EPAMedicationRequest

Das EPAMedicationRequest-Profil fasst die Verschreibungsdaten zusammen, welche durch den E-Rezept-Fachdienst in den Medication Service eingestellt werden. In ihr werden neben des verschriebenen Arzneimittels, ausstellende(r) Arzt/(Praxis), Zeitpunkt sowie der/die Patient:in festgehalten.

Profile

EPA MedicationRequest

idΣ0..1string
id0..1string
extensionI0..*Extension
versionIdS Σ0..1id
lastUpdatedS Σ0..1instant
sourceΣ0..1uri
profileΣ0..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
medicationRequestLinkedStatementI0..*Extension(Reference(EPAMedicationStatement))
id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueBooleanboolean
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..0string
systemΣ I0..0uri
codeΣ0..0code
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..0string
systemΣ I0..0uri
codeΣ0..0code
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
startS Σ I1..1dateTime
endS Σ I0..1dateTime
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemS Σ0..1uriFixed Value
valueS Σ0..1string
periodΣ I0..0Period
assignerΣ I0..0Reference(Organization)
url1..1uriFixed Value
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueBooleanboolean
modifierExtension?! I0..*Extension
RxPrescriptionProcessIdentifier0..1RxPrescriptionProcessIdentifierPattern
RxOriginatorProcessIdentifier0..1RxOriginatorProcessIdentifierPattern
statusΣ ?!1..1codeBinding
statusReason0..1CodeableConcept
intentS Σ ?!1..1codeBinding
category0..*CodeableConcept
priorityΣ0..1codeBinding
doNotPerformΣ ?!0..1boolean
reportedBooleanboolean
reportedReferenceReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
medicationReferenceReference(Medication)
id0..1string
extensionI0..*Extension
referenceΣ I0..1string
typeΣ0..1uriBinding
identifierS Σ1..1IdentifierKvid10
displayΣ0..1string
encounterI0..1Reference(Encounter)
supportingInformationI0..*Reference(Resource)
authoredOnS Σ1..1dateTime
requesterS Σ I0..1Reference(PractitionerRole)
performerI0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)
performerTypeΣ0..1CodeableConcept
recorderI0..1Reference(Practitioner | PractitionerRole)
reasonCode0..*CodeableConcept
reasonReferenceI0..*Reference(Condition | Observation)
instantiatesCanonicalΣ0..*canonical()
instantiatesUriΣ0..*uri
basedOnΣ I0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)
groupIdentifierΣ0..1Identifier
courseOfTherapyType0..1CodeableConcept
insuranceI0..*Reference(Coverage | ClaimResponse)
id0..1string
extensionI0..*Extension
authorStringstring
authorReferenceReference(Practitioner | Patient | RelatedPerson | Organization)
timeΣ0..1dateTime
textS Σ1..1markdown
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
sequenceΣ0..1integer
textS Σ0..1string
additionalInstructionΣ0..*CodeableConcept
patientInstructionS Σ0..1string
timingΣ0..1Timing
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
siteΣ0..1CodeableConcept
routeΣ0..1CodeableConcept
methodΣ0..1CodeableConcept
id0..1string
extensionI0..*Extension
typeΣ0..1CodeableConcept
doseRangeRange
doseQuantitySimpleQuantity
rateRatioRatio
rateRangeRange
rateQuantitySimpleQuantity
maxDosePerPeriodΣ I0..1Ratio
maxDosePerAdministrationΣ I0..1SimpleQuantity
maxDosePerLifetimeΣ I0..1SimpleQuantity
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
quantityI0..1SimpleQuantity
durationI0..1Duration
dispenseIntervalI0..1Duration
validityPeriodI0..1Period
numberOfRepeatsAllowed0..1unsignedInt
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I1..1uriPattern
codeS Σ1..1codePattern
expectedSupplyDurationI0..1Duration
performerI0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
allowedBooleanboolean
reason0..1CodeableConcept
priorPrescriptionI0..1Reference(MedicationRequest)
detectedIssueI0..*Reference(DetectedIssue)
eventHistoryI0..*Reference(Provenance)
MedicationRequest
DefinitionAn order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Cardinality0...*
AliasPrescription, Order
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Request
  • script10.6: Message/Body/NewRx
  • rim: CombinedMedicationRequest
MedicationRequest.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
SummaryTrue
Comments

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

MedicationRequest.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.meta.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.meta.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.meta.versionId
DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Cardinality0...1
Typeid
Must SupportTrue
SummaryTrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.lastUpdated
DefinitionWhen the resource last changed - e.g. when the version changed.
Cardinality0...1
Typeinstant
Must SupportTrue
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.source
DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Cardinality0...1
Typeuri
SummaryTrue
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.profile
DefinitionA list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
Cardinality0...*
Typecanonical(StructureDefinition)
SummaryTrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
MedicationRequest.meta.security
DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Cardinality0...*
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

All Security Labels (extensible)
SummaryTrue
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
MedicationRequest.meta.tag
DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Cardinality0...*
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)
SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
MedicationRequest.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

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

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

A human language.

CommonLanguages (preferred)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

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

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

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

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:medicationRequestLinkedStatement
DefinitionThis FHIR extension is designed for use within the MedicationRequest resource to establish a direct linkage to one or more MedicationStatement resources. It enables the association of medication requests with specific medication statements, facilitating a clear understanding of the relationship between prescribed medications and the patient's medication history. This extension is crucial for ensuring comprehensive medication management and tracking within patient care workflows.
Cardinality0...*
TypeExtension(Reference(EPAMedicationStatement))
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription
DefinitionThis FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.
Cardinality0...1
TypeExtension(Complex)
Must SupportTrue
Aliasextensions, user content
Comments

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

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

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

SlicingUnordered, Closed, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:indicator
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...1
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:indicator.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:multiplePrescription.extension:indicator.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

indicator

Mappings
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
DefinitionIndicator of whether the current prescription is part of a multiple prescription true - the current prescription is part of a multiple prescription false - the current prescription is not part of a multiple prescription
Cardinality1...1
Typeboolean
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:counter
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...1
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:counter.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:multiplePrescription.extension:counter.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

counter

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

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

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

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

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
DefinitionThe field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4"
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

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

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

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

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

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

Comments

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

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

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

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
DefinitionThe field serves to indicate the length of this series. Example: "4" in "2 out of 4"
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

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

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

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

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

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

Comments

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:period.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:multiplePrescription.extension:period.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

period

Mappings
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:period.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypePeriod
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD
    start.toString().length()=10
  • -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD
    end.exists().not() or end.toString().length()=10
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:period.value[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:multiplePrescription.extension:period.value[x].extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
DefinitionDate from which the partial prescription of the multiple prescription can be redeemed
Cardinality1...1
TypedateTime
Must SupportTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
MedicationRequest.extension:multiplePrescription.extension:period.value[x].end
DefinitionDate of the last redemption day for the partial prescription within the multiple prescription series. The issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)
Cardinality0...1
TypedateTime
Must SupportTrue
SummaryTrue
Comments

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:multiplePrescription.extension:id.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:multiplePrescription.extension:id.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

id

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

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

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

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

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

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

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)
SummaryTrue
Requirements

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

Comments

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

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

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

Comments

Identifier.system is always case sensitive.

