MII_PR_Medikation_MedicationRequest (MedicationRequest) | I | | MedicationRequest | Element idShort description Ordering of medication for patient or group Alternate names Prescription, Order Definition An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Comments MI-I Medikamentenverordnung
Data type MedicationRequest Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists()
Mappings- rim: Entity. Role, or Act
- workflow: Request
- script10.6: Message/Body/NewRx
- rim: CombinedMedicationRequest
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id | S Σ | 0..1 | string | There are no (further) constraints on this element Element idShort description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
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.
Data type string |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element idShort description Metadata about the resource Definition The 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.
Data type Meta Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationRequest.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
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.
Data type id Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idMedicationRequest.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed.
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.
Data type instant Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idMedicationRequest.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance 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.
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.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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profile | S Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idMedicationRequest.meta.profile Short description Profiles this resource claims to conform to Definition 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.
Data type canonical(StructureDefinition) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idMedicationRequest.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
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.
Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System.
All Security Labels (extensible)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationRequest.meta.tag Short description Tags applied to this resource Definition Tags 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.
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.
Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
CommonTags (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationRequest.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
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.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.language Short description Language of the resource content Definition The base language in which the resource is written.
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).
Data type code Binding CommonLanguages (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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text | | 0..1 | Narrative | There are no (further) constraints on this element Element idShort description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A 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.
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.
Data type Narrative Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
contained | | 0..* | Resource | There are no (further) constraints on this element Element idMedicationRequest.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
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.
Data type Resource Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
identifier | S | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationRequest.identifier Short description External ids for this request Definition Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Comments This is a business identifier, not a resource identifier.
Data type Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.identifier
- script10.6: Message/Header/PrescriberOrderNumber
- w5: FiveWs.identifier
- v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
- rim: .id
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idShort description active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Definition A code specifying the current state of the order. Generally, this will be active or completed state.
Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Data type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
medicationrequest Status (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.status
- script10.6: no mapping
- w5: FiveWs.status
- rim: .statusCode
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statusReason | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.statusReason Short description Reason for current status Definition Captures the reason for the current state of the MedicationRequest.
Comments This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.
Data type CodeableConcept Binding Identifies the reasons for a given status.
medicationRequest Status Reason Codes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.statusReason
- rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
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intent | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idShort description proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Definition Whether the request is a proposal, plan, or an original order.
Comments It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.
An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.
This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Data type code Binding The kind of medication order.
medicationRequest Intent (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.intent
- w5: FiveWs.class
- rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
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category | | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Comments The category can be used to include where the medication is expected to be consumed or other types of requests.
Data type CodeableConcept Binding A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
medicationRequest Category Codes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
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priority | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.priority Short description routine | urgent | asap | stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests.
Data type code Binding Identifies the level of importance to be assigned to actioning the request.
RequestPriority (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.priority
- w5: FiveWs.grade
- rim: .priorityCode
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doNotPerform | Σ ?! | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationRequest.doNotPerform Short description True if request is prohibiting action Definition If true indicates that the provider is asking for the medication request not to occur.
Comments If do not perform is not specified, the request is a positive request e.g. "do perform".
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: SubstanceAdministration.actionNegationInd
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reported[x] | Σ | 0..1 | | There are no (further) constraints on this element Element idMedicationRequest.reported[x] Short description Reported rather than primary record Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: .participation[typeCode=INF].role
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reportedBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
reportedReference | | | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | There are no (further) constraints on this element Data type Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | S Σ | 1..1 | | Element idMedicationRequest.medication[x] Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying substance or product that can be ordered.
SNOMEDCTMedicationCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
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medicationReference | S Σ | 0..1 | Reference(Medication) | Element idMedicationRequest.medication[x]:medicationReference Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Data type Reference(Medication) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
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medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Element idMedicationRequest.medication[x]:medicationCodeableConcept Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Data type CodeableConcept Binding A coded concept identifying substance or product that can be ordered.
SNOMEDCTMedicationCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
coding | S Σ | 0..* | Coding | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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Pharmazentralnummer | S Σ | 0..* | CodingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://fhir.de/CodeSystem/ifa/pzn"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://fhir.de/CodeSystem/ifa/pzn Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Requirements Need to refer to a particular code in the system.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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atcClassDe | S Σ | 0..* | CodingBindingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe Short description ATC Klassifikation deutsche Version Definition ATC-Codes für Fertigarzneimittel bspw. von Kombiprodukten
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Binding http://fhir.de/ValueSet/bfarm/atc (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://fhir.de/CodeSystem/bfarm/atc"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://fhir.de/CodeSystem/bfarm/atc Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Requirements Need to refer to a particular code in the system.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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atcClassEn | S Σ | 0..* | CodingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn Short description Anatomical Therapeutic Chemical Classification System Definition ATC Classification International WHO Version
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://www.whocc.no/atc"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Requirements Need to refer to a particular code in the system.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments Very often the text is the same as a displayName of one of the codings.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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subject | S Σ I | 1..1 | MII-Reference(Patient | Group) | Element idMedicationRequest.subject Short description A reference from one resource to another Definition A reference from one resource to another.
Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Data type MII-Reference(Patient | Group) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) - mii-reference-1: Either reference.reference OR reference.identifier exists
($this.reference.exists() or ($this.identifier.value.exists() and $this.identifier.system.exists())) xor $this.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
Mappings- 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
- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
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encounter | S | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idMedicationRequest.encounter Short description Encounter created as part of encounter/admission/stay Definition The Encounter during which this [x] was created or to which the creation of this record is tightly associated.
Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.
Data type Reference(Encounter) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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"]
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supportingInformation | | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Data type Reference(Resource) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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)]
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authoredOn | S Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.authoredOn Short description When request was initially authored Definition The date (and perhaps time) when the prescription was initially written or authored on.
Data type dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
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requester | S Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element idMedicationRequest.requester Short description Who/What requested the Request Definition The individual, organization, or device that initiated the request and has responsibility for its activation.
Data type Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.requester
- w5: FiveWs.author
- rim: .participation[typeCode=AUT].role
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performer | | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | There are no (further) constraints on this element Element idMedicationRequest.performer Short description Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration).
Data type Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.performer
- w5: FiveWs.actor
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.performerType Short description Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication.
Comments If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.
Data type CodeableConcept Binding Identifies the type of individual that is desired to administer the medication.
ProcedurePerformerRoleCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.performerType
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
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recorder | S | 0..1 | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idMedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Data type Reference(Practitioner | PractitionerRole) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- w5: FiveWs.who
- rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
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reasonCode | S | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.reasonCode Short description Reason or indication for ordering or not ordering the medication Definition The reason or the indication for ordering or not ordering the medication.
Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
Data type CodeableConcept Binding A coded concept indicating why the medication was ordered.
Condition/Problem/DiagnosisCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- 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
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reasonReference | S | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationRequest.reasonReference Short description Condition or observation that supports why the prescription is being written Definition Condition or observation that supports why the medication was ordered.
Comments This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Data type Reference(Condition | Observation) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.reasonReference
- script10.6: no mapping
- w5: FiveWs.why[x]
- rim: reason.observation[code=ASSERTION].value
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instantiatesCanonical | Σ | 0..* | canonical() | There are no (further) constraints on this element Element idMedicationRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
Data type canonical() Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.instantiates
- rim: .outboundRelationship[typeCode=DEFN].target
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element idMedicationRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: .outboundRelationship[typeCode=DEFN].target
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basedOn | S Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | There are no (further) constraints on this element Element idMedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request.
Data type Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.basedOn
- rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
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groupIdentifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationRequest.groupIdentifier Short description Composite request this is part of Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Data type Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.groupIdentifier
- rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
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courseOfTherapyType | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.courseOfTherapyType Short description Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient.
Comments This attribute should not be confused with the protocol of the medication.
Data type CodeableConcept Binding Identifies the overall pattern of medication administratio.
medicationRequest Course of Therapy Codes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: Act.code where classCode = LIST and moodCode = EVN
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insurance | | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element idMedicationRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Data type Reference(Coverage | ClaimResponse) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.insurance
- rim: .outboundRelationship[typeCode=COVBY].target
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note | S | 0..* | Annotation | There are no (further) constraints on this element Element idShort description Information about the prescription Definition Extra information about the prescription that could not be conveyed by the other attributes.
Data type Annotation Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.note
- script10.6: Message/Body/NewRx/MedicationPrescribed/Note
- rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
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dosageInstruction | S I | 0..* | Dosage | Element idMedicationRequest.dosageInstruction Short description How the medication should be taken Definition Indicates how the medication is to be used by the patient.
