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HdBe-MedicationAgreement

Profile	Description	Status	URL
HdBe-MedicationAgreement	A medication agreement is a prescriber’s proposal for a patient to use medication. An agreement to discontinue the use of medication is also a medication agreement.	draft	https://fhir.healthdata.be/StructureDefinition/HdBe-MedicationAgreement

MedicationRequest	I		MedicationRequest	Element Id MedicationRequest Short description MedicationAgreement Alternate names Prescription, Order, Medicatieafspraak Definition An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. Data Type MedicationRequest Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim:Entity. Role, or Act workflow:Request script10.6:Message/Body/NewRx rim:CombinedMedicationRequest zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.9580 HdBe-MedicationAgreement:MedicationAgreement
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
medicationAgreementAdditionalInformation	I	0..*	Extension(CodeableConcept)	Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-MedicationAgreement.MedicationAgreementAdditionalInformation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-MedicationAgreement.AdditionalInformation Mappings rim:N/A
value[x]		0..1	Binding	Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation.value[x] Short description MedicationAgreementAdditionalInformation Alternate names MedicatieafspraakAanvullendeInformatie Definition Additional information includes details on the structure of the agreement made that are relevant for pharmacovigilance and fulfillment by the pharmacist. This can be used e.g. to indicate that there was a conscious decision to deviate from the norm or that the agreement is to be structured in a certain way. Binding MedicationAgreementAdditionalInformation (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23283 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementAdditionalInformation
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
renderedDosageInstruction	I	0..1	Extension(string)	Element Id MedicationRequest.extension:renderedDosageInstruction Short description Optional Extensions Element Alternate names extensions, user content Definition Pre-adopt from FHIR R5 of the `.renderedDosageInstruction` element found in various medication resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-RenderedDosageInstruction Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A HdBe-InstructionsForUse:InstructionsForUse.Description
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:renderedDosageInstruction.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-RenderedDosageInstruction Mappings rim:N/A
value[x]		0..1		Element Id MedicationRequest.extension:renderedDosageInstruction.value[x] Short description Description Alternate names Omschrijving Definition Textual description of the complete instructions for use including the period of use. Comments The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.9581
valueString			string	There are no (further) constraints on this element Data Type string
periodOfUse	I	0..1	Extension(HdBe-TimeInterval)	Element Id MedicationRequest.extension:periodOfUse Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(HdBe-TimeInterval) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Period Mappings rim:N/A
value[x]	I	0..1		Element Id MedicationRequest.extension:periodOfUse.value[x] Short description PeriodOfUse Alternate names Gebruiksperiode Definition Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued. Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date. With medication for an indefinite period only a start date is indicated. 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. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a rim:N/A v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] HdBe-TimeInterval:TimeInterval zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19936 HdBe-MedicationAgreement:MedicationAgreement.PeriodOfUse
valuePeriod			HdBe-TimeInterval	There are no (further) constraints on this element Data Type HdBe-TimeInterval
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
duration	I	0..1	Extension(Duration)	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Duration) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Duration Mappings rim:N/A
value[x]		0..1		There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration.value[x] Short description Duration Alternate names tijdsDuur Definition The duration of the interval in appropriate units of time (e.g. days or hours, etc. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-timeinterval-v1.0-2020EN:NL-CM:20.3.4 HdBe-TimeInterval:TimeInterval.Duration
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].start Short description startDateTime Alternate names startDatumTijd Definition The start date and time of the interval Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints 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 zib-timeinterval-v1.0-2020EN:NL-CM:20.3.2 HdBe-TimeInterval:TimeInterval.StartDateTime
end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].end Short description endDateTime Alternate names eindDatumTijd Definition The end date and time of the interval 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. Meaning When Missing If the end of the period is missing, it means that the period is ongoing Data Type dateTime Constraints 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 zib-timeinterval-v1.0-2020EN:NL-CM:20.3.3 HdBe-TimeInterval:TimeInterval.EndDateTime
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
stopType	?! I	0..1	Extension(CodeableConcept)	Element Id MedicationRequest.modifierExtension:stopType Short description Optional Extensions Element Alternate names extensions, user content Definition This StopType ModifierExtension works differently than the `.status` element of resources because it has a different meaning. The `.status` element represents the status of the resource at the moment of exchanging the resource. This means that over the lifetime of a resource, the status may change (and is very much related to use period). That – in itself – makes mapping StopType (which may never change in an instance) to status not suitable. For example: suppose you want the patient to stop taking medication definitively three days from today. This is a stop medication agreement with a StopType of definitive. However today, tomorrow and the day after tomorrow the `.status` of this medication agreement is active and only after the end date of the usage period the `status` should be stopped. Status and StopType are simply not the same thing. 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. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-StopType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension:stopType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-StopType Mappings rim:N/A
value[x]		0..1	Binding	Element Id MedicationRequest.modifierExtension:stopType.value[x] Short description MedicationAgreementStopType Alternate names MedicatieafspraakStopType Definition Stop type, the manner in which this medication is discontinued (temporary or definitive). Comments MedicationAgreementStopType, AdministrationAgreementStopType and MedicationUseStopType all have a bound ValueSet that contain the exact same StopType values. These are represented in the CBB with the same Valueset. This MedicationStopType is used to bind to this extension and reusing this extension for all three concepts. Binding StopType values, based on the valueset named MedicatioStopType, which are applicable for StopType in MedicationAgreement, AdministrationAgreement and MedicationUse. MedicationStopType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19954 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementStopType
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
repeatPeriodCyclicalSchedule	?! I	0..1	Extension(Duration)	Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data Type Extension(Duration) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A HdBe-InstructionsForUse:InstructionsForUse.RepeatPeriodCyclicalSchedule
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule Mappings rim:N/A
value[x]		0..1		Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.value[x] Short description RepeatPeriodCyclicalSchedule Alternate names HerhaalperiodeCyclischSchema Definition The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days. Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22505 HdBe-InstructionsForUse:InstructionsForUse.RepeatPeriodCyclicalSchedule
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
identifier		0..*	Identifier	There are no (further) constraints on this element Element Id MedicationRequest.identifier Short description External ids for this request Definition Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. Comments This is a business identifier, not a resource identifier. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Request.identifier script10.6:Message/Header/PrescriberOrderNumber w5:FiveWs.identifier v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number rim:.id
status	Σ ?!	1..1	codeBinding	Element Id MedicationRequest.status Short description active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown Definition A code specifying the current state of the order. Generally, this will be active or completed state. Comments This element is implictly mapped to the CBB concepts period_of_use medication_agreement_stop_type. Unless the status is explicitly recorded, the following guidance applies: When MedicationAgreementStopType is 14803004, `.status` will usually be set to on-hold. When MedicationAgreementStopType is 255545003, `.status` will usually be set to stopped. When the PeriodOfUse start date is in the future, `.status` will usually be set to active. When PeriodOfUse start date is in the past and PeriodOfUse end date is present and in the future, `.status` will usually be set to active. When PeriodOfUse end date is present and in the past, `.status` will usually be set to completed. When PeriodOfUse duration and start date are known, the end date can be deducted and the previous rules apply. When a system is unable to infer the status from the Start and End, `.status` will be set to unknown. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the MedicationAgreement. Data Type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. medicationrequest Status (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.status script10.6:no mapping w5:FiveWs.status rim:.statusCode zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19936 zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19954 HdBe-MedicationAgreement:MedicationAgreement.PeriodOfUse HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementStopType
statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.statusReason Short description Reason for current status Definition Captures the reason for the current state of the MedicationRequest. Comments This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here. Data Type CodeableConcept Binding Identifies the reasons for a given status. medicationRequest Status Reason Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.statusReason rim:.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
intent	Σ ?!	1..1	codeBinding	Element Id MedicationRequest.intent Short description proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Definition Unless `intent` is explicitly recorded and a more appropriate code is known, the value can be set to order because a MedicationAgreement should authorize an action for a patient, pharmacist, professional administrator et cetera. Comments It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Data Type code Binding The kind of medication order. medicationRequest Intent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.intent w5:FiveWs.class rim:.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
category		1..*	CodeableConcept	Element Id MedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) 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) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5:FiveWs.class rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medicationAgreementCode		1..1	CodeableConceptPattern	Element Id MedicationRequest.category:medicationAgreementCode Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data Type CodeableConcept Binding A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. medicationRequest Category Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "16076005" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5:FiveWs.class rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.priority w5:FiveWs.grade rim:.priorityCode
doNotPerform	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element Id MedicationRequest.doNotPerform Short description True if request is prohibiting action Definition If true indicates that the provider is asking for the medication request not to occur. Comments If do not perform is not specified, the request is a positive request e.g. "do perform". Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:SubstanceAdministration.actionNegationInd
reported[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.reported[x] Short description Reported rather than primary record Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.participation[typeCode=INF].role
reportedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
reportedReference			Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
medication[x]	Σ	1..1		Element Id MedicationRequest.medication[x] Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments 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. Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying substance or product that can be ordered. SNOMEDCTMedicationCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.code script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5:FiveWs.what[x] v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim:consumable.administrableMedication
medicationCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
medicationReference	Σ	0..1	Reference(Medication \| HdBe-PharmaceuticalProduct)	Element Id MedicationRequest.medication[x]:medicationReference Short description AgreedMedicine Alternate names Afgesprokengeneesmiddel Definition The medicine agreed upon to be used. 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. Data Type Reference(Medication \| HdBe-PharmaceuticalProduct) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.code script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5:FiveWs.what[x] v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim:consumable.administrableMedication zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19925 HdBe-MedicationAgreement:MedicationAgreement.AgreedMedicine
subject	Σ I	1..1	Reference(Group \| HdBe-Patient)	Element Id MedicationRequest.subject Short description Who or group medication request is for Definition A link to a resource representing the person or set of individuals to whom the medication will be given. 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. Data Type Reference(Group \| HdBe-Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.subject script10.6:Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT) w5:FiveWs.subject[x] v2:PID-3-Patient ID List rim:.participation[typeCode=AUT].role w5:FiveWs.subject
encounter	I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id MedicationRequest.encounter Short description Encounter created as part of encounter/admission/stay Definition The Encounter during which this [x] was created or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.context script10.6:no mapping w5:FiveWs.context v2:PV1-19-Visit Number rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element Id MedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.supportingInfo w5:FiveWs.context rim:.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
authoredOn	Σ	0..1	dateTime	Element Id MedicationRequest.authoredOn Short description MedicationAgreementDateTime Alternate names MedicatieafspraakDatumTijd Definition The time at which the agreement was made. Appointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day). Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.authoredOn script10.6:Message/Body/NewRx/MedicationPrescribed/WrittenDate w5:FiveWs.recorded v2:RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction rim:author.time zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19757 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementDateTime
requester	Σ I	0..1	pattern HealthProfessional Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| HdBe-HealthProfessional PractitionerRole)	Element Id MedicationRequest.requester Short description Prescriber Alternate names Voorschrijver Definition The health professional that entered the medication agreement with the patient. Comments Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. Data Type pattern HealthProfessional Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| HdBe-HealthProfessional PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.requester w5:FiveWs.author rim:.participation[typeCode=AUT].role zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.1030 HdBe-MedicationAgreement:MedicationAgreement.Prescriber
performer	I	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam)	There are no (further) constraints on this element Element Id MedicationRequest.performer Short description Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.performer w5:FiveWs.actor rim:.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
performerType	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.performerType Short description Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication. Comments If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available. Data Type CodeableConcept Binding Identifies the type of individual that is desired to administer the medication. ProcedurePerformerRoleCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.performerType rim:.participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
recorder	I	0..1	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id MedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.who rim:.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