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

urn:ietf:rfc:3986

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
DefinitionA unique ID that is identical across all partial prescriptions of a multiple prescription.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

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

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

123456


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

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

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

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

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

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

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

Fixed Value

https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension

Mappings
  • rim: N/A
MedicationRequest.extension:multiplePrescription.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...0
Typebase64Binary
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:isBvg
DefinitionIndicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.
Cardinality0...1
TypeExtension(boolean)
Must SupportTrue
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.extension:isBvg.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.extension:isBvg.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension

Mappings
  • rim: N/A
MedicationRequest.extension:isBvg.value[x]
DefinitionIndicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG). false - not BVG (default value) true - BVG
Cardinality1...1
Typeboolean
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

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

Comments

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

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

This is a business identifier, not a resource identifier.

SlicingUnordered, Open, by $this(Pattern)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • script10.6: Message/Header/PrescriberOrderNumber
  • w5: FiveWs.identifier
  • v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
  • rim: .id
MedicationRequest.identifier:RxPrescriptionProcessIdentifier
DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Cardinality0...1
TypeRxPrescriptionProcessIdentifier
Comments

This is a business identifier, not a resource identifier.

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

{
  "system": "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"
}

Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • script10.6: Message/Header/PrescriberOrderNumber
  • w5: FiveWs.identifier
  • v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
  • rim: .id
MedicationRequest.identifier:RxOriginatorProcessIdentifier
DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Cardinality0...1
TypeRxOriginatorProcessIdentifier
Comments

This is a business identifier, not a resource identifier.

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

{
  "system": "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
}

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

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

EPAMedicationRequestVS (required)
ModifierTrue
SummaryTrue
Comments

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

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

Identifies the reasons for a given status.

medicationRequest Status Reason Codes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.statusReason
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
MedicationRequest.intent
DefinitionWhen data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.
Cardinality1...1
Typecode
Binding

The kind of medication order.

medicationRequest Intent (required)
Must SupportTrue
ModifierTrue
SummaryTrue
Comments

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

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

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

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

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

medicationRequest Category Codes (example)
Comments

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

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

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

RequestPriority (required)
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

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

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
  • w5: FiveWs.subject[x]
  • v2: PID-3-Patient ID List
  • rim: .participation[typeCode=AUT].role
  • w5: FiveWs.subject
MedicationRequest.subject.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.subject.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.subject.reference
DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality0...1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.subject.type
DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality0...1
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)
SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.subject.identifier
DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Cardinality1...1
TypeIdentifierKvid10
Must SupportTrue
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
MedicationRequest.subject.display
DefinitionPlain text narrative that identifies the resource in addition to the resource reference.
Cardinality0...1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.encounter
DefinitionThe Encounter during which this [x] was created or to which the creation of this record is tightly associated.
Cardinality0...1
TypeReference(Encounter)
Comments

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
  • w5: FiveWs.context
  • rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
MedicationRequest.authoredOn
DefinitionIssue Date of the Prescription
Cardinality1...1
TypedateTime
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
  • w5: FiveWs.recorded
  • v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
  • rim: author.time
MedicationRequest.requester
DefinitionThe individual, organization, or device that initiated the request and has responsibility for its activation.
Cardinality0...1
TypeReference(PractitionerRole)
Must SupportTrue
SummaryTrue
Comments

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

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

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

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

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

ProcedurePerformerRoleCodes (example)
SummaryTrue
Comments

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

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

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

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

A coded concept indicating why the medication was ordered.

Condition/Problem/DiagnosisCodes (example)
Comments

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

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

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

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

see Canonical References

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

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

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

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

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

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

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

Identifies the overall pattern of medication administratio.

medicationRequest Course of Therapy Codes (example)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: Act.code where classCode = LIST and moodCode = EVN
MedicationRequest.insurance
DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Cardinality0...*
TypeReference(Coverage | ClaimResponse)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.insurance
  • rim: .outboundRelationship[typeCode=COVBY].target
MedicationRequest.note
DefinitionExtra information about the prescription that could not be conveyed by the other attributes.
Cardinality0...1
TypeAnnotation
Must SupportTrue
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Note
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationRequest.note.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.note.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.note.author[x]
DefinitionThe individual responsible for making the annotation.
Cardinality0...1
TypeReference(Practitioner | Patient | RelatedPerson | Organization)
SummaryTrue
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
MedicationRequest.note.time
DefinitionIndicates when this particular annotation was made.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
MedicationRequest.note.text
DefinitionInstructions to the pharmacy that go beyond the dosage information
Cardinality1...1
Typemarkdown
Must SupportTrue
SummaryTrue
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/

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
MedicationRequest.dosageInstruction
DefinitionIndicates how the medication is to be used by the patient.
Cardinality0...1
TypeDosage
Must SupportTrue
Comments

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

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

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

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

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.sequence
DefinitionIndicates the order in which the dosage instructions should be applied or interpreted.
Cardinality0...1
Typeinteger
SummaryTrue
Requirements

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-1
  • rim: .text
MedicationRequest.dosageInstruction.text
DefinitionDosage Instructions of a Prescription
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-6; RXE-21
  • rim: .text
MedicationRequest.dosageInstruction.additionalInstruction
DefinitionSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
Cardinality0...*
TypeCodeableConcept
Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)
SummaryTrue
Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-7
  • rim: .text
MedicationRequest.dosageInstruction.patientInstruction
DefinitionInstructions for Use
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-7
  • rim: .text
MedicationRequest.dosageInstruction.timing
DefinitionWhen medication should be administered.
Cardinality0...1
TypeTiming
SummaryTrue
Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: QSET<TS> (GTS)
  • rim: .effectiveTime
MedicationRequest.dosageInstruction.asNeeded[x]
DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Cardinality0...1
Typeboolean
Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

SNOMEDCTMedicationAsNeededReasonCodes (example)
SummaryTrue
Comments

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-9
  • rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
MedicationRequest.dosageInstruction.site
DefinitionBody site to administer to.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)
SummaryTrue
Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-2
  • rim: .approachSiteCode
MedicationRequest.dosageInstruction.route
DefinitionHow drug should enter body.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMEDCTRouteCodes (example)
SummaryTrue
Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-1
  • rim: .routeCode
MedicationRequest.dosageInstruction.method
DefinitionTechnique for administering medication.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)
SummaryTrue
Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-4
  • rim: .doseQuantity
MedicationRequest.dosageInstruction.doseAndRate
DefinitionThe amount of medication administered.
Cardinality0...*
TypeElement
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-2
MedicationRequest.dosageInstruction.doseAndRate.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dosageInstruction.doseAndRate.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
MedicationRequest.dosageInstruction.doseAndRate.type
DefinitionThe kind of dose or rate specified, for example, ordered or calculated.
Cardinality0...1
TypeCodeableConcept
Binding

The kind of dose or rate specified.