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.
Data type Dosage Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - dsg-1: If present, dosage must include free text or structured data
text.exists() or doseAndRate.exists()
Mappings- workflow: Request.occurrence[x]
- rim: see dosageInstruction mapping
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).
Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
sequence | S Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.sequence Short description The order of the dosage instructions Definition Indicates the order in which the dosage instructions should be applied or interpreted.
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.
Data type integer Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG.
Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXO-6; RXE-21
- rim: .text
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additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.additionalInstruction Short description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Definition Supplemental 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").
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.
Data type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
SNOMEDCTAdditionalDosageInstructions (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.patientInstruction Short description Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
timing | S Σ | 0..1 | Timing | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing Short description When medication should be administered Definition When medication should be administered.
Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
Data type Timing Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).
Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
event | S Σ | 0..* | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs.
Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
Data type dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
repeat | S Σ I | 0..1 | Element | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled.
Requirements Many timing schedules are determined by regular repetitions.
Data type Element Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - tim-1: if there's a duration, there needs to be duration units
duration.empty() or durationUnit.exists() - tim-2: if there's a period, there needs to be period units
period.empty() or periodUnit.exists() - tim-4: duration SHALL be a non-negative value
duration.exists() implies duration >= 0 - tim-5: period SHALL be a non-negative value
period.exists() implies period >= 0 - tim-6: If there's a periodMax, there must be a period
periodMax.empty() or period.exists() - tim-7: If there's a durationMax, there must be a duration
durationMax.empty() or duration.exists() - tim-8: If there's a countMax, there must be a count
countMax.empty() or count.exists() - tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) - tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
timeOfDay.empty() or when.empty()
Mappings- rim: Implies PIVL or EIVL
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
bounds[x] | Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Sliced: Unordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: IVL(TS) used in a QSI
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boundsDuration | S Σ | 0..1 | DurationPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Data type Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings- rim: IVL(TS) used in a QSI
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
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comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator Short description < | <= | >= | > - how to understand the value Definition How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
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system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
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boundsRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Data type Range Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: IVL(TS) used in a QSI
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low Short description Low limit Definition The low limit. The boundary is inclusive.
Comments If the low element is missing, the low boundary is not known.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
high | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high Short description High limit Definition The high limit. The boundary is inclusive.
Comments If the high element is missing, the high boundary is not known.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
boundsPeriod | S Σ | 0..1 | Period | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Data type Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: IVL(TS) used in a QSI
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
start | S Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive.
Comments If the low element is missing, the meaning is that the low boundary is not known.
Data type dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
end | S Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Meaning when missing If the end of the period is missing, it means that the period is ongoing
Data type dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
count | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.count Short description Number of times to repeat Definition A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.
Requirements Repetitions may be limited by end time or total occurrences.
Comments If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
Data type positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
countMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.countMax Short description Maximum number of times to repeat Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.
Data type positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
duration | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.duration Short description How long when it happens Definition How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.
Requirements Some activities are not instantaneous and need to be maintained for a period of time.
Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
durationMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.
Requirements Some activities are not instantaneous and need to be maintained for a period of time.
Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
durationUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.durationUnit Short description s | min | h | d | wk | mo | a - unit of time (UCUM) Definition The units of time for the duration, in UCUM units.
Data type code Binding A unit of time (units from UCUM).
UnitsOfTime (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
frequency | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.frequency Short description Event occurs frequency times per period Definition The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.
Meaning when missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Data type positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
frequencyMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.frequencyMax Short description Event occurs up to frequencyMax times per period Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.
Data type positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
period | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.period Short description Event occurs frequency times per period Definition Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
periodMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
periodUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.periodUnit Short description s | min | h | d | wk | mo | a - unit of time (UCUM) Definition The units of time for the period in UCUM units.
Data type code Binding A unit of time (units from UCUM).
UnitsOfTime (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
dayOfWeek | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.dayOfWeek Short description mon | tue | wed | thu | fri | sat | sun Definition If one or more days of week is provided, then the action happens only on the specified day(s).
Comments If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.
Data type code Binding DaysOfWeek (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
timeOfDay | S Σ | 0..* | time | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.timeOfDay Short description Time of day for action Definition Specified time of day for action to take place.
Comments When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.
Data type time Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
when | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.when Short description Code for time period of occurrence Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.
