MedicationRequest
CareConnect-MedicationRequest-1 (MedicationRequest) | I | MedicationRequest | |
id | Σ | 0..1 | id |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | I | 0..1 | Narrative |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
repeatInformation | I | 0..1 | Extension(Complex) |
statusReason | I | 0..1 | Extension(Complex) |
prescriptionType | I | 0..1 | Extension(CodeableConcept) |
modifierExtension | ?! I | 0..* | Extension |
identifier | 0..* | Identifier | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 1..1 | uri |
value | Σ | 1..1 | string |
period | Σ I | 0..1 | Period |
assigner | Σ I | 0..1 | Reference() |
definition | Σ I | 0..* | Reference(ActivityDefinition | PlanDefinition) |
basedOn | Σ I | 0..* | Reference(CarePlan | ProcedureRequest | ReferralRequest | ) |
groupIdentifier | Σ | 0..1 | Identifier |
id | 0..1 | string | |
extension | I | 0..* | Extension |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 0..1 | uri |
value | Σ | 0..1 | string |
period | Σ I | 0..1 | Period |
assigner | Σ I | 0..1 | Reference() |
status | Σ ?! | 0..1 | codeBinding |
intent | Σ ?! | 1..1 | codeBinding |
category | 0..1 | CodeableConceptBinding | |
priority | Σ | 0..1 | codeBinding |
medication[x] | Σ | 1..1 | |
medicationCodeableConcept | CodeableConcept | ||
medicationReference | Reference() | ||
subject | Σ I | 1..1 | Reference(Group | ) |
context | I | 0..1 | Reference(EpisodeOfCare | https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1) |
supportingInformation | I | 0..* | Reference(Resource) |
authoredOn | Σ | 0..1 | dateTime |
requester | Σ I | 0..1 | BackboneElement |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
agent | Σ I | 1..1 | Reference(RelatedPerson | Device | | | ) |
onBehalfOf | Σ I | 0..1 | Reference() |
recorder | I | 0..1 | Reference() |
reasonCode | 0..* | CodeableConcept | |
reasonReference | I | 0..* | Reference( | ) |
note | 0..* | Annotation | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
author[x] | Σ | 0..1 | |
authorString | string | ||
authorReference | Reference(RelatedPerson | | ) | ||
time | Σ | 0..1 | dateTime |
text | 1..1 | string | |
dosageInstruction | 0..* | Dosage | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
sequence | Σ | 0..1 | integer |
text | Σ | 0..1 | string |
additionalInstruction | Σ | 0..* | CodeableConcept |
id | 0..1 | string | |
extension | I | 0..* | Extension |
coding | Σ | 0..* | Coding |
snomedCT | Σ | 0..1 | Coding |
id | 0..1 | string | |
extension | I | 0..* | Extension |
snomedCTDescriptionID | I | 0..1 | Extension(Complex) |
system | Σ | 1..1 | uriFixed Value |
version | Σ | 0..1 | string |
code | Σ | 1..1 | code |
display | Σ | 1..1 | string |
userSelected | Σ | 0..1 | boolean |
text | Σ | 0..1 | string |
patientInstruction | Σ | 0..1 | string |
timing | Σ | 0..1 | Timing |
asNeeded[x] | Σ | 0..1 | |
asNeededBoolean | boolean | ||
asNeededCodeableConcept | CodeableConcept | ||
site | Σ | 0..1 | CodeableConcept |
route | Σ | 0..1 | CodeableConcept |
id | 0..1 | string | |
extension | I | 0..* | Extension |
coding | Σ | 0..* | Coding |
snomedCT | Σ | 0..1 | CodingBinding |
id | 0..1 | string | |
extension | I | 0..* | Extension |
snomedCTDescriptionID | I | 0..1 | Extension(Complex) |
system | Σ | 1..1 | uriFixed Value |
version | Σ | 0..1 | string |
code | Σ | 1..1 | code |
display | Σ | 1..1 | string |
userSelected | Σ | 0..1 | boolean |
text | Σ | 0..1 | string |
method | Σ | 0..1 | CodeableConcept |
dose[x] | Σ | 0..1 | |
doseRange | Range | ||
doseQuantity | SimpleQuantity | ||
maxDosePerPeriod | Σ I | 0..1 | Ratio |
maxDosePerAdministration | Σ I | 0..1 | SimpleQuantity |
maxDosePerLifetime | Σ I | 0..1 | SimpleQuantity |
rate[x] | Σ | 0..1 | |
rateRatio | Ratio | ||
rateRange | Range | ||
rateQuantity | SimpleQuantity | ||
dispenseRequest | 0..1 | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
validityPeriod | I | 0..1 | Period |
numberOfRepeatsAllowed | 0..1 | positiveInt | |
quantity | I | 0..1 | SimpleQuantity |
id | 0..1 | string | |
extension | I | 0..* | Extension |
quantityText | I | 0..1 | Extension(string) |
value | Σ | 0..1 | decimal |
comparator | Σ ?! | 0..0 | codeBinding |
unit | Σ | 0..1 | string |
system | Σ I | 0..1 | uri |
code | Σ | 0..1 | code |
expectedSupplyDuration | I | 0..1 | Duration |
id | 0..1 | string | |
extension | I | 0..* | Extension |
value | Σ | 1..1 | decimal |
comparator | Σ ?! | 0..1 | codeBinding |
unit | Σ | 0..1 | string |
system | Σ I | 1..1 | uriFixed Value |
code | Σ | 1..1 | codeBinding |
performer | I | 0..1 | Reference() |
substitution | 0..1 | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
allowed | ?! | 1..1 | boolean |
reason | 0..1 | CodeableConcept | |
priorPrescription | I | 0..1 | Reference() |
detectedIssue | I | 0..* | Reference(DetectedIssue) |
eventHistory | I | 0..* | Reference(Provenance) |
MedicationRequest | |
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. |
Cardinality | 0...* |
Alias | Prescription, Order |
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MedicationRequest.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | id |
Summary | True |
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. |
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MedicationRequest.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
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MedicationRequest.implicitRules | |
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. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. |
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MedicationRequest.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. Common Languages (extensible) |
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). |
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MedicationRequest.text | |
Definition | A human-readable narrative that contains a summary of the resource, and may 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. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. |
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MedicationRequest.contained | |
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. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. |
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MedicationRequest.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.extension:repeatInformation | |
Definition | Medication repeat information. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
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MedicationRequest.extension:statusReason | |
Definition | To record the reason the medication (plan or order) was stopped and the date this occurred. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
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MedicationRequest.extension:prescriptionType | |
Definition | To record the type of prescription. |
Cardinality | 0...1 |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
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MedicationRequest.modifierExtension | |