DoseAndRateType (example)
SummaryTrue
Requirements

If the type is not populated, assume to be "ordered".

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-21; RXE-23
MedicationRequest.dosageInstruction.doseAndRate.dose[x]
DefinitionAmount of medication per dose.
Cardinality0...1
TypeRange
SummaryTrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
MedicationRequest.dosageInstruction.doseAndRate.rate[x]
DefinitionAmount of medication per unit of time.
Cardinality0...1
TypeRatio
SummaryTrue
Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXE22, RXE23, RXE-24
  • rim: .rateQuantity
MedicationRequest.dosageInstruction.maxDosePerPeriod
DefinitionUpper limit on medication per unit of time.
Cardinality0...1
TypeRatio
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
    (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: RTO
  • v2: RXO-23, RXE-19
  • rim: .maxDoseQuantity
MedicationRequest.dosageInstruction.maxDosePerAdministration
DefinitionUpper limit on medication per administration.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
MedicationRequest.dosageInstruction.maxDosePerLifetime
DefinitionUpper limit on medication per lifetime of the patient.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
MedicationRequest.dispenseRequest
DefinitionIndicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Cardinality1...1
TypeBackboneElement
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
  • rim: component.supplyEvent
MedicationRequest.dispenseRequest.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationRequest.dispenseRequest.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Comments

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

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

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

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

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

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

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

Comments

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

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

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

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

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

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

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

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

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

Comments

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

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

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

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

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

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

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

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

Precision is handled implicitly in almost all cases of measurement.

Comments

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

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

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

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

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

http://unitsofmeasure.org

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

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

Comments

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

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

{Package}

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

In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim: expectedUseTime
MedicationRequest.dispenseRequest.performer
DefinitionIndicates the intended dispensing Organization specified by the prescriber.
Cardinality0...1
TypeReference(Organization)
Comments

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

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

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

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

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

Comments

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

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

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

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

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

v3.SubstanceAdminSubstitutionReason (example)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • script10.6: not mapped
  • v2: RXE-9 Substition status
  • rim: reasonCode
MedicationRequest.priorPrescription
DefinitionA link to a resource representing an earlier order related order or prescription.
Cardinality0...1
TypeReference(MedicationRequest)
Comments

