ERP ServiceRequest MedicationRequest

Übersicht über das Profil

NameDescriptionCanonical_URLStatusVersionBasiert auf
ERPServiceRequestMedicationRequest

Medical and pharmaceutical information for the prescription request

https://gematik.de/fhir/erp-servicerequest/StructureDefinition/erp-service-request-medication-requestdraft1.2http://hl7.org/fhir/StructureDefinition/MedicationRequest

Über das Profil

Motivation

Dieses Profil wird in den Anwendungsfällen genutzt, um angefragte, verordnete oder dispensierte Arzneimittelinformationen zu übertragen.

Als Anfragender möchte ich angeben können, welche Medikation ich für einen Patienten anfragen möchte. Eine Einrichtung/ Person, die eine Verordnung anfragt nutzt dieses Profil, um strukturiert anzugeben, welche Medikation benötigt wird. Hierzu muss in ERPServiceRequestPrescriptionRequest.basedOn ein ERPServiceRequestMedicationRequest mit angegeben werden. Dieser enthält die medizinische Information, die der Verordnende benötigt, um ein entsprechendes Rezept auszustellen.

Analog kann der Verordnende angeben, welches Arzneimittel er verordnet hat, sowie ein abgebender LE welches Arzneimittel geliefert wird.

Die anzugebende Medication entspricht dabei den Medication Profilen aus dem eRezept Projekt der KBV.

Da die KBV_PR_ERP_Prescription Informationen voraussetzt, die u.U. im Moment der Anfrage nicht bekannt sind, wurde dieses Profil spezifiziert. Es lehnt sich an die Spezifikation der KBV_PR_ERP_Prescription an, ist aber offener, erlaubt also auch dass die fehlenden Informationen nicht angegeben werden müssen.

Inhalt des Profils

Folgende Ansichten existieren auf das Profil:

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
PriorPrescriptionIDS I0..1Extension(Identifier Profile for Prescription IDs (GEM_ERP_PR_PrescriptionId))
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueBoolean1..1boolean
url1..1uriFixed Value
modifierExtension?! I0..*Extension
identifier0..*Identifier
statusΣ ?!1..1codeBinding
statusReason0..1CodeableConcept
intentΣ ?!1..1codeBinding
category0..*CodeableConcept
priorityΣ0..1codeBinding
doNotPerformΣ ?!0..1boolean
reportedBooleanboolean
reportedReferenceReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
medicationReferenceReference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)
subjectS Σ I1..1Reference(ERPServiceRequestPatient)
encounterI0..1Reference(Encounter)
supportingInformationI0..*Reference(Resource)
authoredOnΣ0..1dateTime
requesterΣ I0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
performerI0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)
performerTypeΣ0..1CodeableConcept
recorderI0..1Reference(Practitioner | PractitionerRole)
reasonCode0..*CodeableConcept
reasonReferenceI0..*Reference(Condition | Observation)
instantiatesCanonicalΣ0..*canonical()
instantiatesUriΣ0..*uri
basedOnΣ I0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)
groupIdentifierΣ0..1Identifier
courseOfTherapyType0..1CodeableConcept
insuranceI0..*Reference(Coverage | ClaimResponse)
note0..*Annotation
dosageInstruction0..*Dosage
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
quantityI0..1SimpleQuantity
durationI0..1Duration
dispenseIntervalI0..1Duration
validityPeriodI0..1Period
numberOfRepeatsAllowed0..1unsignedInt
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..0string
systemS Σ I1..1uriFixed Value
codeS Σ1..1codeFixed Value
expectedSupplyDurationI0..1Duration
performerI0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
allowedBooleanboolean
allowedCodeableConceptCodeableConcept
reason0..1CodeableConcept
priorPrescriptionI0..1Reference(MedicationRequest)
detectedIssueI0..*Reference(DetectedIssue)
eventHistoryI0..*Reference(Provenance)
MedicationRequest
DefinitionAn order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Cardinality0...*
AliasPrescription, Order
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Request
  • script10.6: Message/Body/NewRx
  • rim: CombinedMedicationRequest
MedicationRequest.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
SummaryTrue
Comments

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

MedicationRequest.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.text
DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
MedicationRequest.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

