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	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
modifierExtension	?! I	0..*	Extension	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
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	CodeableConcept	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) 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 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
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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	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
modifierExtension	?! I	0..*	Extension	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
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	CodeableConcept	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) 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 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
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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	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
modifierExtension	?! I	0..*	Extension	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
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	CodeableConcept	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) 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 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
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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	DurationBinding	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 Binding Appropriate units for Duration. CommonUCUMCodesForDuration (extensible) 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	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