Requirements Timings are frequently determined by occurrences such as waking, eating and sleep.
Comments When more than one event is listed, the event is tied to the union of the specified events.
Data type code Binding Real world event relating to the schedule.
EventTiming (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
offset | S Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.offset Short description Minutes from event (before or after) Definition The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.
Data type unsignedInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.code Short description BID | TID | QID | AM | PM | QD | QOD | + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).
Comments BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).
Data type CodeableConcept Binding Code for a known / defined timing pattern.
TimingAbbreviation (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
asNeeded[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: TQ1-9
- rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
|
asNeededBoolean | S Σ | 0..1 | boolean | Element idMedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: TQ1-9
- rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
|
asNeededCodeableConcept | S Σ | 0..1 | CodeableConcept | Element idMedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Data type CodeableConcept Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: TQ1-9
- rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
|
site | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site Short description Body site to administer to Definition Body site to administer to.
Requirements A coded specification of the anatomic site where the medication first enters the body.
Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.
Data type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body.
SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXR-2
- rim: .approachSiteCode
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
coding | S Σ | 0..* | Coding | Element idMedicationRequest.dosageInstruction.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
SNOMED | S Σ | 0..* | CodingPattern | Element idMedicationRequest.dosageInstruction.site.coding:SNOMED Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Binding TargetSiteCodeUvIps (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://snomed.info/sct"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Requirements Need to refer to a particular code in the system.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments Very often the text is the same as a displayName of one of the codings.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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route | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route Short description How drug should enter body Definition How drug should enter body.
Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.
Data type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
SNOMEDCTRouteCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
coding | S Σ | 0..* | Coding | Element idMedicationRequest.dosageInstruction.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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EDQM | S Σ | 0..1 | CodingBindingPattern | Element idMedicationRequest.dosageInstruction.route.coding:EDQM Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Binding RouteOfAdminUvIps (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://standardterms.edqm.eu"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://standardterms.edqm.eu Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Requirements Need to refer to a particular code in the system.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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SNOMED | S Σ | 0..1 | CodingPattern | Element idMedicationRequest.dosageInstruction.route.coding:SNOMED Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data type Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://snomed.info/sct"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Requirements Need to refer to a particular code in the system.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments Very often the text is the same as a displayName of one of the codings.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.method Short description Technique for administering medication Definition Technique for administering medication.
Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.
Comments Terminologies used often pre-coordinate this term with the route and or form of administration.
Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered.
SNOMEDCTAdministrationMethodCodes (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXR-4
- rim: .doseQuantity
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doseAndRate | S Σ | 0..* | Element | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate Short description Amount of medication administered Definition The amount of medication administered.
Data type Element Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated.
Requirements If the type is not populated, assume to be "ordered".
Data type CodeableConcept Binding The kind of dose or rate specified.
DoseAndRateType (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
dose[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x] Short description Amount of medication per dose Definition Amount of medication per dose.
Requirements The amount of therapeutic or other substance given at one administration event.
Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.
Sliced: Unordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXO-2, RXE-3
- rim: .doseQuantity
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doseRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Short description Amount of medication per dose Definition Amount of medication per dose.
Requirements The amount of therapeutic or other substance given at one administration event.
Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.
Data type Range Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXO-2, RXE-3
- rim: .doseQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short description Low limit Definition The low limit. The boundary is inclusive.
Comments If the low element is missing, the low boundary is not known.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
high | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short description High limit Definition The high limit. The boundary is inclusive.
Comments If the high element is missing, the high boundary is not known.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
doseQuantity | S Σ I | 0..1 | SimpleQuantity | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity
Requirements The amount of therapeutic or other substance given at one administration event.
Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()
Mappings- v2: RXO-2, RXE-3
- rim: .doseQuantity
- rim: n/a
- v2: SN (see also Range) or CQ
- rim: PQ, IVL<PQ>, MO, CO, depending on the values
|
rate[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x] Short description Amount of medication per unit of time Definition Amount of medication per unit of time.
Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.
It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Sliced: Unordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
rateRatio | S Σ | 0..1 | Ratio | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio Short description Amount of medication per unit of time Definition Amount of medication per unit of time.
Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.
It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Data type Ratio Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
numerator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator Short description Numerator value Definition The value of the numerator.
Data type Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.comparator Short description < | <= | >= | > - how to understand the value Definition How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
denominator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator Short description Denominator value Definition The value of the denominator.