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

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
MedicationRequest.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

If the previous recipe ID is known, it can be named here

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:PriorPrescriptionID
DefinitionThe MedicationRequest can contain a PrescriptionId of a prescription that has already been issued. If a previous prescription ID is known, the writing system MAY indicate this in the medication request. If this ID is available, the receiving system MUST be able to search for the previous regulation and give the user the opportunity to display and compare the content.
Cardinality0...1
TypeExtension(Identifier Profile for Prescription IDs (GEM_ERP_PR_PrescriptionId))
Must SupportTrue
Aliasextensions, user content
Comments

Must be given in the form xxx.xxx.xxx.xxx.xxx.xx.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO
DefinitionIf the prescription is should be a multiple prescription order. Only the 'Kennzeichen' should be stated, indicating that the prescription is requested to be a multiple prescription order.
Cardinality0...1
TypeExtension(Complex)
Must SupportTrue
ModifierTrue
Aliasextensions, user content
Comments

When this extension is received by a PVS, the prescriber has to be visually notified about the request for a multiple prescription order.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
  • -erp-multiplePrescriptionKennzeichenTrueNummerierung: Mehrfachverordnung: Wenn das Kennzeichen gleich true ist, muss eine Nummerierung (Zaehler und Nenner) angegeben werden.
    (extension('Kennzeichen').value as boolean)=true implies extension('Nummerierung').exists()
  • -erp-multiplePrescriptionKennzeichenFalseNummerierung: Mehrfachverordnung: Wenn das Kennzeichen gleich false ist, darf keine Nummerierung (Zaehler und Nenner) angegeben werden.
    (extension('Kennzeichen').value as boolean)=false implies extension('Nummerierung').exists().not()
  • -erp-multiplePrescriptionKennzeichenTrueZeitraum: Mehrfachverordnung: Wenn das Kennzeichen gleich true ist, muss ein Zeitraum (mindestens Beginn der Einlösefrist) angegeben werden.
    (extension('Kennzeichen').value as boolean)=true implies extension('Zeitraum').exists()
  • -erp-multiplePrescriptionKennzeichenFalseZeitraum: Mehrfachverordnung: Wenn das Kennzeichen gleich false ist, darf kein Zeitraum angegeben werden.
    (extension('Kennzeichen').value as boolean)=false implies extension('Zeitraum').exists().not()
  • -erp-multiplePrescriptionKennzeichenTrueID: Mehrfachverordnung: Wenn das Kennzeichen gleich true ist, muss eine ID angegeben werden.
    (extension('Kennzeichen').value as boolean)=true implies extension('ID').exists()
  • -erp-multiplePrescriptionKennzeichenFalseID: Mehrfachverordnung: Wenn das Kennzeichen gleich false ist, darf keine ID angegeben werden.
    (extension('Kennzeichen').value as boolean)=false implies extension('ID').exists().not()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality1...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Closed, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Kennzeichen
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality1...1
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Kennzeichen.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Kennzeichen.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Kennzeichen.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

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

Fixed Value

Kennzeichen

Mappings
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Kennzeichen.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
Typeboolean
SlicingUnordered, Closed, by $this(Type)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Kennzeichen.value[x]:valueBoolean
DefinitionAbbildung, ob die aktuelle Verordnung Teil einer Mehrfachverordnung ist true - die aktuelle Verordnung ist Teil einer Mehrfachverordnung false - die aktuelle Verordnung ist kein Teil einer Mehrfachverordnung
Cardinality1...1
Typeboolean
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Nummerierung.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