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. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.identifier | |
Definition | This records 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. For example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system. |
Cardinality | 0...* |
Type | Identifier |
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MedicationRequest.identifier.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.identifier.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.identifier.use | |
Definition | The purpose of this identifier. |
Cardinality | 0...1 |
Type | code |
Binding | Identifies the purpose for this identifier, if known . IdentifierUse (required) |
Modifier | True |
Summary | True |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Comments | This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
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MedicationRequest.identifier.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) |
Summary | True |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
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MedicationRequest.identifier.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Cardinality | 1...1 |
Type | uri |
Summary | True |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
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Examples | General http://www.acme.com/identifiers/patient |
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MedicationRequest.identifier.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Cardinality | 1...1 |
Type | string |
Summary | True |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
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Examples | General 123456 |
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MedicationRequest.identifier.period | |
Definition | Time period during which identifier is/was valid for use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
Comments | This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration. |
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MedicationRequest.identifier.assigner | |
Definition | Organization that issued/manages the identifier. |
Cardinality | 0...1 |
Type | Reference() |
Summary | True |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
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MedicationRequest.definition | |
Definition | Protocol or definition followed by this request. |
Cardinality | 0...* |
Type | Reference(ActivityDefinition | PlanDefinition) |
Summary | True |
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. |
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MedicationRequest.basedOn | |
Definition | A plan or request that is fulfilled in whole or in part by this medication request. |
Cardinality | 0...* |
Type | Reference(CarePlan | ProcedureRequest | ReferralRequest | ) |
Summary | True |
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. |
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MedicationRequest.groupIdentifier | |
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. |
Cardinality | 0...1 |
Type | Identifier |
Summary | True |
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. |
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MedicationRequest.groupIdentifier.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.groupIdentifier.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.groupIdentifier.use | |
Definition | The purpose of this identifier. |
Cardinality | 0...1 |
Type | code |
Binding | Identifies the purpose for this identifier, if known . IdentifierUse (required) |
Modifier | True |
Summary | True |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Comments | This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
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MedicationRequest.groupIdentifier.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) |
Summary | True |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
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MedicationRequest.groupIdentifier.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Cardinality | 0...1 |
Type | uri |
Summary | True |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
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Examples | General http://www.acme.com/identifiers/patient |
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MedicationRequest.groupIdentifier.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
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Examples | General 123456 |
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MedicationRequest.groupIdentifier.period | |
Definition | Time period during which identifier is/was valid for use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
Comments | This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration. |
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MedicationRequest.groupIdentifier.assigner | |
Definition | Organization that issued/manages the identifier. |
Cardinality | 0...1 |
Type | Reference() |
Summary | True |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
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MedicationRequest.status | |
Definition | A code specifying the current state of the order. Generally this will be active or completed state. |
Cardinality | 0...1 |
Type | code |
Binding | A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription MedicationRequestStatus (required) |
Modifier | True |
Summary | True |
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
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MedicationRequest.intent | |
Definition | Whether the request is a proposal, plan, or an original order. |
Cardinality | 1...1 |
Type | code |
Binding | The kind of medication order MedicationRequestIntent (required) |
Modifier | True |
Summary | True |
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. |
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MedicationRequest.category | |
Definition | Indicates the type of medication order and where the medication is expected to be consumed or administered. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept identifying where the medication ordered is expected to be consumed or administered MedicationRequestCategory (preferred) |
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. |
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MedicationRequest.priority | |
Definition | Indicates how quickly the Medication Request should be addressed with respect to other requests. |
Cardinality | 0...1 |
Type | code |
Binding | Identifies the level of importance to be assigned to actioning the request MedicationRequestPriority (required) |
Summary | True |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.medication[x] | |
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. |
Cardinality | 1...1 |
Type | Reference(), CodeableConcept |
Binding | A coded concept identifying substance or product that can be ordered. SNOMED CT Medication Codes (example) |
Summary | True |
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. . |