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

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

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.relevantHistory
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="epa-medication-request" />
    <url value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-request" />
    <version value="1.1.1" />
    <name value="EPAMedicationRequest" />
    <title value="EPA MedicationRequest" />
    <status value="active" />
    <experimental value="false" />
    <date value="2024-08-14" />
    <publisher value="gematik GmbH" />
    <description value="Defines the medication request resource for the Medication Service in the ePA system." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationRequest" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationRequest.meta">
            <path value="MedicationRequest.meta" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.meta.versionId">
            <path value="MedicationRequest.meta.versionId" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.meta.lastUpdated">
            <path value="MedicationRequest.meta.lastUpdated" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:medicationRequestLinkedStatement">
            <path value="MedicationRequest.extension" />
            <sliceName value="medicationRequestLinkedStatement" />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension" />
            </type>
        </element>
        <element id="MedicationRequest.extension:multiplePrescription">
            <path value="MedicationRequest.extension" />
            <sliceName value="multiplePrescription" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:indicator">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="indicator" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]">
            <path value="MedicationRequest.extension.extension.value[x]" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:counter">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="counter" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:counter.value[x]">
            <path value="MedicationRequest.extension.extension.value[x]" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator">
            <path value="MedicationRequest.extension.extension.value[x].numerator" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value">
            <path value="MedicationRequest.extension.extension.value[x].numerator.value" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator">
            <path value="MedicationRequest.extension.extension.value[x].denominator" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value">
            <path value="MedicationRequest.extension.extension.value[x].denominator.value" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:period">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="period" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:period.value[x]">
            <path value="MedicationRequest.extension.extension.value[x]" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:period.value[x].start">
            <path value="MedicationRequest.extension.extension.value[x].start" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:period.value[x].end">
            <path value="MedicationRequest.extension.extension.value[x].end" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:id">
            <path value="MedicationRequest.extension.extension" />
            <sliceName value="id" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:id.value[x]">
            <path value="MedicationRequest.extension.extension.value[x]" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:id.value[x].system">
            <path value="MedicationRequest.extension.extension.value[x].system" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:multiplePrescription.extension:id.value[x].value">
            <path value="MedicationRequest.extension.extension.value[x].value" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:isBvg">
            <path value="MedicationRequest.extension" />
            <sliceName value="isBvg" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.extension:isBvg.value[x]">
            <path value="MedicationRequest.extension.value[x]" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.identifier">
            <path value="MedicationRequest.identifier" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="$this" />
                </discriminator>
                <description value="ePrescription identifier and overall transaction identifier" />
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="MedicationRequest.identifier:RxPrescriptionProcessIdentifier">
            <path value="MedicationRequest.identifier" />
            <sliceName value="RxPrescriptionProcessIdentifier" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Identifier" />
                <profile value="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier" />
            </type>
            <patternIdentifier>
                <system value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier" />
            </patternIdentifier>
        </element>
        <element id="MedicationRequest.identifier:RxOriginatorProcessIdentifier">
            <path value="MedicationRequest.identifier" />
            <sliceName value="RxOriginatorProcessIdentifier" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Identifier" />
                <profile value="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-originator-process-identifier" />
            </type>
            <patternIdentifier>
                <system value="https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier" />
            </patternIdentifier>
        </element>
        <element id="MedicationRequest.status">
            <path value="MedicationRequest.status" />
            <short value="Status of Medication Request" />
            <binding>
                <strength value="required" />
                <valueSet value="https://gematik.de/fhir/terminology/ValueSet/epa-medication-request-vs" />
            </binding>
        </element>
        <element id="MedicationRequest.intent">
            <path value="MedicationRequest.intent" />
            <short value="filler-order" />
            <definition value="When data is synchronized with the E-Rezept-Fachdienst, the &#39;filler-order&#39; code should be used here." />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.medication[x]">
            <path value="MedicationRequest.medication[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.subject">
            <path value="MedicationRequest.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.subject.identifier">
            <path value="MedicationRequest.subject.identifier" />
            <min value="1" />
            <type>
                <code value="Identifier" />
                <profile value="http://fhir.de/StructureDefinition/identifier-kvid-10" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.authoredOn">
            <path value="MedicationRequest.authoredOn" />
            <short value="Issue Date" />
            <definition value="Issue Date of the Prescription" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.requester">
            <path value="MedicationRequest.requester" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.note">
            <path value="MedicationRequest.note" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.note.text">
            <path value="MedicationRequest.note.text" />
            <short value="Dispensing Note" />
            <definition value="Instructions to the pharmacy that go beyond the dosage information" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dosageInstruction">
            <path value="MedicationRequest.dosageInstruction" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dosageInstruction.text">
            <path value="MedicationRequest.dosageInstruction.text" />
            <short value="Dosage Instructions" />
            <definition value="Dosage Instructions of a Prescription" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dosageInstruction.patientInstruction">
            <path value="MedicationRequest.dosageInstruction.patientInstruction" />
            <short value="Instructions for Use" />
            <definition value="Instructions for Use" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest">
            <path value="MedicationRequest.dispenseRequest" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity">
            <path value="MedicationRequest.dispenseRequest.quantity" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.value">
            <path value="MedicationRequest.dispenseRequest.quantity.value" />
            <short value="Number of Prescribed Packages" />
            <definition value="Number of Prescribed Packages" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.system">
            <path value="MedicationRequest.dispenseRequest.quantity.system" />
            <min value="1" />
            <patternUri value="http://unitsofmeasure.org" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.dispenseRequest.quantity.code">
            <path value="MedicationRequest.dispenseRequest.quantity.code" />
            <min value="1" />
            <patternCode value="{Package}" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.substitution">
            <path value="MedicationRequest.substitution" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationRequest.substitution.allowed[x]">
            <path value="MedicationRequest.substitution.allowed[x]" />
            <type>
                <code value="boolean" />
            </type>
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "epa-medication-request",
    "url": "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-request",
    "version": "1.1.1",
    "name": "EPAMedicationRequest",
    "title": "EPA MedicationRequest",
    "status": "active",
    "experimental": false,
    "date": "2024-08-14",
    "publisher": "gematik GmbH",
    "description": "Defines the medication request resource for the Medication Service in the ePA system.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "MedicationRequest",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationRequest.meta",
                "path": "MedicationRequest.meta",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.meta.versionId",
                "path": "MedicationRequest.meta.versionId",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.meta.lastUpdated",
                "path": "MedicationRequest.meta.lastUpdated",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:medicationRequestLinkedStatement",
                "path": "MedicationRequest.extension",
                "sliceName": "medicationRequestLinkedStatement",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription",
                "path": "MedicationRequest.extension",
                "sliceName": "multiplePrescription",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:indicator",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "indicator"
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]",
                "path": "MedicationRequest.extension.extension.value[x]",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:counter",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "counter"
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:counter.value[x]",
                "path": "MedicationRequest.extension.extension.value[x]",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator",
                "path": "MedicationRequest.extension.extension.value[x].numerator",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value",
                "path": "MedicationRequest.extension.extension.value[x].numerator.value",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator",
                "path": "MedicationRequest.extension.extension.value[x].denominator",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value",
                "path": "MedicationRequest.extension.extension.value[x].denominator.value",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:period",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "period"
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:period.value[x]",
                "path": "MedicationRequest.extension.extension.value[x]",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:period.value[x].start",
                "path": "MedicationRequest.extension.extension.value[x].start",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:period.value[x].end",
                "path": "MedicationRequest.extension.extension.value[x].end",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:id",
                "path": "MedicationRequest.extension.extension",
                "sliceName": "id"
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:id.value[x]",
                "path": "MedicationRequest.extension.extension.value[x]",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:id.value[x].system",
                "path": "MedicationRequest.extension.extension.value[x].system",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:multiplePrescription.extension:id.value[x].value",
                "path": "MedicationRequest.extension.extension.value[x].value",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:isBvg",
                "path": "MedicationRequest.extension",
                "sliceName": "isBvg",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.extension:isBvg.value[x]",
                "path": "MedicationRequest.extension.value[x]",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.identifier",
                "path": "MedicationRequest.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "rules": "open",
                    "description": "ePrescription identifier and overall transaction identifier",
                    "ordered": false
                }
            },
            {
                "id": "MedicationRequest.identifier:RxPrescriptionProcessIdentifier",
                "path": "MedicationRequest.identifier",
                "sliceName": "RxPrescriptionProcessIdentifier",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Identifier",
                        "profile":  [
                            "https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier"
                        ]
                    }
                ],
                "patternIdentifier": {
                    "system": "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"
                }
            },
            {
                "id": "MedicationRequest.identifier:RxOriginatorProcessIdentifier",
                "path": "MedicationRequest.identifier",
                "sliceName": "RxOriginatorProcessIdentifier",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Identifier",
                        "profile":  [
                            "https://gematik.de/fhir/epa-medication/StructureDefinition/rx-originator-process-identifier"
                        ]
                    }
                ],
                "patternIdentifier": {
                    "system": "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
                }
            },
            {
                "id": "MedicationRequest.status",
                "path": "MedicationRequest.status",
                "short": "Status of Medication Request",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://gematik.de/fhir/terminology/ValueSet/epa-medication-request-vs"
                }
            },
            {
                "id": "MedicationRequest.intent",
                "path": "MedicationRequest.intent",
                "short": "filler-order",
                "definition": "When data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.medication[x]",
                "path": "MedicationRequest.medication[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Medication"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.subject",
                "path": "MedicationRequest.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.subject.identifier",
                "path": "MedicationRequest.subject.identifier",
                "min": 1,
                "type":  [
                    {
                        "code": "Identifier",
                        "profile":  [
                            "http://fhir.de/StructureDefinition/identifier-kvid-10"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.authoredOn",
                "path": "MedicationRequest.authoredOn",
                "short": "Issue Date",
                "definition": "Issue Date of the Prescription",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.requester",
                "path": "MedicationRequest.requester",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.note",
                "path": "MedicationRequest.note",
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.note.text",
                "path": "MedicationRequest.note.text",
                "short": "Dispensing Note",
                "definition": "Instructions to the pharmacy that go beyond the dosage information",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dosageInstruction",
                "path": "MedicationRequest.dosageInstruction",
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dosageInstruction.text",
                "path": "MedicationRequest.dosageInstruction.text",
                "short": "Dosage Instructions",
                "definition": "Dosage Instructions of a Prescription",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dosageInstruction.patientInstruction",
                "path": "MedicationRequest.dosageInstruction.patientInstruction",
                "short": "Instructions for Use",
                "definition": "Instructions for Use",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest",
                "path": "MedicationRequest.dispenseRequest",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity",
                "path": "MedicationRequest.dispenseRequest.quantity",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.value",
                "path": "MedicationRequest.dispenseRequest.quantity.value",
                "short": "Number of Prescribed Packages",
                "definition": "Number of Prescribed Packages",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.system",
                "path": "MedicationRequest.dispenseRequest.quantity.system",
                "min": 1,
                "patternUri": "http://unitsofmeasure.org",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.dispenseRequest.quantity.code",
                "path": "MedicationRequest.dispenseRequest.quantity.code",
                "min": 1,
                "patternCode": "{Package}",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.substitution",
                "path": "MedicationRequest.substitution",
                "mustSupport": true
            },
            {
                "id": "MedicationRequest.substitution.allowed[x]",
                "path": "MedicationRequest.substitution.allowed[x]",
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "mustSupport": true
            }
        ]
    }
}