Data type Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.comparator Short description < | <= | >= | > - how to understand the value Definition How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
rateRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange Short description Amount of medication per unit of time Definition Amount of medication per unit of time.
Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.
It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Data type Range Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Short description Low limit Definition The low limit. The boundary is inclusive.
Comments If the low element is missing, the low boundary is not known.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
high | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high Short description High limit Definition The high limit. The boundary is inclusive.
Comments If the high element is missing, the high boundary is not known.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
rateQuantity | S Σ I | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity
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 The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
- rim: n/a
- v2: SN (see also Range) or CQ
- rim: PQ, IVL<PQ>, MO, CO, depending on the values
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
maxDosePerPeriod | S Σ | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition Upper limit on medication per unit of time.
Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.
Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
Data type Ratio Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: RXO-23, RXE-19
- rim: .maxDoseQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
numerator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator Short description Numerator value Definition The value of the numerator.
Data type Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.comparator Short description < | <= | >= | > - how to understand the value Definition How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
denominator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator Short description Denominator value Definition The value of the denominator.
Data type Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.comparator Short description < | <= | >= | > - how to understand the value Definition How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
maxDosePerAdministration | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration.
Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern {
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
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).
Data type decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missing If there is no comparator, then there is no modification of the value
Data type code Binding How the Quantity should be understood and represented.
QuantityComparator (required)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data type string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ I | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Data type uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Pattern http://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
Data type code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient.
Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
dispenseRequest | | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest Short description Medication supply authorization Definition Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Data type BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
- rim: component.supplyEvent
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).
Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
initialFill | | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill Short description First fill details Definition Indicates the quantity or duration for the first dispense of the medication.
Comments If populating this element, either the quantity or the duration must be included.
Data type BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).
Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
quantity | | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.quantity Short description First fill quantity Definition The amount or quantity to provide as part of the first dispense.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: Supply.quantity[moodCode=RQO]
|
duration | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.duration Short description First fill duration Definition The length of time that the first dispense is expected to last.
Data type Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: Supply.effectivetime[moodCode=RQO]
|
dispenseInterval | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.dispenseInterval Short description Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication.
Data type Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: Supply.effectivetime[moodCode=RQO]
|
validityPeriod | | 0..1 | Period | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription).
Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.
Data type Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
- rim: effectiveTime
|
numberOfRepeatsAllowed | | 0..1 | unsignedInt | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
Comments If displaying "number of authorized fills", add 1 to this number.
Data type unsignedInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
- v2: RXE-12-Number of Refills
- rim: repeatNumber
|
quantity | | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.quantity Short description Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill.
Data type SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
- v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
- rim: quantity
|
expectedSupplyDuration | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.
Data type Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
- rim: expectedUseTime
|
performer | | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber.
Data type Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- w5: FiveWs.who
- rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
|
substitution | S | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.substitution Short description Any restrictions on medication substitution Definition Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Data type BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- rim: subjectOf.substitutionPersmission
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.substitution.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data type string Mappings |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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).
Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data type Extension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
allowed[x] | S | 1..1 | | Element idMedicationRequest.substitution.allowed[x] Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed.
Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Sliced: Unordered, Open, by $this(Type) Binding Identifies the type of substitution allowed.
v3.ActSubstanceAdminSubstitutionCode (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim: code
|
allowedBoolean | S | 0..1 | boolean | Element idMedicationRequest.substitution.allowed[x]:allowedBoolean Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed.
Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Data type boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim: code
|
allowedCodeableConcept | S | 0..1 | CodeableConcept | Element idMedicationRequest.substitution.allowed[x]:allowedCodeableConcept Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed.
Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Data type CodeableConcept Binding Identifies the type of substitution allowed.
v3.ActSubstanceAdminSubstitutionCode (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim: code
|
reason | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed.
Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
v3.SubstanceAdminSubstitutionReason (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- script10.6: not mapped
- v2: RXE-9 Substition status
- rim: reasonCode
|
priorPrescription | S | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription.
Data type Reference(MedicationRequest) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.replaces
- script10.6: not mapped
- rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
|
detectedIssue | S | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element idMedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
Comments This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
Data type Reference(DetectedIssue) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
|
eventHistory | | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
Data type Reference(Provenance) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- workflow: Request.relevantHistory
- rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
|