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MedicationRequest.subject | |
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given. |
Cardinality | 1...1 |
Type | Reference(Group | ) |
Summary | True |
Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. |
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MedicationRequest.context | |
Definition | A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider. |
Cardinality | 0...1 |
Type | Reference(EpisodeOfCare | https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1) |
Comments | SubstanceAdministration->component->EncounterEvent. |
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MedicationRequest.supportingInformation | |
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication. |
Cardinality | 0...* |
Type | Reference(Resource) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
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MedicationRequest.authoredOn | |
Definition | The date (and perhaps time) when the prescription was initially written or authored on. |
Cardinality | 0...1 |
Type | dateTime |
Summary | True |
Invariants |
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Mappings |
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MedicationRequest.requester | |
Definition | The individual, organization or device that initiated the request and has responsibility for its activation. |
Cardinality | 0...1 |
Type | BackboneElement |
Summary | True |
Invariants |
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Mappings |
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MedicationRequest.requester.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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MedicationRequest.requester.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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MedicationRequest.requester.modifierExtension | |
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 that contains it. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
Invariants |
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Mappings |
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MedicationRequest.requester.agent | |
Definition | The healthcare professional responsible for authorizing the initial prescription. |
Cardinality | 1...1 |
Type | Reference(RelatedPerson | Device | | | ) |
Summary | True |
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. |
Invariants |
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Mappings |
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MedicationRequest.requester.onBehalfOf | |
Definition | The organization the device or practitioner was acting on behalf of. |
Cardinality | 0...1 |
Type | Reference() |
Summary | True |
Requirements | Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request. |
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. |
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MedicationRequest.recorder | |
Definition | The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. |
Cardinality | 0...1 |
Type | Reference() |
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. |
Invariants |
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Mappings |
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MedicationRequest.reasonCode | |
Definition | The reason or the indication for ordering the medication. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | A coded concept indicating why the medication was ordered. Condition/Problem/Diagnosis Codes (example) |
Comments | This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. |
Invariants |
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Mappings |
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MedicationRequest.reasonReference | |
Definition | Condition or observation that supports why the medication was ordered. |
Cardinality | 0...* |
Type | Reference( | ) |
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. |
Invariants |
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Mappings |
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MedicationRequest.note | |
Definition | Extra information about the prescription that could not be conveyed by the other attributes. |
Cardinality | 0...* |
Type | Annotation |
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). |
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MedicationRequest.note.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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Mappings |
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MedicationRequest.note.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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MedicationRequest.note.author[x] | |
Definition | The individual responsible for making the annotation. |
Cardinality | 0...1 |
Type | Reference(RelatedPerson | | ), string |
Summary | True |
Invariants |
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Mappings |
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MedicationRequest.note.time | |
Definition | Indicates when this particular annotation was made. |
Cardinality | 0...1 |
Type | dateTime |
Summary | True |
Invariants |
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Mappings |
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MedicationRequest.note.text | |
Definition | The text of the annotation. |
Cardinality | 1...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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Mappings |
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MedicationRequest.dosageInstruction | |
Definition | Indicates how the medication is to be used by the patient. |
Cardinality | 0...* |
Type | Dosage |
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. |
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MedicationRequest.dosageInstruction.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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MedicationRequest.dosageInstruction.sequence | |
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
Cardinality | 0...1 |
Type | integer |
Summary | True |
Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
Comments | 32 bit number; for values larger than this, use decimal |
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Mappings |
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MedicationRequest.dosageInstruction.text | |
Definition | Free text dosage instructions e.g. SIG. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dosageInstruction.additionalInstruction | |
Definition | Supplemental instruction - e.g. "with meals". |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMED CT Additional Dosage Instructions (example) |
Summary | True |
Requirements | Additional instruction such as "Swallow with plenty of water" which may or may not be coded. |
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. |
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MedicationRequest.dosageInstruction.additionalInstruction.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding | |
Definition | A reference to a code defined by a terminology system. |
Cardinality | 0...* |
Type | Coding |
Summary | True |
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Slicing | Unordered, Open, by system(Value) |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT | |
Definition | A reference to a code defined by a terminology system. |
Cardinality | 0...1 |
Type | Coding |
Summary | True |
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.extension:snomedCTDescriptionID | |
Definition | The SNOMED CT Description ID for the display. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Cardinality | 1...1 |
Type | uri |
Summary | True |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. |
Invariants |
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Fixed Value | http://snomed.info/sct |
Mappings |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.version | |
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Cardinality | 1...1 |
Type | code |
Summary | True |
Requirements | Need to refer to a particular code in the system. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.display | |
Definition | A representation of the meaning of the code in the system, following the rules of the system. |
Cardinality | 1...1 |
Type | string |
Summary | True |
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dosageInstruction.additionalInstruction.coding:snomedCT.userSelected | |
Definition | Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). |
Cardinality | 0...1 |
Type | boolean |
Summary | True |
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. |
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MedicationRequest.dosageInstruction.additionalInstruction.text | |
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
Comments | Very often the text is the same as a displayName of one of the codings. |
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MedicationRequest.dosageInstruction.patientInstruction | |
Definition | Instructions in terms that are understood by the patient or consumer. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dosageInstruction.timing | |
Definition | When medication should be administered. |
Cardinality | 0...1 |
Type | Timing |
Summary | True |
Requirements | The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Comments | This attribute may not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. |
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MedicationRequest.dosageInstruction.asNeeded[x] | |
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). |
Cardinality | 0...1 |
Type | boolean, CodeableConcept |
Binding | A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMED CT Medication As Needed Reason Codes (example) |
Summary | True |
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". |
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MedicationRequest.dosageInstruction.site | |
Definition | Body site to administer to. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example) |
Summary | True |
Requirements | A coded specification of the anatomic site where the medication first enters the body. |
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. |
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MedicationRequest.dosageInstruction.route | |
Definition | How drug should enter body. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes (example) |
Summary | True |
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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MedicationRequest.dosageInstruction.route.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.route.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.route.coding | |
Definition | A reference to a code defined by a terminology system. |
Cardinality | 0...* |
Type | Coding |
Summary | True |
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Slicing | Unordered, Open, by system(Value) |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.route.coding:snomedCT | |
Definition | A reference to a code defined by a terminology system. |
Cardinality | 0...1 |
Type | Coding |
Binding | A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. (preferred) |
Summary | True |
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.extension:snomedCTDescriptionID | |
Definition | The SNOMED CT Description ID for the display. |
Cardinality | 0...1 |
Type | Extension(Complex) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Cardinality | 1...1 |
Type | uri |
Summary | True |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. |
Invariants |
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Fixed Value | http://snomed.info/sct |
Mappings |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.version | |
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. |
Invariants |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Cardinality | 1...1 |
Type | code |
Summary | True |
Requirements | Need to refer to a particular code in the system. |
Comments | Note that FHIR strings may not exceed 1MB in size |
Invariants |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.display | |
Definition | A representation of the meaning of the code in the system, following the rules of the system. |
Cardinality | 1...1 |
Type | string |
Summary | True |
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dosageInstruction.route.coding:snomedCT.userSelected | |
Definition | Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). |
Cardinality | 0...1 |
Type | boolean |
Summary | True |
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. |
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MedicationRequest.dosageInstruction.route.text | |
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
Comments | Very often the text is the same as a displayName of one of the codings. |
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MedicationRequest.dosageInstruction.method | |
Definition | Technique for administering medication. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example) |
Summary | True |
Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. |
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MedicationRequest.dosageInstruction.dose[x] | |
Definition | Amount of medication per dose. |
Cardinality | 0...1 |
Type | Range, SimpleQuantity |
Summary | True |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
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MedicationRequest.dosageInstruction.maxDosePerPeriod | |
Definition | Upper limit on medication per unit of time. |
Cardinality | 0...1 |
Type | Ratio |
Summary | True |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". |
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MedicationRequest.dosageInstruction.maxDosePerAdministration | |
Definition | Upper limit on medication per administration. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Summary | True |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. |
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MedicationRequest.dosageInstruction.maxDosePerLifetime | |