reasonCode		0..1	CodeableConceptBinding	Element Id MedicationRequest.reasonCode Short description ReasonMedicationAgreement Alternate names RedenMedicatieafspraak Definition Reason for this agreement. This can be the reason to start, change or stop the medication treatment. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. Data Type CodeableConcept Binding A coded concept indicating why the medication was ordered. MedicationReason (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.reasonCode script10.6:Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value w5:FiveWs.why[x] v2:ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication rim:reason.observation.reasonCode zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.22094 HdBe-MedicationAgreement:MedicationAgreement.ReasonMedicationAgreement
reasonReference	I	0..1	Reference(Condition \| Observation \| HdBe-Problem)	Element Id MedicationRequest.reasonReference Short description PrescriptionReason Alternate names RedenVanVoorschrijven Definition The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. It can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. Comments This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Data Type Reference(Condition \| Observation \| HdBe-Problem) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.reasonReference script10.6:no mapping w5:FiveWs.why[x] rim:reason.observation[code=ASSERTION].value zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23133 HdBe-MedicationAgreement:MedicationAgreement.PrescriptionReason
instantiatesCanonical	Σ	0..*	canonical()	There are no (further) constraints on this element Element Id MedicationRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see Canonical References Data Type canonical() Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.instantiates rim:.outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element Id MedicationRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=DEFN].target
basedOn	Σ I	0..*	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	There are no (further) constraints on this element Element Id MedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.basedOn rim:.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element Id MedicationRequest.groupIdentifier Short description Composite request this is part of Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Request.groupIdentifier rim:.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
courseOfTherapyType		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.courseOfTherapyType Short description Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient. Comments This attribute should not be confused with the protocol of the medication. Data Type CodeableConcept Binding Identifies the overall pattern of medication administratio. medicationRequest Course of Therapy Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:Act.code where classCode = LIST and moodCode = EVN
insurance	I	0..*	Reference(Coverage \| ClaimResponse)	There are no (further) constraints on this element Element Id MedicationRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Coverage \| ClaimResponse) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.insurance rim:.outboundRelationship[typeCode=COVBY].target
note		0..1	Annotation	There are no (further) constraints on this element Element Id MedicationRequest.note Short description Information about the prescription Definition Extra information about the prescription that could not be conveyed by the other attributes. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act workflow:Request.note script10.6:Message/Body/NewRx/MedicationPrescribed/Note rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
author[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data Type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.effectiveTime
text	Σ	1..1	markdown	Element Id MedicationRequest.note.text Short description Comment Alternate names Toelichting Definition Comments regarding to the medication agreement. For example: in consultation with the medical specialist. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data Type markdown Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.text zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.22273 HdBe-MedicationAgreement:MedicationAgreement.Comment
dosageInstruction		0..*	HdBe-InstructionsForUse.DosageInstructions	Element Id MedicationRequest.dosageInstruction Short description DosingInstructions / InstructionsForUse Alternate names Doseerinstructie, Gebruiksinstructie Definition Instructions for the use of the medication, e.g. dose and route of administration. Comments This element mostly represents the DosingInstructions container from CBB InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are duplicated in every repetition of this element, even though these concepts should be present just once according to the CBB. The RepeatPeriodCyclicalSchedule and Description elements of the CBB are not represented in this profile. When a HdBe profile contains a InstructionsForUse.DosageInstructions datatype, the RepeatPeriodCyclicalSchedule and Description elements are separately added to this profile as well. This element does not contain a mapping to the Dosage container from CBB InstructionsForUse. However, the child concepts of Dosage are all mapped. Multiple Dosage instances are represented by another DosingInstructions that contains a similiar SequenceNumber. Data Type HdBe-InstructionsForUse.DosageInstructions Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT] workflow:Request.occurrence[x] rim:see dosageInstruction mapping zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22095 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23240 HdBe-MedicationAgreement:MedicationAgreement.InstructionsForUse
sequence	Σ	0..1	integer	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.sequence Short description SequenceNumber Alternate names Volgnummer Definition This indicates the sequence of the dosing instructions within the medication agreement. Requirements If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Comments 32 bit number; for values larger than this, use decimal Data Type integer Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-1 rim:.text zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22503 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.SequenceNumber
text	Σ	0..1	string	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG. Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-6; RXE-21 rim:.text
additionalInstruction	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.additionalInstruction Short description AdditionalInstructions Alternate names AanvullendeInstructie Definition The additional instructions contain extra information on the use of the current prescription. This includes all instructions for use. The text can come from the original “paper" medication prescription, but can also be generated from the coded information. This concept may contain more information than what is structurally coded in the information below, but may not conflict with it. The instructions may not conflict with other components of the request for administration. The instructions can also refer to an existing protocol. Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Please note that in contrast to the CBB, this AdditionalInstructions concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions. Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-7 rim:.text zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19944 HdBe-InstructionsForUse:InstructionsForUse.AdditionalInstructions
patientInstruction	Σ	0..1	string	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.patientInstruction Short description Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-7 rim:.text
timing	Σ	0..1	Timing	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing Short description AdministeringSchedule Alternate names Toedieningsschema Definition Specifications of the times at which the medication is to be administered. This is indicated as follows: Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. A specific number of times the medication is to be taken each day ("3x a day"), indicated with the frequency. A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: The end date and time has been reached The total administration duration has been reached (14 days) A specific amount of administrations has been reached (“20 doses”), to be entered in the Frequency concept. Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Data Type Timing Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS) rim:.effectiveTime zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19948 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:QLIST<TS>
repeat	Σ I	0..1	Element	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled. Requirements Many timing schedules are determined by regular repetitions. Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` tim-9:If there's an offset, there must be a when (and not C, CM, CD, CV) `offset.empty() or (when.exists() and ((when in ('C' \| 'CM' \| 'CD' \| 'CV')).not()))` tim-5:period SHALL be a non-negative value `period.exists() implies period >= 0` tim-6:If there's a periodMax, there must be a period `periodMax.empty() or period.exists()` tim-7:If there's a durationMax, there must be a duration `durationMax.empty() or duration.exists()` tim-8:If there's a countMax, there must be a count `countMax.empty() or count.exists()` tim-1:if there's a duration, there needs to be duration units `duration.empty() or durationUnit.exists()` tim-10:If there's a timeOfDay, there cannot be a when, or vice versa `timeOfDay.empty() or when.empty()` tim-2:if there's a period, there needs to be period units `period.empty() or periodUnit.exists()` tim-4:duration SHALL be a non-negative value `duration.exists() implies duration >= 0` Mappings rim:n/a rim:Implies PIVL or EIVL
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
timingExact	I	0..1	Extension(boolean)	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact Short description Whether specified times must be followed as closely as possible Alternate names extensions, user content Definition If true, indicates that the specified times, frequencies, periods are expected to be adhered to as precisely as possible. If false, indicates that a typical degree of variability based on institutional and/or patient convenience is acceptable. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(boolean) Extension URL http://hl7.org/fhir/StructureDefinition/timing-exact Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:N/A rim:GTS.IsFlexible
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value http://hl7.org/fhir/StructureDefinition/timing-exact Mappings rim:N/A
value[x]		1..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact.value[x] Short description Value of extension Definition Indicates that the timing as specified by `.frequency`, `.period` and `.periodUnit` should be strictly interpreted. This is the case when the CBB concept Interval is expressed using these elements (as opposed to the CBB concept Frequency). The times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
valueBoolean			boolean	There are no (further) constraints on this element Data Type boolean
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI
boundsRange			Range	There are no (further) constraints on this element Data Type Range
boundsPeriod			Period	There are no (further) constraints on this element Data Type Period
boundsDuration	Σ	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short description DoseDuration Alternate names Doseerduur Definition The intended time duration for these dosing instructions, e.g. 5 days or 8 weeks. In the case of medication for an indefinite period, the dosing duration is left empty in the last dosing instruction. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22506 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.DoseDuration
count	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.count Short description Frequency / minimumValue / nominalValue Alternate names Frequentie, nominaleWaarde, minimumWaarde Definition Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by this `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Requirements Repetitions may be limited by end time or total occurrences. Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.2 zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.NominalValue HdBe-Range:Range.MinimumValue
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.countMax Short description Frequency / maximumValue Alternate names Frequentie, maximumWaarde Definition Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by the `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MaximumValue
duration	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.duration Short description DurationOfAdministration Alternate names Toedieningsduur Definition The duration of administration defines the length of time during which the drug is administered and is mainly used in the slow parenteral administration of fluids. The `durationUnit` defines the time unit. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.23141 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration
durationMax	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
durationUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.durationUnit Short description DurationOfAdministration Alternate names Toedieningsduur Definition The units of time, in UCUM units, for the duration of administration of time during which the drug is administered. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.23141 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration
frequency	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.frequency Short description Frequency / minimumValue / nominalValue / Interval Alternate names Frequentie, minimumWaarde, nominaleWaarde, Interval Definition The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.2 zib-range-v1.0.1-2020EN:NL-CM:20.1.4 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MinimumValue HdBe-Range:Range.NominalValue HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
frequencyMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.frequencyMax Short description Frequency / maximumValue Alternate names maximumWaarde, Frequentie Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MaximumValue
period	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.period Short description Frequency / Interval Alternate names Frequentie, Interval Definition Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
periodMax	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
periodUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.periodUnit Short description Frequency / Interval Alternate names Frequentie, Interval Definition The units of time for the period in UCUM units for Frequency and Interval. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
dayOfWeek	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek Short description WeekDay Alternate names Weekdag Definition WeekDay indicates a pattern of doses on fixed week days. Comments If no days are specified, the action is assumed to happen every day as otherwise specified. Data Type code Binding Use ConceptMap 'WeekDay_to_DaysOfWeek' to translate CBB terminology to profile terminology in ValueSet 'DaysOfWeek.' DaysOfWeek (required) Permitted Values WeekDay_to_DaysOfWeek Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19952 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.WeekDay
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.timeOfDay Short description AdministrationTime Alternate names Toedientijd Definition The time of administration is a specific time of day (on the clock). This time usually isn’t (intended to be) exact. There can be multiple administering times in one day. The ideal time of administration can also be entered as a time of day (morning, afternoon, evening, night-time). The administration time is then to be left empty, and the time of day can be entered in the TimeOfDay concept. Comments If there's a timeOfDay, there cannot be a when, or vice versa. Data Type time Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19951 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.AdministrationTime
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.when Short description TimeOfDay Alternate names Dagdeel Definition Time of day: morning, afternoon, evening, night. Requirements Timings are frequently determined by occurrences such as waking, eating and sleep. Comments When more than one event is listed, the event is tied to the union of the specified events. Data Type code Binding Use ConceptMap 'TimeOfDay_to_EventTiming' to translate CBB terminology to profile terminology in ValueSet 'EventTiming.' EventTiming (required) Permitted Values TimeOfDay_to_EventTiming Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.event zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19953 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.TimeOfDay
offset	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.offset Short description Minutes from event (before or after) Definition The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. Comments 32 bit number; for values larger than this, use decimal Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). Comments BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). Data Type CodeableConcept Binding Code for a known / defined timing pattern. TimingAbbreviation (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:QSC.code
asNeeded[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBoolean			boolean	There are no (further) constraints on this element Data Type boolean
asNeededCodeableConcept	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept Short description Condition Alternate names Criterium Definition The condition for administering medication can be: a physiological measurement value (plasma glucose concentration, body temperature, blood pressure); a symptom or other circumstance (in the event of a headache, or itch). Physiological measurement values or other conditions do not need to be coded. These can be expressed in free text in the Description concept. Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Data Type CodeableConcept Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. AsNeededCriterium (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19945 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AsNeeded.Condition