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

Fixed Value

Nummerierung

Mappings
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeRatio
SlicingUnordered, Closed, by $this(Type)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeRatio
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • -erp-multiplePrescriptionNummerierung: Mehrfachverordnung: Der Zaehler (Nummer der Teilverordnung) darf nicht größer als der Nenner (Gesamtanzahl) sein.
    numerator.value <= denominator.value
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator
DefinitionThe value of the numerator.
Cardinality1...1
TypeQuantity
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • -erp-multiplePrescriptionNumeratorValue: Mehrfachverordnung: Zaehler muss den Wert 1, 2, 3 oder 4 haben.
    where(value=1 or value=2 or value=3 or value=4).count()=1
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: .numerator
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.value
DefinitionDas Feld dient der Kennzeichnung, um die wievielte Mehrfachverordnung einer Serie es sich handelt. Beispiel: "2" in "2 von 4"
Cardinality1...1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.comparator
DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.unit
DefinitionA human-readable form of the unit.
Cardinality0...0
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...0
Typeuri
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.numerator.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality0...0
Typecode
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator
DefinitionThe value of the denominator.
Cardinality1...1
TypeQuantity
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • -erp-multiplePrescriptionDenominatorValue: Mehrfachverordnung: Nenner muss den Wert 2, 3 oder 4 haben.
    where(value=2 or value=3 or value=4).count()=1
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: .denominator
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.value
DefinitionDas Feld dient der Kennzeichnung der Länge dieser Serie. Beispiel: "4" in "2 von 4"
Cardinality1...1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.comparator
DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.unit
DefinitionA human-readable form of the unit.
Cardinality0...0
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...0
Typeuri
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationRequest.extension:requestMVO.extension:Nummerierung.value[x]:valueRatio.denominator.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality0...0
Typecode
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
MedicationRequest.extension:requestMVO.extension:Zeitraum
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Zeitraum.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Zeitraum.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Zeitraum.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

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

Fixed Value

Zeitraum

Mappings
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Zeitraum.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypePeriod
SlicingUnordered, Closed, by $this(Type)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Zeitraum.value[x]:valuePeriod
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypePeriod
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • -erp-begrenzungDateStart: Begrenzung der Datumsangabe auf 10 Zeichen JJJJ-MM-TT
    start.toString().length()=10
  • -erp-begrenzungDateEnd: Begrenzung der Datumsangabe auf 10 Zeichen JJJJ-MM-TT
    end.exists().not() or end.toString().length()=10
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Zeitraum.value[x]:valuePeriod.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:Zeitraum.value[x]:valuePeriod.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:Zeitraum.value[x]:valuePeriod.start
DefinitionDatum, ab dem die Teilverordnung der Mehrfachverordnung eingelöst werden kann
Cardinality1...1
TypedateTime
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
MedicationRequest.extension:requestMVO.extension:Zeitraum.value[x]:valuePeriod.end
DefinitionDatum des letzten Einlösetages der Teilverordnung der Mehrfachverordnung. Von der ausstellenden Person kann eine von der Arzneimittelverschreibungsverordnung (AMVV) abweichende Einlösefrist angegeben werden.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
MedicationRequest.extension:requestMVO.extension:ID
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:ID.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:ID.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:ID.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

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

Fixed Value

ID

Mappings
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:ID.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeIdentifier
SlicingUnordered, Closed, by $this(Type)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...1
TypeIdentifier
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.use
DefinitionThe purpose of this identifier.
Cardinality0...0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.type
DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality0...0
TypeCodeableConcept
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)
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

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

urn:ietf:rfc:3986

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.value
DefinitionEineindeutige ID, welche über alle Teilverordnungen einer Mehrfachverordnung identisch ist.
Cardinality0...1
Typestring
SummaryTrue
Comments

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

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

123456


Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.period
DefinitionTime period during which identifier is/was valid for use.
Cardinality0...0
TypePeriod
SummaryTrue
Comments

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
MedicationRequest.extension:requestMVO.extension:ID.value[x]:valueIdentifier.assigner
DefinitionOrganization that issued/manages the identifier.
Cardinality0...0
TypeReference(Organization)
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
MedicationRequest.extension:requestMVO.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

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

Fixed Value

https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Multiple_Prescription

Mappings
  • rim: N/A
MedicationRequest.extension:requestMVO.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...0
Typebase64Binary
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

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

Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.identifier
DefinitionIdentifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Cardinality0...*
TypeIdentifier
Comments

This is a business identifier, not a resource identifier.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • script10.6: Message/Header/PrescriberOrderNumber
  • w5: FiveWs.identifier
  • v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
  • rim: .id
MedicationRequest.status
DefinitionA code specifying the current state of the order. Generally, this will be active or completed state.
Cardinality1...1
Typecode
Binding