Definition | Upper limit on medication per lifetime of the patient. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Summary | True |
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. |
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MedicationRequest.dosageInstruction.rate[x] | |
Definition | Amount of medication per unit of time. |
Cardinality | 0...1 |
Type | Ratio, Range, SimpleQuantity |
Summary | True |
Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Comments | It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. |
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MedicationRequest.dispenseRequest | |
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. |
Cardinality | 0...1 |
Type | BackboneElement |
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MedicationRequest.dispenseRequest.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dispenseRequest.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.dispenseRequest.modifierExtension | |
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 that contains it. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
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MedicationRequest.dispenseRequest.validityPeriod | |
Definition | This indicates the validity period of a prescription (stale dating the Prescription). |
Cardinality | 0...1 |
Type | Period |
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. |
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MedicationRequest.dispenseRequest.numberOfRepeatsAllowed | |
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. |
Cardinality | 0...1 |
Type | positiveInt |
Comments | If displaying "number of authorized fills", add 1 to this number. |
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MedicationRequest.dispenseRequest.quantity | |
Definition | The amount that is to be dispensed for one fill. |
Cardinality | 0...1 |
Type | SimpleQuantity |
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. |
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MedicationRequest.dispenseRequest.quantity.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dispenseRequest.quantity.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.dispenseRequest.quantity.extension:quantityText | |
Definition | Quantity representation. |
Cardinality | 0...1 |
Type | Extension(string) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
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MedicationRequest.dispenseRequest.quantity.value | |
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value. |
Cardinality | 0...1 |
Type | decimal |
Summary | True |
Requirements | Precision is handled implicitly in almost all cases of measurement. |
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). |
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MedicationRequest.dispenseRequest.quantity.comparator | |
Definition | Not allowed to be used in this context |
Cardinality | 0...0 |
Type | code |
Binding | How the Quantity should be understood and represented. QuantityComparator (required) |
Modifier | True |
Summary | True |
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. |
Comments | This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. |
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MedicationRequest.dispenseRequest.quantity.unit | |
Definition | A human-readable form of the unit. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dispenseRequest.quantity.system | |
Definition | The identification of the system that provides the coded form of the unit. |
Cardinality | 0...1 |
Type | uri |
Summary | True |
Requirements | Need to know the system that defines the coded form of the unit. |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
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MedicationRequest.dispenseRequest.quantity.code | |
Definition | A computer processable form of the unit in some unit representation system. |
Cardinality | 0...1 |
Type | code |
Summary | True |
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. |
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. |
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MedicationRequest.dispenseRequest.expectedSupplyDuration | |
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. |
Cardinality | 0...1 |
Type | Duration |
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. |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.value | |
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value. |
Cardinality | 1...1 |
Type | decimal |
Summary | True |
Requirements | Precision is handled implicitly in almost all cases of measurement. |
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator | |
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. |
Cardinality | 0...1 |
Type | code |
Binding | How the Quantity should be understood and represented. QuantityComparator (required) |
Modifier | True |
Summary | True |
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. |
Comments | This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.unit | |
Definition | A human-readable form of the unit. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.system | |
Definition | The identification of the system that provides the coded form of the unit. |
Cardinality | 1...1 |
Type | uri |
Summary | True |
Requirements | Need to know the system that defines the coded form of the unit. |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
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Fixed Value | http://unitsofmeasure.org |
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MedicationRequest.dispenseRequest.expectedSupplyDuration.code | |
Definition | A computer processable form of the unit in some unit representation system. |
Cardinality | 1...1 |
Type | code |
Binding | A unit of time (units from UCUM). UnitsOfTime (required) |
Summary | True |
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. |
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. |
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MedicationRequest.dispenseRequest.performer | |
Definition | Indicates the intended dispensing Organization specified by the prescriber. |
Cardinality | 0...1 |
Type | Reference() |
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. |
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MedicationRequest.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. |
Cardinality | 0...1 |
Type | BackboneElement |
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MedicationRequest.substitution.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationRequest.substitution.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationRequest.substitution.modifierExtension | |
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 that contains it. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
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MedicationRequest.substitution.allowed | |
Definition | True if the prescriber allows a different drug to be dispensed from what was prescribed. |
Cardinality | 1...1 |
Type | boolean |
Modifier | True |