site	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.site Short description Body site to administer to Definition Body site to administer to. Requirements A coded specification of the anatomic site where the medication first enters the body. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data Type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-2 rim:.approachSiteCode
route	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.route Short description RouteOfAdministration Alternate names Toedieningsweg Definition The route through which the medication is administered (oral, nasal, intravenous, etc.). Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Comments Please note that in contrast to the CBB, this RouteOfAdministration concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions. Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfMedicationAdministration (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-1 rim:.routeCode zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19941 HdBe-InstructionsForUse:InstructionsForUse.RouteOfAdministration
method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.method Short description Technique for administering medication Definition Technique for administering medication. Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Comments Terminologies used often pre-coordinate this term with the route and or form of administration. Data Type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-4 rim:.doseQuantity
doseAndRate	Σ	0..*	Element	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate Short description Dosage Alternate names Dosering Definition Instructions for the administrator to administer the medication (the patient themselves, a nurse or other aid). When taking stock of medication use, the dosage describes the pattern of use established by the patient. Once the dose schedule (distribution of doses over time) and the dose have been determined, then there should be one single instruction for use. Multiple parallel instructions for use can be included in the event of a changing dose within one day and in the event of a variable use frequency. Multiple sequential instructions for use can be included in the event of changing doses within one period and/or in the event of a changing dose schedule. Comments DurationOfAdministration is not mapped to this element but to `.timing.repeat.duration` and `.timing.repeat.durationUnit`. Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-2 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19935 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-21; RXE-23
dose[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x] Short description Dose Alternate names Keerdosis Definition The dose indicates the amount/unit per administration. The unit can be any unit that can occur with this particular medicine. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19940 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.Dose
doseRange	Σ	0..1	Range	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data Type Range Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity
low	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short description minimumValue Alternate names minimumWaarde Definition The minimal value of the range. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.1 rim:./low zib-range-v1.0.1-2020EN:NL-CM:20.1.2 HdBe-Range:Range.MinimumValue
high	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short description maximumValue Alternate names maximumWaarde Definition The maximum value of the range. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.2 rim:./high zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-Range:Range.MaximumValue
doseQuantity	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short description nominalValue Alternate names nominaleWaarde Definition Amount of medication per dose. The nominal value of the quantity. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-Range:Range.NominalValue
rate[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x] Short description AdministeringSpeed Alternate names Toedieningssnelheid Definition The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: amount = 10, dose unit = ml, time unit = hour Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19942 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSpeed
rateRatio			Ratio	There are no (further) constraints on this element Data Type Ratio
rateRange	Σ	0..1	Range	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data Type Range Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity
low	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Short description minimumValue Alternate names minimumWaarde Definition The minimal value of the range. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.1 rim:./low zib-range-v1.0.1-2020EN:NL-CM:20.1.2 HdBe-Range:Range.MinimumValue
high	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high Short description maximumValue Alternate names maximumWaarde Definition The maximum value of the range. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.2 rim:./high zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-Range:Range.MaximumValue
rateQuantity	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity Short description nominalValue Alternate names nominaleWaarde Definition The nominal value of the quantity. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-Range:Range.NominalValue
maxDosePerPeriod	Σ I	0..1	Ratio	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerPeriod Short description MaximumDose Alternate names MaximaleDosering Definition A maximum dose maximizes (in time) the usage of a drug in an 'as needed' prescription. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Data Type Ratio Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` rat-1:Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())` Mappings rim:n/a v2:N/A rim:RTO v2:RXO-23, RXE-19 rim:.maxDoseQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19946 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AsNeeded.MaximumDose
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:not supported
maxDosePerLifetime	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:not supported
dispenseRequest		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest Short description Medication supply authorization Definition Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:Message/Body/NewRx/MedicationPrescribed/ExpirationDate rim:component.supplyEvent
initialFill		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill Short description First fill details Definition Indicates the quantity or duration for the first dispense of the medication. Comments If populating this element, either the quantity or the duration must be included. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill.quantity Short description First fill quantity Definition The amount or quantity to provide as part of the first dispense. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:Supply.quantity[moodCode=RQO]
duration	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill.duration Short description First fill duration Definition The length of time that the first dispense is expected to last. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values rim:Supply.effectivetime[moodCode=RQO]
dispenseInterval	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.dispenseInterval Short description Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values rim:Supply.effectivetime[moodCode=RQO]
validityPeriod	I	0..1	Period	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription). Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] script10.6:Message/Body/NewRx/MedicationPrescribed/Refills rim:effectiveTime
numberOfRepeatsAllowed		0..1	unsignedInt	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. Comments If displaying "number of authorized fills", add 1 to this number. Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:Message/Body/NewRx/MedicationPrescribed/Quantity v2:RXE-12-Number of Refills rim:repeatNumber
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.quantity Short description Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values script10.6:Message/Body/NewRx/MedicationPrescribed/DaysSupply v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim:quantity
expectedSupplyDuration	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values script10.6:Message/Body/NewRx/MedicationPrescribed/Substitutions rim:expectedUseTime
performer	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.who rim:.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
substitution		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.substitution Short description Any restrictions on medication substitution Definition Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions rim:subjectOf.substitutionPersmission
allowed[x]		1..1		There are no (further) constraints on this element Element Id MedicationRequest.substitution.allowed[x] Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed. Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Binding Identifies the type of substitution allowed. v3.ActSubstanceAdminSubstitutionCode (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2:RXO-9-Allow Substitutions / RXE-9-Substitution Status rim:code
allowedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
allowedCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
reason		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:not mapped v2:RXE-9 Substition status rim:reasonCode
priorPrescription	I	0..1	Reference(MedicationRequest)	There are no (further) constraints on this element Element Id MedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(MedicationRequest) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.replaces script10.6:not mapped rim:.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
detectedIssue	I	0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element Id MedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. Comments This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. Data Type Reference(DetectedIssue) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
eventHistory	I	0..*	Reference(Provenance)	There are no (further) constraints on this element Element Id MedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data Type Reference(Provenance) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.relevantHistory rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

MedicationRequest	I		MedicationRequest	Element Id MedicationRequest Short description MedicationAgreement Alternate names Prescription, Order, Medicatieafspraak Definition An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. Data Type MedicationRequest Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim:Entity. Role, or Act workflow:Request script10.6:Message/Body/NewRx rim:CombinedMedicationRequest zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.9580 HdBe-MedicationAgreement:MedicationAgreement
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
medicationAgreementAdditionalInformation	I	0..*	Extension(CodeableConcept)	Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-MedicationAgreement.MedicationAgreementAdditionalInformation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-MedicationAgreement.AdditionalInformation Mappings rim:N/A
value[x]		0..1	Binding	Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation.value[x] Short description MedicationAgreementAdditionalInformation Alternate names MedicatieafspraakAanvullendeInformatie Definition Additional information includes details on the structure of the agreement made that are relevant for pharmacovigilance and fulfillment by the pharmacist. This can be used e.g. to indicate that there was a conscious decision to deviate from the norm or that the agreement is to be structured in a certain way. Binding MedicationAgreementAdditionalInformation (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23283 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementAdditionalInformation
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
renderedDosageInstruction	I	0..1	Extension(string)	Element Id MedicationRequest.extension:renderedDosageInstruction Short description Optional Extensions Element Alternate names extensions, user content Definition Pre-adopt from FHIR R5 of the `.renderedDosageInstruction` element found in various medication resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-RenderedDosageInstruction Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A HdBe-InstructionsForUse:InstructionsForUse.Description
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:renderedDosageInstruction.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-RenderedDosageInstruction Mappings rim:N/A
value[x]		0..1		Element Id MedicationRequest.extension:renderedDosageInstruction.value[x] Short description Description Alternate names Omschrijving Definition Textual description of the complete instructions for use including the period of use. Comments The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.9581
valueString			string	There are no (further) constraints on this element Data Type string
periodOfUse	I	0..1	Extension(HdBe-TimeInterval)	Element Id MedicationRequest.extension:periodOfUse Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(HdBe-TimeInterval) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Period Mappings rim:N/A
value[x]	I	0..1		Element Id MedicationRequest.extension:periodOfUse.value[x] Short description PeriodOfUse Alternate names Gebruiksperiode Definition Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued. Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date. With medication for an indefinite period only a start date is indicated. 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. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a rim:N/A v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] HdBe-TimeInterval:TimeInterval zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19936 HdBe-MedicationAgreement:MedicationAgreement.PeriodOfUse
valuePeriod			HdBe-TimeInterval	There are no (further) constraints on this element Data Type HdBe-TimeInterval
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
duration	I	0..1	Extension(Duration)	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Duration) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Duration Mappings rim:N/A
value[x]		0..1		There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration.value[x] Short description Duration Alternate names tijdsDuur Definition The duration of the interval in appropriate units of time (e.g. days or hours, etc. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-timeinterval-v1.0-2020EN:NL-CM:20.3.4 HdBe-TimeInterval:TimeInterval.Duration
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].start Short description startDateTime Alternate names startDatumTijd Definition The start date and time of the interval Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints 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 zib-timeinterval-v1.0-2020EN:NL-CM:20.3.2 HdBe-TimeInterval:TimeInterval.StartDateTime
end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].end Short description endDateTime Alternate names eindDatumTijd Definition The end date and time of the interval 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. Meaning When Missing If the end of the period is missing, it means that the period is ongoing Data Type dateTime Constraints 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 zib-timeinterval-v1.0-2020EN:NL-CM:20.3.3 HdBe-TimeInterval:TimeInterval.EndDateTime
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
stopType	?! I	0..1	Extension(CodeableConcept)	Element Id MedicationRequest.modifierExtension:stopType Short description Optional Extensions Element Alternate names extensions, user content Definition This StopType ModifierExtension works differently than the `.status` element of resources because it has a different meaning. The `.status` element represents the status of the resource at the moment of exchanging the resource. This means that over the lifetime of a resource, the status may change (and is very much related to use period). That – in itself – makes mapping StopType (which may never change in an instance) to status not suitable. For example: suppose you want the patient to stop taking medication definitively three days from today. This is a stop medication agreement with a StopType of definitive. However today, tomorrow and the day after tomorrow the `.status` of this medication agreement is active and only after the end date of the usage period the `status` should be stopped. Status and StopType are simply not the same thing. 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. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-StopType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension:stopType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-StopType Mappings rim:N/A
value[x]		0..1	Binding	Element Id MedicationRequest.modifierExtension:stopType.value[x] Short description MedicationAgreementStopType Alternate names MedicatieafspraakStopType Definition Stop type, the manner in which this medication is discontinued (temporary or definitive). Comments MedicationAgreementStopType, AdministrationAgreementStopType and MedicationUseStopType all have a bound ValueSet that contain the exact same StopType values. These are represented in the CBB with the same Valueset. This MedicationStopType is used to bind to this extension and reusing this extension for all three concepts. Binding StopType values, based on the valueset named MedicatioStopType, which are applicable for StopType in MedicationAgreement, AdministrationAgreement and MedicationUse. MedicationStopType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19954 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementStopType
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