Identifier

Profil: RxPrescriptionProcessIdentifier

id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uriPattern
valueS Σ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
Identifier
DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
Identifier.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Identifier.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

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

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

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

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

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
Identifier.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

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

https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Identifier.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality1...1
Typestring
Must SupportTrue
SummaryTrue
Comments

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

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

123456


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

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

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="rx-prescription-process-identifier" />
    <url value="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier" />
    <version value="1.1.1" />
    <name value="RxPrescriptionProcessIdentifier" />
    <status value="active" />
    <experimental value="false" />
    <date value="2024-08-14" />
    <publisher value="gematik GmbH" />
    <description value="This transaction identifier is used to track medication prescription transactions between the E-Rezept-Fachdienst and the ePA. It is generated by the ePA Medication Service, ensuring a consistent and unique identification of each transaction. The identifier is composed of the PrescriptionId and the authoredOn-date of the operations parameters request, providing a robust mechanism for referencing and managing medication-related resources across systems." />
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <type value="Identifier" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Identifier" />
    <derivation value="constraint" />
    <differential>
        <element id="Identifier.system">
            <path value="Identifier.system" />
            <min value="1" />
            <patternUri value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Identifier.value">
            <path value="Identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "rx-prescription-process-identifier",
    "url": "https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier",
    "version": "1.1.1",
    "name": "RxPrescriptionProcessIdentifier",
    "status": "active",
    "experimental": false,
    "date": "2024-08-14",
    "publisher": "gematik GmbH",
    "description": "This transaction identifier is used to track medication prescription transactions between the E-Rezept-Fachdienst and the ePA. It is generated by the ePA Medication Service, ensuring a consistent and unique identification of each transaction. The identifier is composed of the PrescriptionId and the authoredOn-date of the operations parameters request, providing a robust mechanism for referencing and managing medication-related resources across systems.",
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "type": "Identifier",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Identifier",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Identifier.system",
                "path": "Identifier.system",
                "min": 1,
                "patternUri": "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier",
                "mustSupport": true
            },
            {
                "id": "Identifier.value",
                "path": "Identifier.value",
                "min": 1,
                "mustSupport": true
            }
        ]
    }
}

Profil: RxOriginatorProcessIdentifier

id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uriPattern
valueS Σ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
Identifier
DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
Identifier.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Identifier.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

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

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

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

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

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
Identifier.system
DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

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

https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Identifier.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality1...1
Typestring
Must SupportTrue
SummaryTrue
Comments

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

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

123456


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

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

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="rx-originator-process-identifier" />
    <url value="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-originator-process-identifier" />
    <version value="1.1.1" />
    <name value="RxOriginatorProcessIdentifier" />
    <status value="active" />
    <experimental value="false" />
    <date value="2024-08-14" />
    <publisher value="gematik GmbH" />
    <description value="The RxOriginatorProcessIdentifier, generated within the Medication Service, links the prescriptionID from the E-Rezept-Fachdienst with the original input FHIR resource ID, facilitating accurate tracking and utilization of medication data in operational processes within digital healthcare systems." />
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <type value="Identifier" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Identifier" />
    <derivation value="constraint" />
    <differential>
        <element id="Identifier.system">
            <path value="Identifier.system" />
            <min value="1" />
            <patternUri value="https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Identifier.value">
            <path value="Identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "rx-originator-process-identifier",
    "url": "https://gematik.de/fhir/epa-medication/StructureDefinition/rx-originator-process-identifier",
    "version": "1.1.1",
    "name": "RxOriginatorProcessIdentifier",
    "status": "active",
    "experimental": false,
    "date": "2024-08-14",
    "publisher": "gematik GmbH",
    "description": "The RxOriginatorProcessIdentifier, generated within the Medication Service, links the prescriptionID from the E-Rezept-Fachdienst with the original input FHIR resource ID, facilitating accurate tracking and utilization of medication data in operational processes within digital healthcare systems.",
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "type": "Identifier",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Identifier",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Identifier.system",
                "path": "Identifier.system",
                "min": 1,
                "patternUri": "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier",
                "mustSupport": true
            },
            {
                "id": "Identifier.value",
                "path": "Identifier.value",
                "min": 1,
                "mustSupport": true
            }
        ]
    }
}

Extensions

Profil: MedicationRequest Linked Statement

id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueReferenceReference(EPAMedicationStatement)
Extension
DefinitionThis FHIR extension is designed for use within the MedicationRequest resource to establish a direct linkage to one or more MedicationStatement resources. It enables the association of medication requests with specific medication statements, facilitating a clear understanding of the relationship between prescribed medications and the patient's medication history. This extension is crucial for ensuring comprehensive medication management and tracking within patient care workflows.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension

Mappings
  • rim: N/A
Extension.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...1
TypeReference(EPAMedicationStatement)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="medication-request-linked-statement-extension" />
    <url value="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension" />
    <version value="1.1.1" />
    <name value="MedicationRequestLinkedStatementExtension" />
    <title value="MedicationRequest Linked Statement" />
    <status value="active" />
    <experimental value="false" />
    <date value="2024-08-14" />
    <publisher value="gematik GmbH" />
    <description value="This FHIR extension is designed for use within the MedicationRequest resource to establish a direct linkage to one or more MedicationStatement resources. It enables the association of medication requests with specific medication statements, facilitating a clear understanding of the relationship between prescribed medications and the patient&#39;s medication history. This extension is crucial for ensuring comprehensive medication management and tracking within patient care workflows." />
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Element" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <short value="MedicationRequest Linked Statement" />
            <definition value="This FHIR extension is designed for use within the MedicationRequest resource to establish a direct linkage to one or more MedicationStatement resources. It enables the association of medication requests with specific medication statements, facilitating a clear understanding of the relationship between prescribed medications and the patient&#39;s medication history. This extension is crucial for ensuring comprehensive medication management and tracking within patient care workflows." />
        </element>
        <element id="Extension.extension">
            <path value="Extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-statement" />
            </type>
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "medication-request-linked-statement-extension",
    "url": "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension",
    "version": "1.1.1",
    "name": "MedicationRequestLinkedStatementExtension",
    "title": "MedicationRequest Linked Statement",
    "status": "active",
    "experimental": false,
    "date": "2024-08-14",
    "publisher": "gematik GmbH",
    "description": "This FHIR extension is designed for use within the MedicationRequest resource to establish a direct linkage to one or more MedicationStatement resources. It enables the association of medication requests with specific medication statements, facilitating a clear understanding of the relationship between prescribed medications and the patient's medication history. This extension is crucial for ensuring comprehensive medication management and tracking within patient care workflows.",
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Element"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "short": "MedicationRequest Linked Statement",
                "definition": "This FHIR extension is designed for use within the MedicationRequest resource to establish a direct linkage to one or more MedicationStatement resources. It enables the association of medication requests with specific medication statements, facilitating a clear understanding of the relationship between prescribed medications and the patient's medication history. This extension is crucial for ensuring comprehensive medication management and tracking within patient care workflows."
            },
            {
                "id": "Extension.extension",
                "path": "Extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-request-linked-statement-extension"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-statement"
                        ]
                    }
                ]
            }
        ]
    }
}

Profil: MultiplePrescription

id0..1string
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueBooleanboolean
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
valueΣ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..0string
systemΣ I0..0uri
codeΣ0..0code
id0..1string
extensionI0..*Extension
valueΣ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..0string
systemΣ I0..0uri
codeΣ0..0code
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
startΣ I1..1dateTime
endΣ I0..1dateTime
id0..1string
extensionI0..0Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ0..1uriFixed Value
valueΣ0..1string
periodΣ I0..0Period
assignerΣ I0..0Reference(Organization)
url1..1uriFixed Value
Extension
DefinitionThis FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Closed, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:indicator
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...1
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:indicator.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension:indicator.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

indicator

Mappings
  • rim: N/A
Extension.extension:indicator.value[x]
DefinitionIndicator of whether the current prescription is part of a multiple prescription true - the current prescription is part of a multiple prescription false - the current prescription is not part of a multiple prescription
Cardinality1...1
Typeboolean
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:counter
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...1
TypeExtension
Aliasextensions, user content
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:counter.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension:counter.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

counter

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

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

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

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

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:counter.value[x].numerator.value
DefinitionThe field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4"
Cardinality1...1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

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

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

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

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

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

Comments

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

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

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

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:counter.value[x].denominator.value
DefinitionThe field serves to indicate the length of this series. Example: "4" in "2 out of 4"
Cardinality1...1
Typedecimal
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

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

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

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Comments

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

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

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

Comments

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:period.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension:period.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

period

Mappings
  • rim: N/A
Extension.extension:period.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypePeriod
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD
    start.toString().length()=10
  • -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD
    end.exists().not() or end.toString().length()=10
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:period.value[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension:period.value[x].extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:period.value[x].start
DefinitionDate from which the partial prescription of the multiple prescription can be redeemed
Cardinality1...1
TypedateTime
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
Extension.extension:period.value[x].end
DefinitionDate of the last redemption day for the partial prescription within the multiple prescription series. The issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)
Cardinality0...1
TypedateTime
SummaryTrue
Comments

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

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

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.extension:id.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension:id.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

id

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

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

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

Identifies the purpose for this identifier, if known .

IdentifierUse (required)
ModifierTrue
SummaryTrue
Requirements

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

Comments

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

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

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)
SummaryTrue
Requirements

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

Comments

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

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

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

Comments

Identifier.system is always case sensitive.

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

urn:ietf:rfc:3986

Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Extension.extension:id.value[x].value
DefinitionA unique ID that is identical across all partial prescriptions of a multiple prescription.
Cardinality0...1
Typestring
SummaryTrue
Comments