Comments | This element is labeled as a modifer because whether substitution is allow or not cannot be ignored. |
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MedicationRequest.substitution.reason | |
Definition | Indicates the reason for the substitution, or why substitution must or must not be performed. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. SubstanceAdminSubstitutionReason (example) |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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MedicationRequest.priorPrescription | |
Definition | A link to a resource representing an earlier order related order or prescription. |
Cardinality | 0...1 |
Type | Reference() |
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. |
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MedicationRequest.detectedIssue | |
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. |
Cardinality | 0...* |
Type | Reference(DetectedIssue) |
Alias | Contraindication, Drug Utilization Review (DUR), Alert |
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. |
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MedicationRequest.eventHistory | |
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. |
Cardinality | 0...* |
Type | Reference(Provenance) |
Comments | This may 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.). |
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MedicationDispense
CareConnect-MedicationDispense-1 (MedicationDispense) | I | MedicationDispense | |
id | Σ | 0..1 | id |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | I | 0..1 | Narrative |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
modifierExtension | ?! I | 0..* | Extension |
identifier | 0..* | Identifier | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 1..1 | uri |
value | Σ | 1..1 | string |
period | Σ I | 0..1 | Period |
assigner | Σ I | 0..1 | Reference() |
partOf | I | 0..* | Reference() |
status | Σ ?! | 0..1 | codeBinding |
category | 0..1 | CodeableConceptBinding | |
medication[x] | Σ | 1..1 | |
medicationCodeableConcept | CodeableConcept | ||
medicationReference | Reference() | ||
subject | Σ I | 0..1 | Reference(Group | ) |
context | I | 0..1 | Reference( | https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1) |
supportingInformation | I | 0..* | Reference(Resource) |
performer | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
actor | I | 1..1 | Reference(Device | | | | ) |
onBehalfOf | I | 0..1 | Reference() |
authorizingPrescription | I | 0..* | Reference() |
type | 0..1 | CodeableConceptBinding | |
quantity | I | 0..1 | SimpleQuantity |
id | 0..1 | string | |
extension | I | 0..* | Extension |
quantityText | I | 0..1 | Extension(string) |
value | Σ | 0..1 | decimal |
comparator | Σ ?! | 0..0 | codeBinding |
unit | Σ | 0..1 | string |
system | Σ I | 0..1 | uri |
code | Σ | 0..1 | code |
daysSupply | I | 0..1 | SimpleQuantity |
whenPrepared | Σ | 0..1 | dateTime |
whenHandedOver | 0..1 | dateTime | |
destination | I | 0..1 | Reference() |
receiver | I | 0..* | Reference( | ) |
note | 0..* | Annotation | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
author[x] | Σ | 0..1 | |
authorString | string | ||
authorReference | Reference( | | ) | ||
time | Σ | 0..1 | dateTime |
text | 1..1 | string | |
dosageInstruction | 0..* | Dosage | |
substitution | 0..1 | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
wasSubstituted | 1..1 | boolean | |
type | 0..1 | CodeableConcept | |
reason | 0..* | CodeableConcept | |
responsibleParty | I | 0..* | Reference() |
detectedIssue | I | 0..* | Reference(DetectedIssue) |
notDone | 0..1 | boolean | |
notDoneReason[x] | 0..1 | ||
notDoneReasonCodeableConcept | CodeableConcept | ||
notDoneReasonReference | Reference(DetectedIssue) | ||
eventHistory | I | 0..* | Reference(Provenance) |
MedicationDispense | |
Definition | Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order. |
Cardinality | 0...* |
Comments | The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html). |
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MedicationDispense.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | id |
Summary | True |
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. |
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MedicationDispense.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
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MedicationDispense.implicitRules | |
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. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. |
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MedicationDispense.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. Common Languages (extensible) |
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). |
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MedicationDispense.text | |
Definition | A human-readable narrative that contains a summary of the resource, and may 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. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. |
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MedicationDispense.contained | |
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. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. |
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MedicationDispense.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.modifierExtension | |
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. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.identifier | |
Definition | Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR. |
Cardinality | 0...* |
Type | Identifier |
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MedicationDispense.identifier.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.identifier.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.identifier.use | |
Definition | The purpose of this identifier. |
Cardinality | 0...1 |
Type | code |
Binding | Identifies the purpose for this identifier, if known . IdentifierUse (required) |
Modifier | True |
Summary | True |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Comments | This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
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MedicationDispense.identifier.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) |
Summary | True |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
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MedicationDispense.identifier.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Cardinality | 1...1 |
Type | uri |
Summary | True |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
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Examples | General http://www.acme.com/identifiers/patient |
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MedicationDispense.identifier.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Cardinality | 1...1 |
Type | string |
Summary | True |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
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Examples | General 123456 |
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MedicationDispense.identifier.period | |