repeatPeriodCyclicalSchedule	?! I	0..1	Extension(Duration)	Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data Type Extension(Duration) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A HdBe-InstructionsForUse:InstructionsForUse.RepeatPeriodCyclicalSchedule
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule Mappings rim:N/A
value[x]		0..1		Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.value[x] Short description RepeatPeriodCyclicalSchedule Alternate names HerhaalperiodeCyclischSchema Definition The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days. Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22505 HdBe-InstructionsForUse:InstructionsForUse.RepeatPeriodCyclicalSchedule
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
identifier		0..*	Identifier	There are no (further) constraints on this element Element Id MedicationRequest.identifier Short description External ids for this request Definition Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. Comments This is a business identifier, not a resource identifier. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Request.identifier script10.6:Message/Header/PrescriberOrderNumber w5:FiveWs.identifier v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number rim:.id
status	Σ ?!	1..1	codeBinding	Element Id MedicationRequest.status Short description active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown Definition A code specifying the current state of the order. Generally, this will be active or completed state. Comments This element is implictly mapped to the CBB concepts period_of_use medication_agreement_stop_type. Unless the status is explicitly recorded, the following guidance applies: When MedicationAgreementStopType is 14803004, `.status` will usually be set to on-hold. When MedicationAgreementStopType is 255545003, `.status` will usually be set to stopped. When the PeriodOfUse start date is in the future, `.status` will usually be set to active. When PeriodOfUse start date is in the past and PeriodOfUse end date is present and in the future, `.status` will usually be set to active. When PeriodOfUse end date is present and in the past, `.status` will usually be set to completed. When PeriodOfUse duration and start date are known, the end date can be deducted and the previous rules apply. When a system is unable to infer the status from the Start and End, `.status` will be set to unknown. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the MedicationAgreement. Data Type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. medicationrequest Status (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.status script10.6:no mapping w5:FiveWs.status rim:.statusCode zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19936 zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19954 HdBe-MedicationAgreement:MedicationAgreement.PeriodOfUse HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementStopType
statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.statusReason Short description Reason for current status Definition Captures the reason for the current state of the MedicationRequest. Comments This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here. Data Type CodeableConcept Binding Identifies the reasons for a given status. medicationRequest Status Reason Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.statusReason rim:.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
intent	Σ ?!	1..1	codeBinding	Element Id MedicationRequest.intent Short description proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Definition Unless `intent` is explicitly recorded and a more appropriate code is known, the value can be set to order because a MedicationAgreement should authorize an action for a patient, pharmacist, professional administrator et cetera. Comments It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Data Type code Binding The kind of medication order. medicationRequest Intent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.intent w5:FiveWs.class rim:.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
category		1..*	CodeableConcept	Element Id MedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) 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) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5:FiveWs.class rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medicationAgreementCode		1..1	CodeableConceptPattern	Element Id MedicationRequest.category:medicationAgreementCode Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data Type CodeableConcept Binding A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. medicationRequest Category Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "16076005" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5:FiveWs.class rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.priority w5:FiveWs.grade rim:.priorityCode
doNotPerform	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element Id MedicationRequest.doNotPerform Short description True if request is prohibiting action Definition If true indicates that the provider is asking for the medication request not to occur. Comments If do not perform is not specified, the request is a positive request e.g. "do perform". Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:SubstanceAdministration.actionNegationInd
reported[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.reported[x] Short description Reported rather than primary record Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.participation[typeCode=INF].role
reportedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
reportedReference			Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
medication[x]	Σ	1..1		Element Id MedicationRequest.medication[x] Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments 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. Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying substance or product that can be ordered. SNOMEDCTMedicationCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.code script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5:FiveWs.what[x] v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim:consumable.administrableMedication
medicationCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
medicationReference	Σ	0..1	Reference(Medication \| HdBe-PharmaceuticalProduct)	Element Id MedicationRequest.medication[x]:medicationReference Short description AgreedMedicine Alternate names Afgesprokengeneesmiddel Definition The medicine agreed upon to be used. 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. Data Type Reference(Medication \| HdBe-PharmaceuticalProduct) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.code script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5:FiveWs.what[x] v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim:consumable.administrableMedication zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19925 HdBe-MedicationAgreement:MedicationAgreement.AgreedMedicine
subject	Σ I	1..1	Reference(Group \| HdBe-Patient)	Element Id MedicationRequest.subject Short description Who or group medication request is for Definition A link to a resource representing the person or set of individuals to whom the medication will be given. 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. Data Type Reference(Group \| HdBe-Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.subject script10.6:Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT) w5:FiveWs.subject[x] v2:PID-3-Patient ID List rim:.participation[typeCode=AUT].role w5:FiveWs.subject
encounter	I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id MedicationRequest.encounter Short description Encounter created as part of encounter/admission/stay Definition The Encounter during which this [x] was created or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.context script10.6:no mapping w5:FiveWs.context v2:PV1-19-Visit Number rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element Id MedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.supportingInfo w5:FiveWs.context rim:.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
authoredOn	Σ	0..1	dateTime	Element Id MedicationRequest.authoredOn Short description MedicationAgreementDateTime Alternate names MedicatieafspraakDatumTijd Definition The time at which the agreement was made. Appointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day). Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.authoredOn script10.6:Message/Body/NewRx/MedicationPrescribed/WrittenDate w5:FiveWs.recorded v2:RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction rim:author.time zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19757 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementDateTime
requester	Σ I	0..1	pattern HealthProfessional Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| HdBe-HealthProfessional PractitionerRole)	Element Id MedicationRequest.requester Short description Prescriber Alternate names Voorschrijver Definition The health professional that entered the medication agreement with the patient. Comments Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. Data Type pattern HealthProfessional Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| HdBe-HealthProfessional PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.requester w5:FiveWs.author rim:.participation[typeCode=AUT].role zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.1030 HdBe-MedicationAgreement:MedicationAgreement.Prescriber
performer	I	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam)	There are no (further) constraints on this element Element Id MedicationRequest.performer Short description Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.performer w5:FiveWs.actor rim:.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
performerType	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.performerType Short description Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication. Comments If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available. Data Type CodeableConcept Binding Identifies the type of individual that is desired to administer the medication. ProcedurePerformerRoleCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.performerType rim:.participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
recorder	I	0..1	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id MedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.who rim:.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
reasonCode		0..1	CodeableConceptBinding	Element Id MedicationRequest.reasonCode Short description ReasonMedicationAgreement Alternate names RedenMedicatieafspraak Definition Reason for this agreement. This can be the reason to start, change or stop the medication treatment. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. Data Type CodeableConcept Binding A coded concept indicating why the medication was ordered. MedicationReason (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.reasonCode script10.6:Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value w5:FiveWs.why[x] v2:ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication rim:reason.observation.reasonCode zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.22094 HdBe-MedicationAgreement:MedicationAgreement.ReasonMedicationAgreement
reasonReference	I	0..1	Reference(Condition \| Observation \| HdBe-Problem)	Element Id MedicationRequest.reasonReference Short description PrescriptionReason Alternate names RedenVanVoorschrijven Definition The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. It can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. Comments This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Data Type Reference(Condition \| Observation \| HdBe-Problem) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.reasonReference script10.6:no mapping w5:FiveWs.why[x] rim:reason.observation[code=ASSERTION].value zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23133 HdBe-MedicationAgreement:MedicationAgreement.PrescriptionReason
instantiatesCanonical	Σ	0..*	canonical()	There are no (further) constraints on this element Element Id MedicationRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see Canonical References Data Type canonical() Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.instantiates rim:.outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element Id MedicationRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=DEFN].target
basedOn	Σ I	0..*	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	There are no (further) constraints on this element Element Id MedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.basedOn rim:.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element Id MedicationRequest.groupIdentifier Short description Composite request this is part of Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Request.groupIdentifier rim:.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
courseOfTherapyType		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.courseOfTherapyType Short description Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient. Comments This attribute should not be confused with the protocol of the medication. Data Type CodeableConcept Binding Identifies the overall pattern of medication administratio. medicationRequest Course of Therapy Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:Act.code where classCode = LIST and moodCode = EVN
insurance	I	0..*	Reference(Coverage \| ClaimResponse)	There are no (further) constraints on this element Element Id MedicationRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Coverage \| ClaimResponse) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.insurance rim:.outboundRelationship[typeCode=COVBY].target
note		0..1	Annotation	There are no (further) constraints on this element Element Id MedicationRequest.note Short description Information about the prescription Definition Extra information about the prescription that could not be conveyed by the other attributes. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act workflow:Request.note script10.6:Message/Body/NewRx/MedicationPrescribed/Note rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
author[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data Type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.effectiveTime
text	Σ	1..1	markdown	Element Id MedicationRequest.note.text Short description Comment Alternate names Toelichting Definition Comments regarding to the medication agreement. For example: in consultation with the medical specialist. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data Type markdown Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.text zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.22273 HdBe-MedicationAgreement:MedicationAgreement.Comment
dosageInstruction		0..*	HdBe-InstructionsForUse.DosageInstructions	Element Id MedicationRequest.dosageInstruction Short description DosingInstructions / InstructionsForUse Alternate names Doseerinstructie, Gebruiksinstructie Definition Instructions for the use of the medication, e.g. dose and route of administration. Comments This element mostly represents the DosingInstructions container from CBB InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are duplicated in every repetition of this element, even though these concepts should be present just once according to the CBB. The RepeatPeriodCyclicalSchedule and Description elements of the CBB are not represented in this profile. When a HdBe profile contains a InstructionsForUse.DosageInstructions datatype, the RepeatPeriodCyclicalSchedule and Description elements are separately added to this profile as well. This element does not contain a mapping to the Dosage container from CBB InstructionsForUse. However, the child concepts of Dosage are all mapped. Multiple Dosage instances are represented by another DosingInstructions that contains a similiar SequenceNumber. Data Type HdBe-InstructionsForUse.DosageInstructions Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT] workflow:Request.occurrence[x] rim:see dosageInstruction mapping zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22095 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23240 HdBe-MedicationAgreement:MedicationAgreement.InstructionsForUse
sequence	Σ	0..1	integer	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.sequence Short description SequenceNumber Alternate names Volgnummer Definition This indicates the sequence of the dosing instructions within the medication agreement. Requirements If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Comments 32 bit number; for values larger than this, use decimal Data Type integer Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-1 rim:.text zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22503 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.SequenceNumber
text	Σ	0..1	string	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG. Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-6; RXE-21 rim:.text
additionalInstruction	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.additionalInstruction Short description AdditionalInstructions Alternate names AanvullendeInstructie Definition The additional instructions contain extra information on the use of the current prescription. This includes all instructions for use. The text can come from the original “paper" medication prescription, but can also be generated from the coded information. This concept may contain more information than what is structurally coded in the information below, but may not conflict with it. The instructions may not conflict with other components of the request for administration. The instructions can also refer to an existing protocol. Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Please note that in contrast to the CBB, this AdditionalInstructions concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions. Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-7 rim:.text zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19944 HdBe-InstructionsForUse:InstructionsForUse.AdditionalInstructions
patientInstruction	Σ	0..1	string	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.patientInstruction Short description Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-7 rim:.text