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

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

123456


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

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

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

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

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

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

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

Fixed Value

https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension

Mappings
  • rim: N/A
Extension.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...0
Typebase64Binary
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="multiple-prescription-extension" />
    <url value="https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension" />
    <version value="1.1.1" />
    <name value="MultiplePrescriptionExtension" />
    <title value="MultiplePrescription" />
    <status value="active" />
    <experimental value="false" />
    <date value="2024-08-14" />
    <publisher value="gematik GmbH" />
    <description value="This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources." />
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Element" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <short value="MultiplePrescription" />
            <definition value="This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources." />
        </element>
        <element id="Extension.extension">
            <path value="Extension.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="closed" />
            </slicing>
        </element>
        <element id="Extension.extension:indicator">
            <path value="Extension.extension" />
            <sliceName value="indicator" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:indicator.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:indicator.url">
            <path value="Extension.extension.url" />
            <fixedUri value="indicator" />
        </element>
        <element id="Extension.extension:indicator.value[x]">
            <path value="Extension.extension.value[x]" />
            <short value="Multiple Prescription Indicator" />
            <definition value="Indicator of whether the current prescription is part of a multiple prescription\n\ntrue - the current prescription is part of a multiple prescription \nfalse - the current prescription is not part of a multiple prescription" />
            <min value="1" />
            <type>
                <code value="boolean" />
            </type>
        </element>
        <element id="Extension.extension:counter">
            <path value="Extension.extension" />
            <sliceName value="counter" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:counter.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.url">
            <path value="Extension.extension.url" />
            <fixedUri value="counter" />
        </element>
        <element id="Extension.extension:counter.value[x]">
            <path value="Extension.extension.value[x]" />
            <min value="1" />
            <type>
                <code value="Ratio" />
            </type>
        </element>
        <element id="Extension.extension:counter.value[x].numerator">
            <path value="Extension.extension.value[x].numerator" />
            <min value="1" />
        </element>
        <element id="Extension.extension:counter.value[x].numerator.value">
            <path value="Extension.extension.value[x].numerator.value" />
            <short value="Multiple Prescription Counter" />
            <definition value="The field serves to indicate which number in a series of multiple prescriptions it is. Example: &quot;2&quot; in &quot;2 out of 4&quot;" />
            <min value="1" />
        </element>
        <element id="Extension.extension:counter.value[x].numerator.comparator">
            <path value="Extension.extension.value[x].numerator.comparator" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].numerator.unit">
            <path value="Extension.extension.value[x].numerator.unit" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].numerator.system">
            <path value="Extension.extension.value[x].numerator.system" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].numerator.code">
            <path value="Extension.extension.value[x].numerator.code" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].denominator">
            <path value="Extension.extension.value[x].denominator" />
            <min value="1" />
        </element>
        <element id="Extension.extension:counter.value[x].denominator.value">
            <path value="Extension.extension.value[x].denominator.value" />
            <short value="Denominator of Multiple Prescription Series" />
            <definition value="The field serves to indicate the length of this series. Example: &quot;4&quot; in &quot;2 out of 4&quot;" />
            <min value="1" />
        </element>
        <element id="Extension.extension:counter.value[x].denominator.comparator">
            <path value="Extension.extension.value[x].denominator.comparator" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].denominator.unit">
            <path value="Extension.extension.value[x].denominator.unit" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].denominator.system">
            <path value="Extension.extension.value[x].denominator.system" />
            <max value="0" />
        </element>
        <element id="Extension.extension:counter.value[x].denominator.code">
            <path value="Extension.extension.value[x].denominator.code" />
            <max value="0" />
        </element>
        <element id="Extension.extension:period">
            <path value="Extension.extension" />
            <sliceName value="period" />
            <short value="Zeitraum der Einl&#246;sefrist" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:period.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:period.url">
            <path value="Extension.extension.url" />
            <fixedUri value="period" />
        </element>
        <element id="Extension.extension:period.value[x]">
            <path value="Extension.extension.value[x]" />
            <min value="1" />
            <type>
                <code value="Period" />
            </type>
            <constraint>
                <key value="-limitationDateStart" />
                <severity value="error" />
                <human value="Limitation of the date format to 10 characters YYYY-MM-DD" />
                <expression value="start.toString().length()=10" />
                <source value="https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension" />
            </constraint>
            <constraint>
                <key value="-limitationDateEnd" />
                <severity value="error" />
                <human value="Limitation of the date format to 10 characters YYYY-MM-DD" />
                <expression value="end.exists().not() or end.toString().length()=10" />
                <source value="https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension" />
            </constraint>
        </element>
        <element id="Extension.extension:period.value[x].start">
            <path value="Extension.extension.value[x].start" />
            <short value="Start Date of the Prescription Redemption Period" />
            <definition value="Date from which the partial prescription of the multiple prescription can be redeemed" />
            <min value="1" />
        </element>
        <element id="Extension.extension:period.value[x].end">
            <path value="Extension.extension.value[x].end" />
            <short value="End Date of the Prescription Redemption Period" />
            <definition value="Date of the last redemption day for the partial prescription within the multiple prescription series. \nThe issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)" />
        </element>
        <element id="Extension.extension:id">
            <path value="Extension.extension" />
            <sliceName value="id" />
            <min value="0" />
            <max value="1" />
        </element>
        <element id="Extension.extension:id.extension">
            <path value="Extension.extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.extension:id.url">
            <path value="Extension.extension.url" />
            <fixedUri value="id" />
        </element>
        <element id="Extension.extension:id.value[x]">
            <path value="Extension.extension.value[x]" />
            <min value="1" />
            <type>
                <code value="Identifier" />
            </type>
        </element>
        <element id="Extension.extension:id.value[x].use">
            <path value="Extension.extension.value[x].use" />
            <max value="0" />
        </element>
        <element id="Extension.extension:id.value[x].type">
            <path value="Extension.extension.value[x].type" />
            <max value="0" />
        </element>
        <element id="Extension.extension:id.value[x].system">
            <path value="Extension.extension.value[x].system" />
            <short value="Specification as UUID" />
            <fixedUri value="urn:ietf:rfc:3986" />
        </element>
        <element id="Extension.extension:id.value[x].value">
            <path value="Extension.extension.value[x].value" />
            <short value="Multiple Prescription ID" />
            <definition value="A unique ID that is identical across all partial prescriptions of a multiple prescription." />
        </element>
        <element id="Extension.extension:id.value[x].period">
            <path value="Extension.extension.value[x].period" />
            <max value="0" />
        </element>
        <element id="Extension.extension:id.value[x].assigner">
            <path value="Extension.extension.value[x].assigner" />
            <max value="0" />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "multiple-prescription-extension",
    "url": "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension",
    "version": "1.1.1",
    "name": "MultiplePrescriptionExtension",
    "title": "MultiplePrescription",
    "status": "active",
    "experimental": false,
    "date": "2024-08-14",
    "publisher": "gematik GmbH",
    "description": "This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.",
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Element"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "short": "MultiplePrescription",
                "definition": "This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources."
            },
            {
                "id": "Extension.extension",
                "path": "Extension.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "closed"
                }
            },
            {
                "id": "Extension.extension:indicator",
                "path": "Extension.extension",
                "sliceName": "indicator",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:indicator.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:indicator.url",
                "path": "Extension.extension.url",
                "fixedUri": "indicator"
            },
            {
                "id": "Extension.extension:indicator.value[x]",
                "path": "Extension.extension.value[x]",
                "short": "Multiple Prescription Indicator",
                "definition": "Indicator of whether the current prescription is part of a multiple prescription\n\ntrue - the current prescription is part of a multiple prescription \nfalse - the current prescription is not part of a multiple prescription",
                "min": 1,
                "type":  [
                    {
                        "code": "boolean"
                    }
                ]
            },
            {
                "id": "Extension.extension:counter",
                "path": "Extension.extension",
                "sliceName": "counter",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:counter.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.url",
                "path": "Extension.extension.url",
                "fixedUri": "counter"
            },
            {
                "id": "Extension.extension:counter.value[x]",
                "path": "Extension.extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Ratio"
                    }
                ]
            },
            {
                "id": "Extension.extension:counter.value[x].numerator",
                "path": "Extension.extension.value[x].numerator",
                "min": 1
            },
            {
                "id": "Extension.extension:counter.value[x].numerator.value",
                "path": "Extension.extension.value[x].numerator.value",
                "short": "Multiple Prescription Counter",
                "definition": "The field serves to indicate which number in a series of multiple prescriptions it is. Example: \"2\" in \"2 out of 4\"",
                "min": 1
            },
            {
                "id": "Extension.extension:counter.value[x].numerator.comparator",
                "path": "Extension.extension.value[x].numerator.comparator",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].numerator.unit",
                "path": "Extension.extension.value[x].numerator.unit",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].numerator.system",
                "path": "Extension.extension.value[x].numerator.system",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].numerator.code",
                "path": "Extension.extension.value[x].numerator.code",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].denominator",
                "path": "Extension.extension.value[x].denominator",
                "min": 1
            },
            {
                "id": "Extension.extension:counter.value[x].denominator.value",
                "path": "Extension.extension.value[x].denominator.value",
                "short": "Denominator of Multiple Prescription Series",
                "definition": "The field serves to indicate the length of this series. Example: \"4\" in \"2 out of 4\"",
                "min": 1
            },
            {
                "id": "Extension.extension:counter.value[x].denominator.comparator",
                "path": "Extension.extension.value[x].denominator.comparator",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].denominator.unit",
                "path": "Extension.extension.value[x].denominator.unit",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].denominator.system",
                "path": "Extension.extension.value[x].denominator.system",
                "max": "0"
            },
            {
                "id": "Extension.extension:counter.value[x].denominator.code",
                "path": "Extension.extension.value[x].denominator.code",
                "max": "0"
            },
            {
                "id": "Extension.extension:period",
                "path": "Extension.extension",
                "sliceName": "period",
                "short": "Zeitraum der Einlösefrist",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:period.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:period.url",
                "path": "Extension.extension.url",
                "fixedUri": "period"
            },
            {
                "id": "Extension.extension:period.value[x]",
                "path": "Extension.extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "constraint":  [
                    {
                        "key": "-limitationDateStart",
                        "human": "Limitation of the date format to 10 characters YYYY-MM-DD",
                        "source": "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension",
                        "severity": "error",
                        "expression": "start.toString().length()=10"
                    },
                    {
                        "key": "-limitationDateEnd",
                        "human": "Limitation of the date format to 10 characters YYYY-MM-DD",
                        "source": "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension",
                        "severity": "error",
                        "expression": "end.exists().not() or end.toString().length()=10"
                    }
                ]
            },
            {
                "id": "Extension.extension:period.value[x].start",
                "path": "Extension.extension.value[x].start",
                "short": "Start Date of the Prescription Redemption Period",
                "definition": "Date from which the partial prescription of the multiple prescription can be redeemed",
                "min": 1
            },
            {
                "id": "Extension.extension:period.value[x].end",
                "path": "Extension.extension.value[x].end",
                "short": "End Date of the Prescription Redemption Period",
                "definition": "Date of the last redemption day for the partial prescription within the multiple prescription series. \nThe issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)"
            },
            {
                "id": "Extension.extension:id",
                "path": "Extension.extension",
                "sliceName": "id",
                "min": 0,
                "max": "1"
            },
            {
                "id": "Extension.extension:id.extension",
                "path": "Extension.extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.extension:id.url",
                "path": "Extension.extension.url",
                "fixedUri": "id"
            },
            {
                "id": "Extension.extension:id.value[x]",
                "path": "Extension.extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ]
            },
            {
                "id": "Extension.extension:id.value[x].use",
                "path": "Extension.extension.value[x].use",
                "max": "0"
            },
            {
                "id": "Extension.extension:id.value[x].type",
                "path": "Extension.extension.value[x].type",
                "max": "0"
            },
            {
                "id": "Extension.extension:id.value[x].system",
                "path": "Extension.extension.value[x].system",
                "short": "Specification as UUID",
                "fixedUri": "urn:ietf:rfc:3986"
            },
            {
                "id": "Extension.extension:id.value[x].value",
                "path": "Extension.extension.value[x].value",
                "short": "Multiple Prescription ID",
                "definition": "A unique ID that is identical across all partial prescriptions of a multiple prescription."
            },
            {
                "id": "Extension.extension:id.value[x].period",
                "path": "Extension.extension.value[x].period",
                "max": "0"
            },
            {
                "id": "Extension.extension:id.value[x].assigner",
                "path": "Extension.extension.value[x].assigner",
                "max": "0"
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "max": "0"
            }
        ]
    }
}

