00:00:00+00:00"
},
"numberOfRepeatsAllowed": 1,
"quantity": {
"value": 0.0
},
"expectedSupplyDuration": {
"value": 10.0,
"unit": "days",
"system": "http://unitsofmeasure.org",
"code": "d"
}
},
"substitution": {
"allowedBoolean": true
}
},
"fullUrl": "https://telus.com/MedicationRequest/ma-labtestsk1-MedicationRequest-2302754",
"request": {
"method": "PUT",
"url": "MedicationRequest/ma-labtestsk1-MedicationRequest-2302754"
}
}