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

medicationrequest Status (required)
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.status
  • script10.6: no mapping
  • w5: FiveWs.status
  • rim: .statusCode
MedicationRequest.statusReason
DefinitionCaptures the reason for the current state of the MedicationRequest.
Cardinality0...1
TypeCodeableConcept
Binding

Identifies the reasons for a given status.

medicationRequest Status Reason Codes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.statusReason
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
MedicationRequest.intent
DefinitionWhether the request is a proposal, plan, or an original order.
Cardinality1...1
Typecode
Binding

The kind of medication order.

medicationRequest Intent (required)
ModifierTrue
SummaryTrue
Comments

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.intent
  • w5: FiveWs.class
  • rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
MedicationRequest.category
DefinitionIndicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Cardinality0...*
TypeCodeableConcept
Binding

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

medicationRequest Category Codes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
  • w5: FiveWs.class
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
MedicationRequest.priority
DefinitionIndicates how quickly the Medication Request should be addressed with respect to other requests.
Cardinality0...1
Typecode
Binding

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

RequestPriority (required)
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.priority
  • w5: FiveWs.grade
  • rim: .priorityCode
MedicationRequest.doNotPerform
DefinitionIf true indicates that the provider is asking for the medication request not to occur.
Cardinality0...1
Typeboolean
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: SubstanceAdministration.actionNegationInd
MedicationRequest.reported[x]
DefinitionIndicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Cardinality0...1
Typeboolean
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .participation[typeCode=INF].role
MedicationRequest.medication[x]
DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Cardinality1...1
TypeReference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)
Must SupportTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.code
  • script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
  • w5: FiveWs.what[x]
  • v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
  • rim: consumable.administrableMedication
MedicationRequest.subject
DefinitionA link to a resource representing the person or set of individuals to whom the medication will be given.
Cardinality1...1
TypeReference(ERPServiceRequestPatient)
Must SupportTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
  • w5: FiveWs.subject[x]
  • v2: PID-3-Patient ID List
  • rim: .participation[typeCode=AUT].role
  • w5: FiveWs.subject
MedicationRequest.encounter
DefinitionThe Encounter during which this [x] was created or to which the creation of this record is tightly associated.
Cardinality0...1
TypeReference(Encounter)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.context
  • script10.6: no mapping
  • w5: FiveWs.context
  • v2: PV1-19-Visit Number
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
MedicationRequest.supportingInformation
DefinitionInclude additional information (for example, patient height and weight) that supports the ordering of the medication.
Cardinality0...*
TypeReference(Resource)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
  • w5: FiveWs.context
  • rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
MedicationRequest.authoredOn
DefinitionThe date (and perhaps time) when the prescription was initially written or authored on.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
  • w5: FiveWs.recorded
  • v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
  • rim: author.time
MedicationRequest.requester
DefinitionThe individual, organization, or device that initiated the request and has responsibility for its activation.
Cardinality0...1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.requester
  • w5: FiveWs.author
  • rim: .participation[typeCode=AUT].role
MedicationRequest.performer
DefinitionThe specified desired performer of the medication treatment (e.g. the performer of the medication administration).
Cardinality0...1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)
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
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.performer
  • w5: FiveWs.actor
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
MedicationRequest.performerType
DefinitionIndicates the type of performer of the administration of the medication.
Cardinality0...1
TypeCodeableConcept
Binding

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

ProcedurePerformerRoleCodes (example)
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.performerType
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
MedicationRequest.recorder
DefinitionThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Cardinality0...1
TypeReference(Practitioner | PractitionerRole)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.who
  • rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
MedicationRequest.reasonCode
DefinitionThe reason or the indication for ordering or not ordering the medication.
Cardinality0...*
TypeCodeableConcept
Binding

A coded concept indicating why the medication was ordered.