Profil: IndicatorBVGExtension

id0..1string
extensionI0..0Extension
url1..1uriFixed Value
valueBooleanboolean
Extension
DefinitionIndicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Extension.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Extension.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...0
TypeExtension
Aliasextensions, user content
Comments

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

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

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

Fixed Value

https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension

Mappings
  • rim: N/A
Extension.value[x]
DefinitionIndicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG). false - not BVG (default value) true - BVG
Cardinality1...1
Typeboolean
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="indicator-bvg-extension" />
    <url value="https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension" />
    <version value="1.1.1" />
    <name value="IndicatorBVGExtension" />
    <status value="active" />
    <experimental value="false" />
    <date value="2024-08-14" />
    <publisher value="gematik GmbH" />
    <description value="Indicator of whether this regulation is made in reference to the &#39;Bundesentsch&#228;digungsgesetz&#39; or the &#39;Bundesversorgungsgesetz&#39;." />
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Element" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <definition value="Indicator of whether this regulation is made in reference to the &#39;Bundesentsch&#228;digungsgesetz&#39; or the &#39;Bundesversorgungsgesetz&#39;." />
        </element>
        <element id="Extension.extension">
            <path value="Extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <short value="BVG" />
            <definition value="Indicator of whether this regulation applies to claimants under the &#39;Bundesentsch&#228;digungsgesetz&#39; (BEG) or to claimants under the &#39;Bundesversorgungsgesetz&#39; (BVG).\n\n\nfalse - not BVG (default value)\n\ntrue - BVG" />
            <min value="1" />
            <type>
                <code value="boolean" />
            </type>
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "indicator-bvg-extension",
    "url": "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension",
    "version": "1.1.1",
    "name": "IndicatorBVGExtension",
    "status": "active",
    "experimental": false,
    "date": "2024-08-14",
    "publisher": "gematik GmbH",
    "description": "Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.",
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Element"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "definition": "Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'."
            },
            {
                "id": "Extension.extension",
                "path": "Extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "short": "BVG",
                "definition": "Indicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG).\n\n\nfalse - not BVG (default value)\n\ntrue - BVG",
                "min": 1,
                "type":  [
                    {
                        "code": "boolean"
                    }
                ]
            }
        ]
    }
}