Definition | Time period during which identifier is/was valid for use. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
Comments | This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration. |
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MedicationDispense.identifier.assigner | |
Definition | Organization that issued/manages the identifier. |
Cardinality | 0...1 |
Type | Reference() |
Summary | True |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
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MedicationDispense.partOf | |
Definition | The procedure that the dispense is done because of. |
Cardinality | 0...* |
Type | Reference() |
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. |
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MedicationDispense.status | |
Definition | A code specifying the state of the set of dispense events. |
Cardinality | 0...1 |
Type | code |
Binding | A coded concept specifying the state of the dispense event. MedicationDispenseStatus (required) |
Modifier | True |
Summary | True |
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
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MedicationDispense.category | |
Definition | Indicates type of medication dispense and where the medication is expected to be consumed or administered. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code describing where the dispensed medication is expected to be consumed or administered MedicationDispenseCategory (preferred) |
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. |
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MedicationDispense.medication[x] | |
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. |
Cardinality | 1...1 |
Type | Reference(), CodeableConcept |
Binding | A coded concept identifying which substance or product can be dispensed SNOMED CT Medication Codes (example) |
Summary | True |
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example if you require form or lot number, then you must reference the Medication resource. . |
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MedicationDispense.subject | |
Definition | A link to a resource representing the person or the group to whom the medication will be given. |
Cardinality | 0...1 |
Type | Reference(Group | ) |
Summary | True |
Comments | SubstanceAdministration->subject->Patient. |
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MedicationDispense.context | |
Definition | The encounter or episode of care that establishes the context for this event. |
Cardinality | 0...1 |
Type | Reference( | https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
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MedicationDispense.supportingInformation | |
Definition | Additional information that supports the medication being dispensed. |
Cardinality | 0...* |
Type | Reference(Resource) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
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MedicationDispense.performer | |
Definition | Indicates who or what performed the event. It should be assumed that the performer is the dispenser of the medication. |
Cardinality | 0...* |
Type | BackboneElement |
Comments | The performer will be reviewed as part of STU4. |
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MedicationDispense.performer.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.performer.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.performer.modifierExtension | |
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 that contains it. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
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MedicationDispense.performer.actor | |
Definition | The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. |
Cardinality | 1...1 |
Type | Reference(Device | | | | ) |
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. |
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MedicationDispense.performer.onBehalfOf | |
Definition | The organization the device or practitioner was acting on behalf of. |
Cardinality | 0...1 |
Type | Reference() |
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. |
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MedicationDispense.authorizingPrescription | |
Definition | Indicates the medication order that is being dispensed against. |
Cardinality | 0...* |
Type | Reference() |
Comments | Maps to basedOn in Event logical model. |
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MedicationDispense.type | |
Definition | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A ValueSet to identify the type of medication supply. (preferred) |
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. |
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MedicationDispense.quantity | |
Definition | The amount of medication that has been dispensed. Includes unit of measure. |
Cardinality | 0...1 |
Type | SimpleQuantity |
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. |
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MedicationDispense.quantity.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.quantity.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.quantity.extension:quantityText | |
Definition | Quantity representation. |
Cardinality | 0...1 |
Type | Extension(string) |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
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MedicationDispense.quantity.value | |
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value. |
Cardinality | 0...1 |
Type | decimal |
Summary | True |
Requirements | Precision is handled implicitly in almost all cases of measurement. |
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). |
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MedicationDispense.quantity.comparator | |
Definition | Not allowed to be used in this context |
Cardinality | 0...0 |
Type | code |
Binding | How the Quantity should be understood and represented. QuantityComparator (required) |
Modifier | True |
Summary | True |
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. |
Comments | This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. |
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MedicationDispense.quantity.unit | |
Definition | A human-readable form of the unit. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.quantity.system | |
Definition | The identification of the system that provides the coded form of the unit. |
Cardinality | 0...1 |
Type | uri |
Summary | True |
Requirements | Need to know the system that defines the coded form of the unit. |
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
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MedicationDispense.quantity.code | |
Definition | A computer processable form of the unit in some unit representation system. |
Cardinality | 0...1 |
Type | code |
Summary | True |
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. |
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. |
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MedicationDispense.daysSupply | |