Condition/Problem/DiagnosisCodes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.reasonCode
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
  • w5: FiveWs.why[x]
  • v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
  • rim: reason.observation.reasonCode
MedicationRequest.reasonReference
DefinitionCondition or observation that supports why the medication was ordered.
Cardinality0...*
TypeReference(Condition | Observation)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.reasonReference
  • script10.6: no mapping
  • w5: FiveWs.why[x]
  • rim: reason.observation[code=ASSERTION].value
MedicationRequest.instantiatesCanonical
DefinitionThe URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
Cardinality0...*
Typecanonical()
SummaryTrue
Comments

see Canonical References

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiates
  • rim: .outboundRelationship[typeCode=DEFN].target
MedicationRequest.instantiatesUri
DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.
Cardinality0...*
Typeuri
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=DEFN].target
MedicationRequest.basedOn
DefinitionA plan or request that is fulfilled in whole or in part by this medication request.
Cardinality0...*
TypeReference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.basedOn
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
MedicationRequest.groupIdentifier
DefinitionA shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
Cardinality0...1
TypeIdentifier
SummaryTrue
Requirements

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.groupIdentifier
  • rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
MedicationRequest.courseOfTherapyType
DefinitionThe description of the overall patte3rn of the administration of the medication to the patient.
Cardinality0...1
TypeCodeableConcept
Binding

Identifies the overall pattern of medication administratio.

medicationRequest Course of Therapy Codes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: Act.code where classCode = LIST and moodCode = EVN
MedicationRequest.insurance
DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Cardinality0...*
TypeReference(Coverage | ClaimResponse)
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
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.insurance
  • rim: .outboundRelationship[typeCode=COVBY].target
MedicationRequest.note
DefinitionExtra information about the prescription that could not be conveyed by the other attributes.
Cardinality0...*
TypeAnnotation
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Note
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationRequest.dosageInstruction
DefinitionIndicates how the medication is to be used by the patient.
Cardinality0...*
TypeDosage
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • workflow: Request.occurrence[x]
  • rim: see dosageInstruction mapping
MedicationRequest.dispenseRequest
DefinitionIndicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Cardinality0...1
TypeBackboneElement
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
  • rim: component.supplyEvent
MedicationRequest.dispenseRequest.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.initialFill
DefinitionIndicates the quantity or duration for the first dispense of the medication.
Cardinality0...1
TypeBackboneElement
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
MedicationRequest.dispenseRequest.initialFill.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.initialFill.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.initialFill.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.initialFill.quantity
DefinitionThe amount or quantity to provide as part of the first dispense.
Cardinality0...1
TypeSimpleQuantity
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: Supply.quantity[moodCode=RQO]
MedicationRequest.dispenseRequest.initialFill.duration
DefinitionThe length of time that the first dispense is expected to last.
Cardinality0...1
TypeDuration
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • rim: Supply.effectivetime[moodCode=RQO]
MedicationRequest.dispenseRequest.dispenseInterval
DefinitionThe minimum period of time that must occur between dispenses of the medication.
Cardinality0...1
TypeDuration
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • rim: Supply.effectivetime[moodCode=RQO]
MedicationRequest.dispenseRequest.validityPeriod
DefinitionThis indicates the validity period of a prescription (stale dating the Prescription).
Cardinality0...1
TypePeriod
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
  • rim: effectiveTime
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
DefinitionAn integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
Cardinality0...1
TypeunsignedInt
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
  • v2: RXE-12-Number of Refills
  • rim: repeatNumber
MedicationRequest.dispenseRequest.quantity
DefinitionThe amount that is to be dispensed for one fill.
Cardinality1...1
TypeSimpleQuantity
Must SupportTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
  • v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
  • rim: quantity
MedicationRequest.dispenseRequest.quantity.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.quantity.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dispenseRequest.quantity.value
DefinitionNumber of packs prescribed
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationRequest.dispenseRequest.quantity.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationRequest.dispenseRequest.quantity.unit
DefinitionA human-readable form of the unit.
Cardinality0...0
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationRequest.dispenseRequest.quantity.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

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

Comments

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

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

http://unitsofmeasure.org

Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationRequest.dispenseRequest.quantity.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

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

Comments

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

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

{Package}

Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
MedicationRequest.dispenseRequest.expectedSupplyDuration
DefinitionIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
Cardinality0...1
TypeDuration
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim: expectedUseTime
MedicationRequest.dispenseRequest.performer
DefinitionIndicates the intended dispensing Organization specified by the prescriber.
Cardinality0...1
TypeReference(Organization)
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
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.who
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
MedicationRequest.substitution
DefinitionIndicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Cardinality0...1
TypeBackboneElement
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim: subjectOf.substitutionPersmission
MedicationRequest.substitution.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.substitution.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.substitution.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.substitution.allowed[x]
DefinitionTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
Cardinality1...1
Typeboolean
Binding