timing	Σ	0..1	Timing	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing Short description AdministeringSchedule Alternate names Toedieningsschema Definition Specifications of the times at which the medication is to be administered. This is indicated as follows: Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. A specific number of times the medication is to be taken each day ("3x a day"), indicated with the frequency. A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: The end date and time has been reached The total administration duration has been reached (14 days) A specific amount of administrations has been reached (“20 doses”), to be entered in the Frequency concept. Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Data Type Timing Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS) rim:.effectiveTime zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19948 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:QLIST<TS>
repeat	Σ I	0..1	Element	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled. Requirements Many timing schedules are determined by regular repetitions. Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` tim-9:If there's an offset, there must be a when (and not C, CM, CD, CV) `offset.empty() or (when.exists() and ((when in ('C' \| 'CM' \| 'CD' \| 'CV')).not()))` tim-5:period SHALL be a non-negative value `period.exists() implies period >= 0` tim-6:If there's a periodMax, there must be a period `periodMax.empty() or period.exists()` tim-7:If there's a durationMax, there must be a duration `durationMax.empty() or duration.exists()` tim-8:If there's a countMax, there must be a count `countMax.empty() or count.exists()` tim-1:if there's a duration, there needs to be duration units `duration.empty() or durationUnit.exists()` tim-10:If there's a timeOfDay, there cannot be a when, or vice versa `timeOfDay.empty() or when.empty()` tim-2:if there's a period, there needs to be period units `period.empty() or periodUnit.exists()` tim-4:duration SHALL be a non-negative value `duration.exists() implies duration >= 0` Mappings rim:n/a rim:Implies PIVL or EIVL
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
timingExact	I	0..1	Extension(boolean)	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact Short description Whether specified times must be followed as closely as possible Alternate names extensions, user content Definition If true, indicates that the specified times, frequencies, periods are expected to be adhered to as precisely as possible. If false, indicates that a typical degree of variability based on institutional and/or patient convenience is acceptable. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(boolean) Extension URL http://hl7.org/fhir/StructureDefinition/timing-exact Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:N/A rim:GTS.IsFlexible
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value http://hl7.org/fhir/StructureDefinition/timing-exact Mappings rim:N/A
value[x]		1..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact.value[x] Short description Value of extension Definition Indicates that the timing as specified by `.frequency`, `.period` and `.periodUnit` should be strictly interpreted. This is the case when the CBB concept Interval is expressed using these elements (as opposed to the CBB concept Frequency). The times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
valueBoolean			boolean	There are no (further) constraints on this element Data Type boolean
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI
boundsRange			Range	There are no (further) constraints on this element Data Type Range
boundsPeriod			Period	There are no (further) constraints on this element Data Type Period
boundsDuration	Σ	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short description DoseDuration Alternate names Doseerduur Definition The intended time duration for these dosing instructions, e.g. 5 days or 8 weeks. In the case of medication for an indefinite period, the dosing duration is left empty in the last dosing instruction. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22506 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.DoseDuration
count	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.count Short description Frequency / minimumValue / nominalValue Alternate names Frequentie, nominaleWaarde, minimumWaarde Definition Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by this `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Requirements Repetitions may be limited by end time or total occurrences. Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.2 zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.NominalValue HdBe-Range:Range.MinimumValue
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.countMax Short description Frequency / maximumValue Alternate names Frequentie, maximumWaarde Definition Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by the `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MaximumValue
duration	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.duration Short description DurationOfAdministration Alternate names Toedieningsduur Definition The duration of administration defines the length of time during which the drug is administered and is mainly used in the slow parenteral administration of fluids. The `durationUnit` defines the time unit. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.23141 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration
durationMax	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
durationUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.durationUnit Short description DurationOfAdministration Alternate names Toedieningsduur Definition The units of time, in UCUM units, for the duration of administration of time during which the drug is administered. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.23141 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration
frequency	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.frequency Short description Frequency / minimumValue / nominalValue / Interval Alternate names Frequentie, minimumWaarde, nominaleWaarde, Interval Definition The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.2 zib-range-v1.0.1-2020EN:NL-CM:20.1.4 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MinimumValue HdBe-Range:Range.NominalValue HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
frequencyMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.frequencyMax Short description Frequency / maximumValue Alternate names maximumWaarde, Frequentie Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MaximumValue
period	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.period Short description Frequency / Interval Alternate names Frequentie, Interval Definition Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
periodMax	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
periodUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.periodUnit Short description Frequency / Interval Alternate names Frequentie, Interval Definition The units of time for the period in UCUM units for Frequency and Interval. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
dayOfWeek	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek Short description WeekDay Alternate names Weekdag Definition WeekDay indicates a pattern of doses on fixed week days. Comments If no days are specified, the action is assumed to happen every day as otherwise specified. Data Type code Binding Use ConceptMap 'WeekDay_to_DaysOfWeek' to translate CBB terminology to profile terminology in ValueSet 'DaysOfWeek.' DaysOfWeek (required) Permitted Values WeekDay_to_DaysOfWeek Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19952 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.WeekDay
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.timeOfDay Short description AdministrationTime Alternate names Toedientijd Definition The time of administration is a specific time of day (on the clock). This time usually isn’t (intended to be) exact. There can be multiple administering times in one day. The ideal time of administration can also be entered as a time of day (morning, afternoon, evening, night-time). The administration time is then to be left empty, and the time of day can be entered in the TimeOfDay concept. Comments If there's a timeOfDay, there cannot be a when, or vice versa. Data Type time Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19951 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.AdministrationTime
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.when Short description TimeOfDay Alternate names Dagdeel Definition Time of day: morning, afternoon, evening, night. Requirements Timings are frequently determined by occurrences such as waking, eating and sleep. Comments When more than one event is listed, the event is tied to the union of the specified events. Data Type code Binding Use ConceptMap 'TimeOfDay_to_EventTiming' to translate CBB terminology to profile terminology in ValueSet 'EventTiming.' EventTiming (required) Permitted Values TimeOfDay_to_EventTiming Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.event zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19953 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.TimeOfDay
offset	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.offset Short description Minutes from event (before or after) Definition The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. Comments 32 bit number; for values larger than this, use decimal Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). Comments BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). Data Type CodeableConcept Binding Code for a known / defined timing pattern. TimingAbbreviation (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:QSC.code
asNeeded[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBoolean			boolean	There are no (further) constraints on this element Data Type boolean
asNeededCodeableConcept	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept Short description Condition Alternate names Criterium Definition The condition for administering medication can be: a physiological measurement value (plasma glucose concentration, body temperature, blood pressure); a symptom or other circumstance (in the event of a headache, or itch). Physiological measurement values or other conditions do not need to be coded. These can be expressed in free text in the Description concept. Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Data Type CodeableConcept Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. AsNeededCriterium (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19945 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AsNeeded.Condition
site	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.site Short description Body site to administer to Definition Body site to administer to. Requirements A coded specification of the anatomic site where the medication first enters the body. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data Type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-2 rim:.approachSiteCode
route	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.route Short description RouteOfAdministration Alternate names Toedieningsweg Definition The route through which the medication is administered (oral, nasal, intravenous, etc.). Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Comments Please note that in contrast to the CBB, this RouteOfAdministration concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions. Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfMedicationAdministration (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-1 rim:.routeCode zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19941 HdBe-InstructionsForUse:InstructionsForUse.RouteOfAdministration
method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.method Short description Technique for administering medication Definition Technique for administering medication. Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Comments Terminologies used often pre-coordinate this term with the route and or form of administration. Data Type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-4 rim:.doseQuantity
doseAndRate	Σ	0..*	Element	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate Short description Dosage Alternate names Dosering Definition Instructions for the administrator to administer the medication (the patient themselves, a nurse or other aid). When taking stock of medication use, the dosage describes the pattern of use established by the patient. Once the dose schedule (distribution of doses over time) and the dose have been determined, then there should be one single instruction for use. Multiple parallel instructions for use can be included in the event of a changing dose within one day and in the event of a variable use frequency. Multiple sequential instructions for use can be included in the event of changing doses within one period and/or in the event of a changing dose schedule. Comments DurationOfAdministration is not mapped to this element but to `.timing.repeat.duration` and `.timing.repeat.durationUnit`. Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-2 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19935 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-21; RXE-23
dose[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x] Short description Dose Alternate names Keerdosis Definition The dose indicates the amount/unit per administration. The unit can be any unit that can occur with this particular medicine. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19940 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.Dose
doseRange	Σ	0..1	Range	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data Type Range Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity
low	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short description minimumValue Alternate names minimumWaarde Definition The minimal value of the range. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.1 rim:./low zib-range-v1.0.1-2020EN:NL-CM:20.1.2 HdBe-Range:Range.MinimumValue
high	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short description maximumValue Alternate names maximumWaarde Definition The maximum value of the range. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.2 rim:./high zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-Range:Range.MaximumValue
doseQuantity	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short description nominalValue Alternate names nominaleWaarde Definition Amount of medication per dose. The nominal value of the quantity. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-Range:Range.NominalValue
rate[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x] Short description AdministeringSpeed Alternate names Toedieningssnelheid Definition The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: amount = 10, dose unit = ml, time unit = hour Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19942 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSpeed
rateRatio			Ratio	There are no (further) constraints on this element Data Type Ratio
rateRange	Σ	0..1	Range	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data Type Range Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity
low	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Short description minimumValue Alternate names minimumWaarde Definition The minimal value of the range. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.1 rim:./low zib-range-v1.0.1-2020EN:NL-CM:20.1.2 HdBe-Range:Range.MinimumValue
high	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high Short description maximumValue Alternate names maximumWaarde Definition The maximum value of the range. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.2 rim:./high zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-Range:Range.MaximumValue
rateQuantity	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity Short description nominalValue Alternate names nominaleWaarde Definition The nominal value of the quantity. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-Range:Range.NominalValue
maxDosePerPeriod	Σ I	0..1	Ratio	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerPeriod Short description MaximumDose Alternate names MaximaleDosering Definition A maximum dose maximizes (in time) the usage of a drug in an 'as needed' prescription. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Data Type Ratio Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` rat-1:Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())` Mappings rim:n/a v2:N/A rim:RTO v2:RXO-23, RXE-19 rim:.maxDoseQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19946 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AsNeeded.MaximumDose
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:not supported
maxDosePerLifetime	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:not supported
dispenseRequest		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest Short description Medication supply authorization Definition Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:Message/Body/NewRx/MedicationPrescribed/ExpirationDate rim:component.supplyEvent
initialFill		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill Short description First fill details Definition Indicates the quantity or duration for the first dispense of the medication. Comments If populating this element, either the quantity or the duration must be included. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill.quantity Short description First fill quantity Definition The amount or quantity to provide as part of the first dispense. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:Supply.quantity[moodCode=RQO]
duration	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill.duration Short description First fill duration Definition The length of time that the first dispense is expected to last. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values rim:Supply.effectivetime[moodCode=RQO]
dispenseInterval	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.dispenseInterval Short description Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values rim:Supply.effectivetime[moodCode=RQO]
validityPeriod	I	0..1	Period	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription). Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] script10.6:Message/Body/NewRx/MedicationPrescribed/Refills rim:effectiveTime
numberOfRepeatsAllowed		0..1	unsignedInt	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. Comments If displaying "number of authorized fills", add 1 to this number. Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:Message/Body/NewRx/MedicationPrescribed/Quantity v2:RXE-12-Number of Refills rim:repeatNumber
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.quantity Short description Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values script10.6:Message/Body/NewRx/MedicationPrescribed/DaysSupply v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim:quantity
expectedSupplyDuration	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values script10.6:Message/Body/NewRx/MedicationPrescribed/Substitutions rim:expectedUseTime
performer	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.who rim:.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
substitution		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.substitution Short description Any restrictions on medication substitution Definition Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions rim:subjectOf.substitutionPersmission
allowed[x]		1..1		There are no (further) constraints on this element Element Id MedicationRequest.substitution.allowed[x] Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed. Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Binding Identifies the type of substitution allowed. v3.ActSubstanceAdminSubstitutionCode (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2:RXO-9-Allow Substitutions / RXE-9-Substitution Status rim:code
allowedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
allowedCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
reason		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:not mapped v2:RXE-9 Substition status rim:reasonCode
priorPrescription	I	0..1	Reference(MedicationRequest)	There are no (further) constraints on this element Element Id MedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(MedicationRequest) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.replaces script10.6:not mapped rim:.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
detectedIssue	I	0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element Id MedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. Comments This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. Data Type Reference(DetectedIssue) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
eventHistory	I	0..*	Reference(Provenance)	There are no (further) constraints on this element Element Id MedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data Type Reference(Provenance) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.relevantHistory rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

MedicationRequest	I		MedicationRequest	Element Id MedicationRequest Short description MedicationAgreement Alternate names Prescription, Order, Medicatieafspraak Definition An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. Data Type MedicationRequest Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim:Entity. Role, or Act workflow:Request script10.6:Message/Body/NewRx rim:CombinedMedicationRequest zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.9580 HdBe-MedicationAgreement:MedicationAgreement
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
medicationAgreementAdditionalInformation	I	0..*	Extension(CodeableConcept)	Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-MedicationAgreement.MedicationAgreementAdditionalInformation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-MedicationAgreement.AdditionalInformation Mappings rim:N/A
value[x]		0..1	Binding	Element Id MedicationRequest.extension:medicationAgreementAdditionalInformation.value[x] Short description MedicationAgreementAdditionalInformation Alternate names MedicatieafspraakAanvullendeInformatie Definition Additional information includes details on the structure of the agreement made that are relevant for pharmacovigilance and fulfillment by the pharmacist. This can be used e.g. to indicate that there was a conscious decision to deviate from the norm or that the agreement is to be structured in a certain way. Binding MedicationAgreementAdditionalInformation (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23283 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementAdditionalInformation
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
renderedDosageInstruction	I	0..1	Extension(string)	Element Id MedicationRequest.extension:renderedDosageInstruction Short description Optional Extensions Element Alternate names extensions, user content Definition Pre-adopt from FHIR R5 of the `.renderedDosageInstruction` element found in various medication resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-RenderedDosageInstruction Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A HdBe-InstructionsForUse:InstructionsForUse.Description
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:renderedDosageInstruction.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-RenderedDosageInstruction Mappings rim:N/A
value[x]		0..1		Element Id MedicationRequest.extension:renderedDosageInstruction.value[x] Short description Description Alternate names Omschrijving Definition Textual description of the complete instructions for use including the period of use. Comments The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.9581
valueString			string	There are no (further) constraints on this element Data Type string
periodOfUse	I	0..1	Extension(HdBe-TimeInterval)	Element Id MedicationRequest.extension:periodOfUse Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(HdBe-TimeInterval) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Period Mappings rim:N/A
value[x]	I	0..1		Element Id MedicationRequest.extension:periodOfUse.value[x] Short description PeriodOfUse Alternate names Gebruiksperiode Definition Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued. Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date. With medication for an indefinite period only a start date is indicated. 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. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a rim:N/A v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] HdBe-TimeInterval:TimeInterval zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19936 HdBe-MedicationAgreement:MedicationAgreement.PeriodOfUse
valuePeriod			HdBe-TimeInterval	There are no (further) constraints on this element Data Type HdBe-TimeInterval
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
duration	I	0..1	Extension(Duration)	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Duration) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TimeInterval.Duration Mappings rim:N/A
value[x]		0..1		There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].extension:duration.value[x] Short description Duration Alternate names tijdsDuur Definition The duration of the interval in appropriate units of time (e.g. days or hours, etc. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-timeinterval-v1.0-2020EN:NL-CM:20.3.4 HdBe-TimeInterval:TimeInterval.Duration
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].start Short description startDateTime Alternate names startDatumTijd Definition The start date and time of the interval Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints 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 zib-timeinterval-v1.0-2020EN:NL-CM:20.3.2 HdBe-TimeInterval:TimeInterval.StartDateTime
end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.extension:periodOfUse.value[x].end Short description endDateTime Alternate names eindDatumTijd Definition The end date and time of the interval 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. Meaning When Missing If the end of the period is missing, it means that the period is ongoing Data Type dateTime Constraints 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 zib-timeinterval-v1.0-2020EN:NL-CM:20.3.3 HdBe-TimeInterval:TimeInterval.EndDateTime
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
stopType	?! I	0..1	Extension(CodeableConcept)	Element Id MedicationRequest.modifierExtension:stopType Short description Optional Extensions Element Alternate names extensions, user content Definition This StopType ModifierExtension works differently than the `.status` element of resources because it has a different meaning. The `.status` element represents the status of the resource at the moment of exchanging the resource. This means that over the lifetime of a resource, the status may change (and is very much related to use period). That – in itself – makes mapping StopType (which may never change in an instance) to status not suitable. For example: suppose you want the patient to stop taking medication definitively three days from today. This is a stop medication agreement with a StopType of definitive. However today, tomorrow and the day after tomorrow the `.status` of this medication agreement is active and only after the end date of the usage period the `status` should be stopped. Status and StopType are simply not the same thing. 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. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-StopType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension:stopType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-StopType Mappings rim:N/A
value[x]		0..1	Binding	Element Id MedicationRequest.modifierExtension:stopType.value[x] Short description MedicationAgreementStopType Alternate names MedicatieafspraakStopType Definition Stop type, the manner in which this medication is discontinued (temporary or definitive). Comments MedicationAgreementStopType, AdministrationAgreementStopType and MedicationUseStopType all have a bound ValueSet that contain the exact same StopType values. These are represented in the CBB with the same Valueset. This MedicationStopType is used to bind to this extension and reusing this extension for all three concepts. Binding StopType values, based on the valueset named MedicatioStopType, which are applicable for StopType in MedicationAgreement, AdministrationAgreement and MedicationUse. MedicationStopType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19954 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementStopType
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
repeatPeriodCyclicalSchedule	?! I	0..1	Extension(Duration)	Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data Type Extension(Duration) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A HdBe-InstructionsForUse:InstructionsForUse.RepeatPeriodCyclicalSchedule
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule Mappings rim:N/A
value[x]		0..1		Element Id MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.value[x] Short description RepeatPeriodCyclicalSchedule Alternate names HerhaalperiodeCyclischSchema Definition The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days. Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22505 HdBe-InstructionsForUse:InstructionsForUse.RepeatPeriodCyclicalSchedule
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
identifier		0..*	Identifier	There are no (further) constraints on this element Element Id MedicationRequest.identifier Short description External ids for this request Definition Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. Comments This is a business identifier, not a resource identifier. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Request.identifier script10.6:Message/Header/PrescriberOrderNumber w5:FiveWs.identifier v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number rim:.id
status	Σ ?!	1..1	codeBinding	Element Id MedicationRequest.status Short description active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown Definition A code specifying the current state of the order. Generally, this will be active or completed state. Comments This element is implictly mapped to the CBB concepts period_of_use medication_agreement_stop_type. Unless the status is explicitly recorded, the following guidance applies: When MedicationAgreementStopType is 14803004, `.status` will usually be set to on-hold. When MedicationAgreementStopType is 255545003, `.status` will usually be set to stopped. When the PeriodOfUse start date is in the future, `.status` will usually be set to active. When PeriodOfUse start date is in the past and PeriodOfUse end date is present and in the future, `.status` will usually be set to active. When PeriodOfUse end date is present and in the past, `.status` will usually be set to completed. When PeriodOfUse duration and start date are known, the end date can be deducted and the previous rules apply. When a system is unable to infer the status from the Start and End, `.status` will be set to unknown. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the MedicationAgreement. Data Type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. medicationrequest Status (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.status script10.6:no mapping w5:FiveWs.status rim:.statusCode zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19936 zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19954 HdBe-MedicationAgreement:MedicationAgreement.PeriodOfUse HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementStopType
statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.statusReason Short description Reason for current status Definition Captures the reason for the current state of the MedicationRequest. Comments This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here. Data Type CodeableConcept Binding Identifies the reasons for a given status. medicationRequest Status Reason Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.statusReason rim:.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
intent	Σ ?!	1..1	codeBinding	Element Id MedicationRequest.intent Short description proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Definition Unless `intent` is explicitly recorded and a more appropriate code is known, the value can be set to order because a MedicationAgreement should authorize an action for a patient, pharmacist, professional administrator et cetera. Comments It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Data Type code Binding The kind of medication order. medicationRequest Intent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.intent w5:FiveWs.class rim:.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
category		1..*	CodeableConcept	Element Id MedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) 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) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5:FiveWs.class rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medicationAgreementCode		1..1	CodeableConceptPattern	Element Id MedicationRequest.category:medicationAgreementCode Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data Type CodeableConcept Binding A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. medicationRequest Category Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "16076005" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5:FiveWs.class rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.priority w5:FiveWs.grade rim:.priorityCode
doNotPerform	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element Id MedicationRequest.doNotPerform Short description True if request is prohibiting action Definition If true indicates that the provider is asking for the medication request not to occur. Comments If do not perform is not specified, the request is a positive request e.g. "do perform". Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:SubstanceAdministration.actionNegationInd
reported[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.reported[x] Short description Reported rather than primary record Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.participation[typeCode=INF].role
reportedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
reportedReference			Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
medication[x]	Σ	1..1		Element Id MedicationRequest.medication[x] Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments 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. Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying substance or product that can be ordered. SNOMEDCTMedicationCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.code script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5:FiveWs.what[x] v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim:consumable.administrableMedication
medicationCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
medicationReference	Σ	0..1	Reference(Medication \| HdBe-PharmaceuticalProduct)	Element Id MedicationRequest.medication[x]:medicationReference Short description AgreedMedicine Alternate names Afgesprokengeneesmiddel Definition The medicine agreed upon to be used. 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. Data Type Reference(Medication \| HdBe-PharmaceuticalProduct) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.code script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5:FiveWs.what[x] v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim:consumable.administrableMedication zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19925 HdBe-MedicationAgreement:MedicationAgreement.AgreedMedicine
subject	Σ I	1..1	Reference(Group \| HdBe-Patient)	Element Id MedicationRequest.subject Short description Who or group medication request is for Definition A link to a resource representing the person or set of individuals to whom the medication will be given. 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. Data Type Reference(Group \| HdBe-Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.subject script10.6:Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT) w5:FiveWs.subject[x] v2:PID-3-Patient ID List rim:.participation[typeCode=AUT].role w5:FiveWs.subject
encounter	I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id MedicationRequest.encounter Short description Encounter created as part of encounter/admission/stay Definition The Encounter during which this [x] was created or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.context script10.6:no mapping w5:FiveWs.context v2:PV1-19-Visit Number rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element Id MedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.supportingInfo w5:FiveWs.context rim:.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