Definition | The amount of medication expressed as a timing amount. |
Cardinality | 0...1 |
Type | SimpleQuantity |
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. |
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MedicationDispense.whenPrepared | |
Definition | The time when the dispensed product was packaged and reviewed. |
Cardinality | 0...1 |
Type | dateTime |
Summary | True |
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MedicationDispense.whenHandedOver | |
Definition | The time the dispensed product was provided to the patient or their representative. |
Cardinality | 0...1 |
Type | dateTime |
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MedicationDispense.destination | |
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event. |
Cardinality | 0...1 |
Type | Reference() |
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. |
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MedicationDispense.receiver | |
Definition | Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. |
Cardinality | 0...* |
Type | Reference( | ) |
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. |
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MedicationDispense.note | |
Definition | Extra information about the dispense that could not be conveyed in the other attributes. |
Cardinality | 0...* |
Type | Annotation |
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). |
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MedicationDispense.note.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.note.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.note.author[x] | |
Definition | The individual responsible for making the annotation. |
Cardinality | 0...1 |
Type | Reference( | | ), string |
Summary | True |
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MedicationDispense.note.time | |
Definition | Indicates when this particular annotation was made. |
Cardinality | 0...1 |
Type | dateTime |
Summary | True |
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MedicationDispense.note.text | |
Definition | The text of the annotation. |
Cardinality | 1...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.dosageInstruction | |
Definition | Indicates how the medication is to be used by the patient. |
Cardinality | 0...* |
Type | Dosage |
Comments | When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed. |
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MedicationDispense.substitution | |
Definition | Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. |
Cardinality | 0...1 |
Type | BackboneElement |
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MedicationDispense.substitution.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings may not exceed 1MB in size |
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MedicationDispense.substitution.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
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MedicationDispense.substitution.modifierExtension | |
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 that contains it. Usually modifier elements provide negation or qualification. In order 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. |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
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MedicationDispense.substitution.wasSubstituted | |
Definition | True if the dispenser dispensed a different drug or product from what was prescribed. |
Cardinality | 1...1 |
Type | boolean |
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MedicationDispense.substitution.type | |
Definition | A code signifying whether a different drug was dispensed from what was prescribed. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription ActSubstanceAdminSubstitutionCode (example) |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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MedicationDispense.substitution.reason | |
Definition | Indicates the reason for the substitution of (or lack of substitution) from what was prescribed. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed SubstanceAdminSubstitutionReason (example) |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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MedicationDispense.substitution.responsibleParty | |
Definition | The person or organization that has primary responsibility for the substitution. |
Cardinality | 0...* |
Type | Reference() |
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. |
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MedicationDispense.detectedIssue | |
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. |
Cardinality | 0...* |
Type | Reference(DetectedIssue) |
Alias | Contraindication, Drug Utilization Review (DUR), Alert |
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. |
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MedicationDispense.notDone | |
Definition | True if the dispense was not performed for some reason. |
Cardinality | 0...1 |
Type | boolean |
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MedicationDispense.notDoneReason[x] | |
Definition | Indicates the reason why a dispense was not performed. |
Cardinality | 0...1 |
Type | Reference(DetectedIssue), CodeableConcept |
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MedicationDispense.eventHistory | |
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified. |
Cardinality | 0...* |
Type | Reference(Provenance) |
Comments | This may 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.). |
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MedicationStatement
CareConnect-MedicationStatement-1 (MedicationStatement) | I | MedicationStatement | |
id | Σ | 0..1 | id |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | I | 0..1 | Narrative |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
lastIssueDate | I | 0..1 | Extension(dateTime) |
changeSummary | I | 0..1 | Extension(Complex) |
dosageLastChanged | I | 0..1 | Extension(dateTime) |
prescribingAgency | I | 0..1 | Extension(CodeableConcept) |
modifierExtension | ?! I | 0..* | Extension |
identifier | Σ | 0..* | Identifier |
id | 0..1 | string | |
extension | I | 0..* | Extension |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 1..1 | uri |
value | Σ | 1..1 | string |
period | Σ I | 0..1 | Period |
assigner | Σ I | 0..1 | Reference() |
basedOn | Σ I | 0..* | Reference(CarePlan | ProcedureRequest | ReferralRequest | ) |
partOf | Σ I | 0..* | Reference(MedicationAdministration | | | | ) |
context | Σ I | 0..1 | Reference(EpisodeOfCare | https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1) |
status | Σ ?! | 1..1 | codeBinding |
category | Σ | 0..1 | CodeableConceptBinding |
medication[x] | Σ | 1..1 | |
medicationCodeableConcept | CodeableConcept | ||
medicationReference | Reference() | ||
effective[x] | Σ | 0..1 | |
effectiveDateTime | dateTime | ||
effectivePeriod | Period | ||
dateAsserted | Σ | 0..1 | dateTime |
informationSource | I | 0..1 | Reference(RelatedPerson | | | ) |
subject | Σ I | 1..1 | Reference(Group | ) |