Identifies the type of substitution allowed.

v3.ActSubstanceAdminSubstitutionCode (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
  • rim: code
MedicationRequest.substitution.reason
DefinitionIndicates the reason for the substitution, or why substitution must or must not be performed.
Cardinality0...1
TypeCodeableConcept
Binding

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

v3.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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6: not mapped
  • v2: RXE-9 Substition status
  • rim: reasonCode
MedicationRequest.priorPrescription
DefinitionA link to a resource representing an earlier order related order or prescription.
Cardinality0...1
TypeReference(MedicationRequest)
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
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.replaces
  • script10.6: not mapped
  • rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
MedicationRequest.detectedIssue
DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
Cardinality0...*
TypeReference(DetectedIssue)
AliasContraindication, Drug Utilization Review (DUR), Alert
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
MedicationRequest.eventHistory
DefinitionLinks to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
Cardinality0...*
TypeReference(Provenance)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.relevantHistory
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="erp-service-request-medication-request" />
    <url value="https://gematik.de/fhir/erp-servicerequest/StructureDefinition/erp-service-request-medication-request" />
    <version value="1.2" />
    <name value="ERPServiceRequestMedicationRequest" />
    <title value="ERP Service Request Medication Request" />
    <status value="draft" />
    <experimental value="false" />
    <date value="2025-01-01" />
    <publisher value="gematik GmbH" />
    <description value="Medical and pharmaceutical information for the prescription request" />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationRequest" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationRequest.extension">
            <path value="MedicationRequest.extension" />
            <comment value="If the previous recipe ID is known, it can be named here" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:PriorPrescriptionID">
            <path value="MedicationRequest.extension" />
            <sliceName value="PriorPrescriptionID" />
            <short value="Provide a previous PrescriptionID that corresponds to the requested medication." />
            <definition value="The MedicationRequest can contain a PrescriptionId of a prescription that has already been issued.\nIf a previous prescription ID is known, the writing system MAY indicate this in the medication request.\nIf this ID is available, the receiving system MUST be able to search for the previous regulation and give the user the opportunity to display and compare the content." />
            <comment value="Must be given in the form xxx.xxx.xxx.xxx.xxx.xx." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:requestMVO">
            <path value="MedicationRequest.extension" />
            <sliceName value="requestMVO" />
            <short value="Multiple prescription order" />
            <definition value="If the prescription is should be a multiple prescription order. Only the &#39;Kennzeichen&#39; should be stated, indicating that the prescription is requested to be a multiple prescription order." />
            <comment value="When this extension is received by a PVS, the prescriber has to be visually notified about the request for a multiple prescription order." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Multiple_Prescription" />
            </type>
            <mustSupport value="true" />
            <isModifier value="true" />
        </element>
        <element id="MedicationRequest.extension:requestMVO.extension:Kennzeichen">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="Kennzeichen" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:requestMVO.extension:Nummerierung">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="Nummerierung" />
            <max value="0" />
        </element>
        <element id="MedicationRequest.extension:requestMVO.extension:Zeitraum">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="Zeitraum" />
            <max value="0" />
        </element>
        <element id="MedicationRequest.extension:requestMVO.extension:ID">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="ID" />
            <max value="0" />
        </element>
        <element id="MedicationRequest.medication[x]">
            <path value="MedicationRequest.medication[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_PZN" />
                <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Compounding" />
                <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Ingredient" />
                <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_FreeText" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.subject">
            <path value="MedicationRequest.subject" />
            <short value="Patient for whom a dispense is requested on behalf of the patient." />
            <type>
                <code value="Reference" />
                <targetProfile value="https://gematik.de/fhir/erp-servicerequest/StructureDefinition/erp-service-request-patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest">
            <path value="MedicationRequest.dispenseRequest" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity">
            <path value="MedicationRequest.dispenseRequest.quantity" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.value">
            <path value="MedicationRequest.dispenseRequest.quantity.value" />
            <short value="Number of packs prescribed" />
            <definition value="Number of packs prescribed" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.unit">