authoredOn	Σ	0..1	dateTime	Element Id MedicationRequest.authoredOn Short description MedicationAgreementDateTime Alternate names MedicatieafspraakDatumTijd Definition The time at which the agreement was made. Appointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day). Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.authoredOn script10.6:Message/Body/NewRx/MedicationPrescribed/WrittenDate w5:FiveWs.recorded v2:RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction rim:author.time zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.19757 HdBe-MedicationAgreement:MedicationAgreement.MedicationAgreementDateTime
requester	Σ I	0..1	pattern HealthProfessional Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| HdBe-HealthProfessional PractitionerRole)	Element Id MedicationRequest.requester Short description Prescriber Alternate names Voorschrijver Definition The health professional that entered the medication agreement with the patient. Comments Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. Data Type pattern HealthProfessional Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device \| HdBe-HealthProfessional PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.requester w5:FiveWs.author rim:.participation[typeCode=AUT].role zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.1030 HdBe-MedicationAgreement:MedicationAgreement.Prescriber
performer	I	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam)	There are no (further) constraints on this element Element Id MedicationRequest.performer Short description Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.performer w5:FiveWs.actor rim:.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
performerType	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.performerType Short description Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication. Comments If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available. Data Type CodeableConcept Binding Identifies the type of individual that is desired to administer the medication. ProcedurePerformerRoleCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.performerType rim:.participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
recorder	I	0..1	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id MedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.who rim:.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
reasonCode		0..1	CodeableConceptBinding	Element Id MedicationRequest.reasonCode Short description ReasonMedicationAgreement Alternate names RedenMedicatieafspraak Definition Reason for this agreement. This can be the reason to start, change or stop the medication treatment. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. Data Type CodeableConcept Binding A coded concept indicating why the medication was ordered. MedicationReason (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Request.reasonCode script10.6:Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value w5:FiveWs.why[x] v2:ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication rim:reason.observation.reasonCode zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.22094 HdBe-MedicationAgreement:MedicationAgreement.ReasonMedicationAgreement
reasonReference	I	0..1	Reference(Condition \| Observation \| HdBe-Problem)	Element Id MedicationRequest.reasonReference Short description PrescriptionReason Alternate names RedenVanVoorschrijven Definition The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. It can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. Comments This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Data Type Reference(Condition \| Observation \| HdBe-Problem) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.reasonReference script10.6:no mapping w5:FiveWs.why[x] rim:reason.observation[code=ASSERTION].value zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23133 HdBe-MedicationAgreement:MedicationAgreement.PrescriptionReason
instantiatesCanonical	Σ	0..*	canonical()	There are no (further) constraints on this element Element Id MedicationRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see Canonical References Data Type canonical() Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Request.instantiates rim:.outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element Id MedicationRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=DEFN].target
basedOn	Σ I	0..*	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	There are no (further) constraints on this element Element Id MedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.basedOn rim:.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element Id MedicationRequest.groupIdentifier Short description Composite request this is part of Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Request.groupIdentifier rim:.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
courseOfTherapyType		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.courseOfTherapyType Short description Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient. Comments This attribute should not be confused with the protocol of the medication. Data Type CodeableConcept Binding Identifies the overall pattern of medication administratio. medicationRequest Course of Therapy Codes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:Act.code where classCode = LIST and moodCode = EVN
insurance	I	0..*	Reference(Coverage \| ClaimResponse)	There are no (further) constraints on this element Element Id MedicationRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Coverage \| ClaimResponse) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.insurance rim:.outboundRelationship[typeCode=COVBY].target
note		0..1	Annotation	There are no (further) constraints on this element Element Id MedicationRequest.note Short description Information about the prescription Definition Extra information about the prescription that could not be conveyed by the other attributes. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act workflow:Request.note script10.6:Message/Body/NewRx/MedicationPrescribed/Note rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
author[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data Type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.effectiveTime
text	Σ	1..1	markdown	Element Id MedicationRequest.note.text Short description Comment Alternate names Toelichting Definition Comments regarding to the medication agreement. For example: in consultation with the medical specialist. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data Type markdown Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.text zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.22273 HdBe-MedicationAgreement:MedicationAgreement.Comment
dosageInstruction		0..*	HdBe-InstructionsForUse.DosageInstructions	Element Id MedicationRequest.dosageInstruction Short description DosingInstructions / InstructionsForUse Alternate names Doseerinstructie, Gebruiksinstructie Definition Instructions for the use of the medication, e.g. dose and route of administration. Comments This element mostly represents the DosingInstructions container from CBB InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are duplicated in every repetition of this element, even though these concepts should be present just once according to the CBB. The RepeatPeriodCyclicalSchedule and Description elements of the CBB are not represented in this profile. When a HdBe profile contains a InstructionsForUse.DosageInstructions datatype, the RepeatPeriodCyclicalSchedule and Description elements are separately added to this profile as well. This element does not contain a mapping to the Dosage container from CBB InstructionsForUse. However, the child concepts of Dosage are all mapped. Multiple Dosage instances are represented by another DosingInstructions that contains a similiar SequenceNumber. Data Type HdBe-InstructionsForUse.DosageInstructions Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT] workflow:Request.occurrence[x] rim:see dosageInstruction mapping zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22095 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions zib-medicationagreement-v1.2-2020EN:NL-CM:9.6.23240 HdBe-MedicationAgreement:MedicationAgreement.InstructionsForUse
sequence	Σ	0..1	integer	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.sequence Short description SequenceNumber Alternate names Volgnummer Definition This indicates the sequence of the dosing instructions within the medication agreement. Requirements If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Comments 32 bit number; for values larger than this, use decimal Data Type integer Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-1 rim:.text zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22503 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.SequenceNumber
text	Σ	0..1	string	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG. Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-6; RXE-21 rim:.text
additionalInstruction	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.additionalInstruction Short description AdditionalInstructions Alternate names AanvullendeInstructie Definition The additional instructions contain extra information on the use of the current prescription. This includes all instructions for use. The text can come from the original “paper" medication prescription, but can also be generated from the coded information. This concept may contain more information than what is structurally coded in the information below, but may not conflict with it. The instructions may not conflict with other components of the request for administration. The instructions can also refer to an existing protocol. Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Please note that in contrast to the CBB, this AdditionalInstructions concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions. Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-7 rim:.text zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19944 HdBe-InstructionsForUse:InstructionsForUse.AdditionalInstructions
patientInstruction	Σ	0..1	string	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.patientInstruction Short description Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-7 rim:.text
timing	Σ	0..1	Timing	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing Short description AdministeringSchedule Alternate names Toedieningsschema Definition Specifications of the times at which the medication is to be administered. This is indicated as follows: Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. A specific number of times the medication is to be taken each day ("3x a day"), indicated with the frequency. A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: The end date and time has been reached The total administration duration has been reached (14 days) A specific amount of administrations has been reached (“20 doses”), to be entered in the Frequency concept. Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Data Type Timing Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS) rim:.effectiveTime zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19948 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:QLIST<TS>
repeat	Σ I	0..1	Element	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled. Requirements Many timing schedules are determined by regular repetitions. Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` tim-9:If there's an offset, there must be a when (and not C, CM, CD, CV) `offset.empty() or (when.exists() and ((when in ('C' \| 'CM' \| 'CD' \| 'CV')).not()))` tim-5:period SHALL be a non-negative value `period.exists() implies period >= 0` tim-6:If there's a periodMax, there must be a period `periodMax.empty() or period.exists()` tim-7:If there's a durationMax, there must be a duration `durationMax.empty() or duration.exists()` tim-8:If there's a countMax, there must be a count `countMax.empty() or count.exists()` tim-1:if there's a duration, there needs to be duration units `duration.empty() or durationUnit.exists()` tim-10:If there's a timeOfDay, there cannot be a when, or vice versa `timeOfDay.empty() or when.empty()` tim-2:if there's a period, there needs to be period units `period.empty() or periodUnit.exists()` tim-4:duration SHALL be a non-negative value `duration.exists() implies duration >= 0` Mappings rim:n/a rim:Implies PIVL or EIVL
extension	I	0..*	Extension	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
timingExact	I	0..1	Extension(boolean)	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact Short description Whether specified times must be followed as closely as possible Alternate names extensions, user content Definition If true, indicates that the specified times, frequencies, periods are expected to be adhered to as precisely as possible. If false, indicates that a typical degree of variability based on institutional and/or patient convenience is acceptable. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(boolean) Extension URL http://hl7.org/fhir/StructureDefinition/timing-exact Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A v2:N/A rim:GTS.IsFlexible
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data Type System.String Fixed Value http://hl7.org/fhir/StructureDefinition/timing-exact Mappings rim:N/A
value[x]		1..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.extension:timingExact.value[x] Short description Value of extension Definition Indicates that the timing as specified by `.frequency`, `.period` and `.periodUnit` should be strictly interpreted. This is the case when the CBB concept Interval is expressed using these elements (as opposed to the CBB concept Frequency). The times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
valueBoolean			boolean	There are no (further) constraints on this element Data Type boolean
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI
boundsRange			Range	There are no (further) constraints on this element Data Type Range
boundsPeriod			Period	There are no (further) constraints on this element Data Type Period
boundsDuration	Σ	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short description DoseDuration Alternate names Doseerduur Definition The intended time duration for these dosing instructions, e.g. 5 days or 8 weeks. In the case of medication for an indefinite period, the dosing duration is left empty in the last dosing instruction. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.22506 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.DoseDuration
count	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.count Short description Frequency / minimumValue / nominalValue Alternate names Frequentie, nominaleWaarde, minimumWaarde Definition Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by this `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Requirements Repetitions may be limited by end time or total occurrences. Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.2 zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.NominalValue HdBe-Range:Range.MinimumValue
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.countMax Short description Frequency / maximumValue Alternate names Frequentie, maximumWaarde Definition Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by the `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MaximumValue
duration	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.duration Short description DurationOfAdministration Alternate names Toedieningsduur Definition The duration of administration defines the length of time during which the drug is administered and is mainly used in the slow parenteral administration of fluids. The `durationUnit` defines the time unit. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.23141 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration
durationMax	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
durationUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.durationUnit Short description DurationOfAdministration Alternate names Toedieningsduur Definition The units of time, in UCUM units, for the duration of administration of time during which the drug is administered. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.23141 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration
frequency	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.frequency Short description Frequency / minimumValue / nominalValue / Interval Alternate names Frequentie, minimumWaarde, nominaleWaarde, Interval Definition The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.2 zib-range-v1.0.1-2020EN:NL-CM:20.1.4 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MinimumValue HdBe-Range:Range.NominalValue HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
frequencyMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.frequencyMax Short description Frequency / maximumValue Alternate names maximumWaarde, Frequentie Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-Range:Range.MaximumValue
period	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.period Short description Frequency / Interval Alternate names Frequentie, Interval Definition Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
periodMax	Σ	0..1	decimal	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data Type decimal Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
periodUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.periodUnit Short description Frequency / Interval Alternate names Frequentie, Interval Definition The units of time for the period in UCUM units for Frequency and Interval. If the `extension:timingExact` element is absent or set to false, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to true, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). Comments Notes on the CBB concepts Frequency and Interval: An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is not represented as a frequency, but with the `.count` element. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: CBB concept Frequency: With time unit: Nominal value: `.frequency`, `.period` and `.periodUnit` Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` Without time unit: Nominal value: `.count` Range: `.count` and `.countMax` CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to true) Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19949 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19950 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval
dayOfWeek	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek Short description WeekDay Alternate names Weekdag Definition WeekDay indicates a pattern of doses on fixed week days. Comments If no days are specified, the action is assumed to happen every day as otherwise specified. Data Type code Binding Use ConceptMap 'WeekDay_to_DaysOfWeek' to translate CBB terminology to profile terminology in ValueSet 'DaysOfWeek.' DaysOfWeek (required) Permitted Values WeekDay_to_DaysOfWeek Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19952 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.WeekDay
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.timeOfDay Short description AdministrationTime Alternate names Toedientijd Definition The time of administration is a specific time of day (on the clock). This time usually isn’t (intended to be) exact. There can be multiple administering times in one day. The ideal time of administration can also be entered as a time of day (morning, afternoon, evening, night-time). The administration time is then to be left empty, and the time of day can be entered in the TimeOfDay concept. Comments If there's a timeOfDay, there cannot be a when, or vice versa. Data Type time Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19951 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.AdministrationTime
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.when Short description TimeOfDay Alternate names Dagdeel Definition Time of day: morning, afternoon, evening, night. Requirements Timings are frequently determined by occurrences such as waking, eating and sleep. Comments When more than one event is listed, the event is tied to the union of the specified events. Data Type code Binding Use ConceptMap 'TimeOfDay_to_EventTiming' to translate CBB terminology to profile terminology in ValueSet 'EventTiming.' EventTiming (required) Permitted Values TimeOfDay_to_EventTiming Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.event zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19953 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.TimeOfDay
offset	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.repeat.offset Short description Minutes from event (before or after) Definition The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. Comments 32 bit number; for values larger than this, use decimal Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). Comments BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). Data Type CodeableConcept Binding Code for a known / defined timing pattern. TimingAbbreviation (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:QSC.code
asNeeded[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBoolean			boolean	There are no (further) constraints on this element Data Type boolean
asNeededCodeableConcept	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept Short description Condition Alternate names Criterium Definition The condition for administering medication can be: a physiological measurement value (plasma glucose concentration, body temperature, blood pressure); a symptom or other circumstance (in the event of a headache, or itch). Physiological measurement values or other conditions do not need to be coded. These can be expressed in free text in the Description concept. Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Data Type CodeableConcept Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. AsNeededCriterium (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19945 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AsNeeded.Condition
site	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.site Short description Body site to administer to Definition Body site to administer to. Requirements A coded specification of the anatomic site where the medication first enters the body. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data Type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-2 rim:.approachSiteCode
route	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.route Short description RouteOfAdministration Alternate names Toedieningsweg Definition The route through which the medication is administered (oral, nasal, intravenous, etc.). Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Comments Please note that in contrast to the CBB, this RouteOfAdministration concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions. Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfMedicationAdministration (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-1 rim:.routeCode zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19941 HdBe-InstructionsForUse:InstructionsForUse.RouteOfAdministration
method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.method Short description Technique for administering medication Definition Technique for administering medication. Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Comments Terminologies used often pre-coordinate this term with the route and or form of administration. Data Type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-4 rim:.doseQuantity
doseAndRate	Σ	0..*	Element	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate Short description Dosage Alternate names Dosering Definition Instructions for the administrator to administer the medication (the patient themselves, a nurse or other aid). When taking stock of medication use, the dosage describes the pattern of use established by the patient. Once the dose schedule (distribution of doses over time) and the dose have been determined, then there should be one single instruction for use. Multiple parallel instructions for use can be included in the event of a changing dose within one day and in the event of a variable use frequency. Multiple sequential instructions for use can be included in the event of changing doses within one period and/or in the event of a changing dose schedule. Comments DurationOfAdministration is not mapped to this element but to `.timing.repeat.duration` and `.timing.repeat.durationUnit`. Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-2 zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19935 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-21; RXE-23
dose[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x] Short description Dose Alternate names Keerdosis Definition The dose indicates the amount/unit per administration. The unit can be any unit that can occur with this particular medicine. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19940 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.Dose
doseRange	Σ	0..1	Range	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data Type Range Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity
low	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short description minimumValue Alternate names minimumWaarde Definition The minimal value of the range. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.1 rim:./low zib-range-v1.0.1-2020EN:NL-CM:20.1.2 HdBe-Range:Range.MinimumValue
high	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short description maximumValue Alternate names maximumWaarde Definition The maximum value of the range. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.2 rim:./high zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-Range:Range.MaximumValue
doseQuantity	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short description nominalValue Alternate names nominaleWaarde Definition Amount of medication per dose. The nominal value of the quantity. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-Range:Range.NominalValue
rate[x]	Σ	0..1		There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x] Short description AdministeringSpeed Alternate names Toedieningssnelheid Definition The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: amount = 10, dose unit = ml, time unit = hour Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19942 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AdministeringSpeed
rateRatio			Ratio	There are no (further) constraints on this element Data Type Ratio
rateRange	Σ	0..1	Range	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data Type Range Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity
low	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Short description minimumValue Alternate names minimumWaarde Definition The minimal value of the range. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.1 rim:./low zib-range-v1.0.1-2020EN:NL-CM:20.1.2 HdBe-Range:Range.MinimumValue
high	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high Short description maximumValue Alternate names maximumWaarde Definition The maximum value of the range. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values v2:NR.2 rim:./high zib-range-v1.0.1-2020EN:NL-CM:20.1.3 HdBe-Range:Range.MaximumValue
rateQuantity	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity Short description nominalValue Alternate names nominaleWaarde Definition The nominal value of the quantity. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 rim:.rateQuantity zib-range-v1.0.1-2020EN:NL-CM:20.1.4 HdBe-Range:Range.NominalValue
maxDosePerPeriod	Σ I	0..1	Ratio	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerPeriod Short description MaximumDose Alternate names MaximaleDosering Definition A maximum dose maximizes (in time) the usage of a drug in an 'as needed' prescription. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Data Type Ratio Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` rat-1:Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())` Mappings rim:n/a v2:N/A rim:RTO v2:RXO-23, RXE-19 rim:.maxDoseQuantity zib-instructionsforuse-v1.2.1-2020EN:NL-CM:9.12.19946 HdBe-InstructionsForUse:InstructionsForUse.DosingInstructions.Dosage.AsNeeded.MaximumDose
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:not supported
maxDosePerLifetime	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:not supported
dispenseRequest		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest Short description Medication supply authorization Definition Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:Message/Body/NewRx/MedicationPrescribed/ExpirationDate rim:component.supplyEvent
initialFill		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill Short description First fill details Definition Indicates the quantity or duration for the first dispense of the medication. Comments If populating this element, either the quantity or the duration must be included. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill.quantity Short description First fill quantity Definition The amount or quantity to provide as part of the first dispense. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:Supply.quantity[moodCode=RQO]
duration	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.initialFill.duration Short description First fill duration Definition The length of time that the first dispense is expected to last. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values rim:Supply.effectivetime[moodCode=RQO]
dispenseInterval	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.dispenseInterval Short description Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values rim:Supply.effectivetime[moodCode=RQO]
validityPeriod	I	0..1	Period	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription). Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] script10.6:Message/Body/NewRx/MedicationPrescribed/Refills rim:effectiveTime
numberOfRepeatsAllowed		0..1	unsignedInt	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. Comments If displaying "number of authorized fills", add 1 to this number. Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:Message/Body/NewRx/MedicationPrescribed/Quantity v2:RXE-12-Number of Refills rim:repeatNumber
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.quantity Short description Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data Type SimpleQuantity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1:The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values script10.6:Message/Body/NewRx/MedicationPrescribed/DaysSupply v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim:quantity
expectedSupplyDuration	I	0..1	Duration	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. Data Type Duration Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3:If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim:n/a v2:SN (see also Range) or CQ rim:PQ, IVL<PQ>, MO, CO, depending on the values rim:PQ, IVL<PQ> depending on the values script10.6:Message/Body/NewRx/MedicationPrescribed/Substitutions rim:expectedUseTime
performer	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id MedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.who rim:.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
substitution		0..1	BackboneElement	There are no (further) constraints on this element Element Id MedicationRequest.substitution Short description Any restrictions on medication substitution Definition Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions rim:subjectOf.substitutionPersmission
allowed[x]		1..1		There are no (further) constraints on this element Element Id MedicationRequest.substitution.allowed[x] Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed. Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Binding Identifies the type of substitution allowed. v3.ActSubstanceAdminSubstitutionCode (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2:RXO-9-Allow Substitutions / RXE-9-Substitution Status rim:code
allowedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
allowedCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
reason		0..1	CodeableConcept	There are no (further) constraints on this element Element Id MedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD script10.6:not mapped v2:RXE-9 Substition status rim:reasonCode
priorPrescription	I	0..1	Reference(MedicationRequest)	There are no (further) constraints on this element Element Id MedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(MedicationRequest) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.replaces script10.6:not mapped rim:.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
detectedIssue	I	0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element Id MedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. Comments This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. Data Type Reference(DetectedIssue) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
eventHistory	I	0..*	Reference(Provenance)	There are no (further) constraints on this element Element Id MedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data Type Reference(Provenance) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Request.relevantHistory rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Mapping FHIR profile to CBB

Path	map	CBB	comment
MedicationRequest.extension:renderedDosageInstruction	InstructionsForUse.Description	HdBe-InstructionsForUse
MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule	InstructionsForUse.RepeatPeriodCyclicalSchedule	HdBe-InstructionsForUse
MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.value[x]	InstructionsForUse.RepeatPeriodCyclicalSchedule	HdBe-InstructionsForUse
MedicationRequest	MedicationAgreement	HdBe-MedicationAgreement
MedicationRequest.extension:medicationAgreementAdditionalInformation.value[x]	MedicationAgreement.MedicationAgreementAdditionalInformation	HdBe-MedicationAgreement
MedicationRequest.extension:periodOfUse.value[x]	MedicationAgreement.PeriodOfUse	HdBe-MedicationAgreement
MedicationRequest.modifierExtension:stopType.value[x]	MedicationAgreement.MedicationAgreementStopType	HdBe-MedicationAgreement
MedicationRequest.status	MedicationAgreement.PeriodOfUse	HdBe-MedicationAgreement	implicit, main mapping is on the extensions ext-TimeInterval.Period and ext-TimeInterval.Duration
MedicationRequest.status	MedicationAgreement.MedicationAgreementStopType	HdBe-MedicationAgreement	implicit, main mapping is on StopType extension
MedicationRequest.medication[x]:medicationReference	MedicationAgreement.AgreedMedicine	HdBe-MedicationAgreement
MedicationRequest.authoredOn	MedicationAgreement.MedicationAgreementDateTime	HdBe-MedicationAgreement
MedicationRequest.requester	MedicationAgreement.Prescriber	HdBe-MedicationAgreement
MedicationRequest.reasonCode	MedicationAgreement.ReasonMedicationAgreement	HdBe-MedicationAgreement
MedicationRequest.reasonReference	MedicationAgreement.PrescriptionReason	HdBe-MedicationAgreement
MedicationRequest.note.text	MedicationAgreement.Comment	HdBe-MedicationAgreement
MedicationRequest.dosageInstruction	MedicationAgreement.InstructionsForUse	HdBe-MedicationAgreement

HdBe-MedicationAgreement-01

zib MedicationAgreement difference

Concept	Category	Description
`status`	textual	Replaced Dutch SNOMED-CT codes with the corresponding codes in the ValueSet MedicationStopType in the guidance on the correct use of status.
`reasonReference`	textual	Removed context regarding the Dutch G-standard.
`modifierExtension:stopType`	terminology	Renamed ValueSet from MedicationAgreementStopType to MedicationStopType, to be able to reuse it at MedicationUse and AdministrationAgreement. Also replaced Dutch SNOMED-CT codes with international codes in ValueSet MedicationStopType.
`reasonCode`	terminology	Renamed ValueSet from MedicationAgreementReason to MedicationReason, to be able to reuse it at MedicationUse2. Replaced several values in ValueSet. 1. Added SNOMED-CT code for Unknown and Other. 2. Added CodeSystem MedicationReason which replaces all Dutch SNOMED-CT codes. 3. Removed all Dutch SNOMED-CT codes from valueset.
`extension:medicationAgreementAdditionalInformation`	terminology	Replaced several values in MedicationAgreementAdditionalInformation valueSet. 1. Replaced OTH with SNOMED-CT code for Other. 2. Added SNOMED-CT code for Unknown. 3. Added CodeSystem MedicationAgreementAdditionalInformation which replaces all Dutch SNOMED-CT codes. 4. Removed all Dutch SNOMED-CT codes from valueset.

Terminology Bindings

Path	Name	Strength	URL	ConceptMap
MedicationRequest.reasonCode	MedicationReason	required	https://fhir.healthdata.be/ValueSet/MedicationReason	No bound ConceptMap