            <path value="MedicationRequest.dispenseRequest.quantity.unit" />
            <max value="0" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.system">
            <path value="MedicationRequest.dispenseRequest.quantity.system" />
            <min value="1" />
            <fixedUri value="http://unitsofmeasure.org" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.code">
            <path value="MedicationRequest.dispenseRequest.quantity.code" />
            <min value="1" />
            <fixedCode value="{Package}" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "erp-service-request-medication-request",
    "url": "https://gematik.de/fhir/erp-servicerequest/StructureDefinition/erp-service-request-medication-request",
    "version": "1.2",
    "name": "ERPServiceRequestMedicationRequest",
    "title": "ERP Service Request Medication Request",
    "status": "draft",
    "experimental": false,
    "date": "2025-01-01",
    "publisher": "gematik GmbH",
    "description": "Medical and pharmaceutical information for the prescription request",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "MedicationRequest",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationRequest.extension",
                "path": "MedicationRequest.extension",
                "comment": "If the previous recipe ID is known, it can be named here",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:PriorPrescriptionID",
                "path": "MedicationRequest.extension",
                "sliceName": "PriorPrescriptionID",
                "short": "Provide a previous PrescriptionID that corresponds to the requested medication.",
                "definition": "\nThe MedicationRequest can contain a PrescriptionId of a prescription that has already been issued.\nIf a previous prescription ID is known, the writing system MAY indicate this in the medication request.\nIf this ID is available, the receiving system MUST be able to search for the previous regulation and give the user the opportunity to display and compare the content.\n",
                "comment": "Must be given in the form xxx.xxx.xxx.xxx.xxx.xx.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:requestMVO",
                "path": "MedicationRequest.extension",
                "sliceName": "requestMVO",
                "short": "Multiple prescription order",
                "definition": "If the prescription is should be a multiple prescription order. Only the 'Kennzeichen' should be stated, indicating that the prescription is requested to be a multiple prescription order.",
                "comment": "When this extension is received by a PVS, the prescriber has to be visually notified about the request for a multiple prescription order.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.kbv.de/StructureDefinition/KBV_EX_ERP_Multiple_Prescription"
                        ]
                    }
                ],
                "mustSupport": true,
                "isModifier": true
            },
            {
                "id": "MedicationRequest.extension:requestMVO.extension:Kennzeichen",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "Kennzeichen",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:requestMVO.extension:Nummerierung",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "Nummerierung",
                "max": "0"
            },
            {
                "id": "MedicationRequest.extension:requestMVO.extension:Zeitraum",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "Zeitraum",
                "max": "0"
            },
            {
                "id": "MedicationRequest.extension:requestMVO.extension:ID",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "ID",
                "max": "0"
            },
            {
                "id": "MedicationRequest.medication[x]",
                "path": "MedicationRequest.medication[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_PZN",
                            "https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Compounding",
                            "https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Ingredient",
                            "https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_FreeText"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.subject",
                "path": "MedicationRequest.subject",
                "short": "Patient for whom a dispense is requested on behalf of the patient.",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://gematik.de/fhir/erp-servicerequest/StructureDefinition/erp-service-request-patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest",
                "path": "MedicationRequest.dispenseRequest",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity",
                "path": "MedicationRequest.dispenseRequest.quantity",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.value",
                "path": "MedicationRequest.dispenseRequest.quantity.value",
                "short": "Number of packs prescribed",
                "definition": "Number of packs prescribed",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.unit",
                "path": "MedicationRequest.dispenseRequest.quantity.unit",
                "max": "0"
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.system",
                "path": "MedicationRequest.dispenseRequest.quantity.system",
                "min": 1,
                "fixedUri": "http://unitsofmeasure.org",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.code",
                "path": "MedicationRequest.dispenseRequest.quantity.code",
                "min": 1,
                "fixedCode": "{Package}",
                "mustSupport": true
            }
        ]
    }
}

Terminologie Bindings

Folgende Bindings sind für diese Ressource spezifiziert:

Constraints

Folgende Constraints sind für diese Ressource spezifiziert: