| 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.
MI-I Medikamentenverordnung
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()
- rim: Entity. Role, or Act
- workflow: Request
- script10.6: Message/Body/NewRx
- rim: CombinedMedicationRequest
|
| 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.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
Meta Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.meta.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.meta.extension 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.
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.
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()
|
| versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationRequest.meta.versionId 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.
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.
id Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idMedicationRequest.meta.lastUpdated When the resource version last changed Definition When the resource last changed - e.g. when the version changed.
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.
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 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.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| profile | S Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idMedicationRequest.meta.profile 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.
canonical(StructureDefinition) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idMedicationRequest.meta.security 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.
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.
Coding Binding Security Labels from the Healthcare Privacy and Security Classification System.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationRequest.meta.tag 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.
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.
Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationRequest.implicitRules 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.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.language Language of the resource content Definition The base language in which the resource is written.
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).
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.
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.
Narrative Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| contained | | 0..* | Resource | There are no (further) constraints on this element Element idMedicationRequest.contained 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.
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.
Resource Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.extension 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.
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.
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()
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| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.modifierExtension 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).
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.
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.
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()
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| identifier | S | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationRequest.identifier 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.
This is a business identifier, not a resource identifier.
Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.status
- script10.6: no mapping
- w5: FiveWs.status
- rim: .statusCode
|
| statusReason | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.statusReason Reason for current status Definition Captures the reason for the current state of the MedicationRequest.
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.
CodeableConcept Binding Identifies the reasons for a given status.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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.
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.
code Binding The kind of medication order.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.intent
- w5: FiveWs.class
- rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
|
| category | | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.category 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)).
The category can be used to include where the medication is expected to be consumed or other types of requests.
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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 routine | urgent | asap | stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests.
code Binding Identifies the level of importance to be assigned to actioning the request.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 True if request is prohibiting action Definition If true indicates that the provider is asking for the medication request not to occur.
If do not perform is not specified, the request is a positive request e.g. "do perform".
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: SubstanceAdministration.actionNegationInd
|
| reported[x] | Σ | 0..1 | | There are no (further) constraints on this element Element idMedicationRequest.reported[x] 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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: .participation[typeCode=INF].role
|
| reportedBoolean | | | boolean | There are no (further) constraints on this element Data type boolean |
| reportedReference | | | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | There are no (further) constraints on this element Data type Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
| medication[x] | S Σ | 1..1 | | Element idMedicationRequest.medication[x] 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.
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.
Unordered, Open, by $this(Type) Binding A coded concept identifying substance or product that can be ordered.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| medicationReference | S Σ | 0..1 | Reference(Medication) | Element idMedicationRequest.medication[x]:medicationReference 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.
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.
Reference(Medication) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.code
- script10.6: Message/Body/NewRx/MedicationPrescribed
Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode
Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier
Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
- w5: FiveWs.what[x]
- v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
- rim: consumable.administrableMedication
|
| medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Element idMedicationRequest.medication[x]:medicationCodeableConcept 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.
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.
CodeableConcept Binding A coded concept identifying substance or product that can be ordered.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.extension 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.
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.
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()
|
| coding | S Σ | 0..* | Coding | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
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())
- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| Pharmazentralnummer | S Σ | 0..* | CodingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://fhir.de/CodeSystem/ifa/pzn"
}- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.extension 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.
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.
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()
|
| system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.system Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://fhir.de/CodeSystem/ifa/pzn - 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.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.version 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.display Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.userSelected 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).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 ]
|
| atcClassDe | S Σ | 0..* | CodingBindingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe ATC Klassifikation deutsche Version Definition ATC-Codes für Fertigarzneimittel bspw. von Kombiprodukten
Allows for alternative encodings within a code system, and translations to other code systems.
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.
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())
{
"system": "http://fhir.de/CodeSystem/bfarm/atc"
}- 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:atcClassDe.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.extension 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.
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.
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()
|
| system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.system Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://fhir.de/CodeSystem/bfarm/atc - 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.medication[x]:medicationCodeableConcept.coding:atcClassDe.version 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.display Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.userSelected 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).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 ]
|
| atcClassEn | S Σ | 0..* | CodingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn Anatomical Therapeutic Chemical Classification System Definition ATC Classification International WHO Version
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://www.whocc.no/atc"
}- 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:atcClassEn.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.extension 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.
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.
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()
|
| system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.system Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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.medication[x]:medicationCodeableConcept.coding:atcClassEn.version 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.display Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.userSelected 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).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 ]
|
| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.text 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| subject | S Σ I | 1..1 | MII-Reference(Patient | Group) | Element idMedicationRequest.subject A reference from one resource to another Definition A reference from one resource to another.
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.
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()
- 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)
|
| encounter | S | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idMedicationRequest.encounter 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.
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.
Reference(Encounter) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.context
- script10.6: no mapping
- w5: FiveWs.context
- v2: PV1-19-Visit Number
- rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
|
| supportingInformation | | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationRequest.supportingInformation Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Reference(Resource) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.supportingInfo
- w5: FiveWs.context
- rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
|
| authoredOn | S Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.authoredOn When request was initially authored Definition The date (and perhaps time) when the prescription was initially written or authored on.
dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| requester | S Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element idMedicationRequest.requester Who/What requested the Request Definition The individual, organization, or device that initiated the request and has responsibility for its activation.
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())
- workflow: Request.requester
- w5: FiveWs.author
- rim: .participation[typeCode=AUT].role
|
| performer | | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | There are no (further) constraints on this element Element idMedicationRequest.performer Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration).
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())
- workflow: Request.performer
- w5: FiveWs.actor
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
|
| performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.performerType Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication.
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.
CodeableConcept Binding Identifies the type of individual that is desired to administer the medication.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.performerType
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
|
| recorder | S | 0..1 | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idMedicationRequest.recorder 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.
Reference(Practitioner | PractitionerRole) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- w5: FiveWs.who
- rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
|
| reasonCode | S | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.reasonCode Reason or indication for ordering or not ordering the medication Definition The reason or the indication for ordering or not ordering the medication.
This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
CodeableConcept Binding A coded concept indicating why the medication was ordered.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| reasonReference | S | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationRequest.reasonReference Condition or observation that supports why the prescription is being written Definition Condition or observation that supports why the medication was ordered.
This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Reference(Condition | Observation) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.reasonReference
- script10.6: no mapping
- w5: FiveWs.why[x]
- rim: reason.observation[code=ASSERTION].value
|
| instantiatesCanonical | Σ | 0..* | canonical() | There are no (further) constraints on this element Element idMedicationRequest.instantiatesCanonical 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.
canonical() Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.instantiates
- rim: .outboundRelationship[typeCode=DEFN].target
|
| instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element idMedicationRequest.instantiatesUri 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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: .outboundRelationship[typeCode=DEFN].target
|
| basedOn | S Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | There are no (further) constraints on this element Element idMedicationRequest.basedOn What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request.
Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.basedOn
- rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
|
| groupIdentifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationRequest.groupIdentifier 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.
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.
Identifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.groupIdentifier
- rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
|
| courseOfTherapyType | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.courseOfTherapyType Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient.
This attribute should not be confused with the protocol of the medication.
CodeableConcept Binding Identifies the overall pattern of medication administratio.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: Act.code where classCode = LIST and moodCode = EVN
|
| insurance | | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element idMedicationRequest.insurance Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Reference(Coverage | ClaimResponse) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.insurance
- rim: .outboundRelationship[typeCode=COVBY].target
|
| 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.
Annotation Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.note
- script10.6: Message/Body/NewRx/MedicationPrescribed/Note
- rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
|
| dosageInstruction | S I | 0..* | Dosage | Element idMedicationRequest.dosageInstruction How the medication should be taken Definition Indicates how the medication is to be used by the patient.
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.
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()
- workflow: Request.occurrence[x]
- rim: see dosageInstruction mapping
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.extension 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.
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.
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()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.modifierExtension 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).
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.
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.
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()
|
| sequence | S Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.sequence The order of the dosage instructions Definition Indicates the order in which the dosage instructions should be applied or interpreted.
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.
integer Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.text Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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").
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.
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.
CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.patientInstruction Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| timing | S Σ | 0..1 | Timing | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing When medication should be administered Definition When medication should be administered.
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.
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.
Timing 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.dosageInstruction.timing.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.extension 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.
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.
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()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.modifierExtension 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).
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.
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.
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()
|
| event | S Σ | 0..* | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.event When the event occurs Definition Identifies specific times when the event occurs.
In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| repeat | S Σ I | 0..1 | Element | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat When the event is to occur Definition A set of rules that describe when the event is scheduled.
Many timing schedules are determined by regular repetitions.
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()
- rim: Implies PIVL or EIVL
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.extension 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.
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.
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()
|
| bounds[x] | Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x] 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.
Unordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: IVL(TS) used in a QSI
|
| boundsDuration | S Σ | 0..1 | DurationPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration 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.
Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
}- 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]:boundsDuration.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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.timing.repeat.bounds[x]:boundsDuration.comparator < | <= | >= | > - 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.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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]:boundsDuration.unit Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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]:boundsDuration.system System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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]:boundsDuration.code Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
| boundsRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange 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.
Range Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension 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.
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.
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()
|
| low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low Low limit Definition The low limit. The boundary is inclusive.
If the low element is missing, the low boundary is not known.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 High limit Definition The high limit. The boundary is inclusive.
If the high element is missing, the high boundary is not known.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.extension 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.
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.
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()
|
| start | S Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive.
If the low element is missing, the meaning is that the low boundary is not known.
dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| end | S Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end 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.
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.
If the end of the period is missing, it means that the period is ongoing
dateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| count | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.count 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.
Repetitions may be limited by end time or total occurrences.
If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| countMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.countMax 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.
positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| duration | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.duration 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.
Some activities are not instantaneous and need to be maintained for a period of time.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| durationMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.durationMax 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.
Some activities are not instantaneous and need to be maintained for a period of time.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| durationUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) Definition The units of time for the duration, in UCUM units.
code Binding A unit of time (units from UCUM).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| frequency | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.frequency 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.
If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| frequencyMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.frequencyMax 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.
positiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| period | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.period 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.
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| periodMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.periodMax 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.
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| periodUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) Definition The units of time for the period in UCUM units.
code Binding A unit of time (units from UCUM).
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| dayOfWeek | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.dayOfWeek 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).
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.
code Binding DaysOfWeek (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| timeOfDay | S Σ | 0..* | time | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.timeOfDay Time of day for action Definition Specified time of day for action to take place.
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.
time Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| when | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.when 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.
Timings are frequently determined by occurrences such as waking, eating and sleep.
When more than one event is listed, the event is tied to the union of the specified events.
code Binding Real world event relating to the schedule.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| offset | S Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.offset 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.
unsignedInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.code 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).
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).
CodeableConcept Binding Code for a known / defined timing pattern.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| asNeeded[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.asNeeded[x] 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).
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".
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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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).
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".
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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).
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".
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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Body site to administer to Definition Body site to administer to.
A coded specification of the anatomic site where the medication first enters the body.
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.
CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: RXR-2
- rim: .approachSiteCode
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.extension 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.
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.
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()
|
| coding | S Σ | 0..* | Coding | Element idMedicationRequest.dosageInstruction.site.coding Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
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())
- 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 Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Binding TargetSiteCodeUvIps (example)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://snomed.info/sct"
}- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.extension 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.
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.
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()
|
| system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.system Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.code 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.display Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.userSelected 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).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.text 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| route | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route How drug should enter body Definition How drug should enter body.
A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.
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.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.extension 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.
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.
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()
|
| coding | S Σ | 0..* | Coding | Element idMedicationRequest.dosageInstruction.route.coding Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
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())
- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| EDQM | S Σ | 0..1 | CodingBindingPattern | Element idMedicationRequest.dosageInstruction.route.coding:EDQM Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Binding RouteOfAdminUvIps (preferred)Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://standardterms.edqm.eu"
}- 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.route.coding:EDQM.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.extension 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.
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.
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()
|
| system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.system Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://standardterms.edqm.eu - 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.route.coding:EDQM.version 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.code 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.display Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.userSelected 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).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 ]
|
| SNOMED | S Σ | 0..1 | CodingPattern | Element idMedicationRequest.dosageInstruction.route.coding:SNOMED Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Allows for alternative encodings within a code system, and translations to other code systems.
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.
Coding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://snomed.info/sct"
}- 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.route.coding:SNOMED.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.extension 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.
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.
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()
|
| system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.system Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
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.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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.route.coding:SNOMED.version 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.
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.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.code 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).
Need to refer to a particular code in the system.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.display Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.userSelected 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).
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.
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.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.text 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.
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.
Very often the text is the same as a displayName of one of the codings.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
|
| method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.method Technique for administering medication Definition Technique for administering medication.
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.
Terminologies used often pre-coordinate this term with the route and or form of administration.
CodeableConcept Binding A coded concept describing the technique by which the medicine is administered.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: RXR-4
- rim: .doseQuantity
|
| doseAndRate | S Σ | 0..* | Element | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate Amount of medication administered Definition The amount of medication administered.
Element Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.extension 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.
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.
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()
|
| type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.type The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated.
If the type is not populated, assume to be "ordered".
CodeableConcept Binding The kind of dose or rate specified.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| dose[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x] Amount of medication per dose Definition Amount of medication per dose.
The amount of therapeutic or other substance given at one administration event.
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.
Unordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: RXO-2, RXE-3
- rim: .doseQuantity
|
| doseRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Amount of medication per dose Definition Amount of medication per dose.
The amount of therapeutic or other substance given at one administration event.
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.
Range Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.extension 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.
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.
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()
|
| low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Low limit Definition The low limit. The boundary is inclusive.
If the low element is missing, the low boundary is not known.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 High limit Definition The high limit. The boundary is inclusive.
If the high element is missing, the high boundary is not known.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity
The amount of therapeutic or other substance given at one administration event.
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.
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()
- 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] Amount of medication per unit of time Definition Amount of medication per unit of time.
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.
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.
Unordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
| rateRatio | S Σ | 0..1 | Ratio | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio Amount of medication per unit of time Definition Amount of medication per unit of time.
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.
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.
Ratio Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.extension 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.
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.
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()
|
| numerator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator Numerator value Definition The value of the numerator.
Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - 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.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Denominator value Definition The value of the denominator.
Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - 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.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Amount of medication per unit of time Definition Amount of medication per unit of time.
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.
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.
Range Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.extension 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.
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.
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()
|
| low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Low limit Definition The low limit. The boundary is inclusive.
If the low element is missing, the low boundary is not known.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 High limit Definition The high limit. The boundary is inclusive.
If the high element is missing, the high boundary is not known.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity
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.
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.
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()
{
"system": "http://unitsofmeasure.org"
}- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Upper limit on medication per unit of time Definition Upper limit on medication per unit of time.
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.
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".
Ratio Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- v2: RXO-23, RXE-19
- rim: .maxDoseQuantity
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.extension 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.
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.
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()
|
| numerator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator Numerator value Definition The value of the numerator.
Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - 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.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Denominator value Definition The value of the denominator.
Quantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - 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.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Upper limit on medication per administration Definition Upper limit on medication per administration.
The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
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.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
{
"system": "http://unitsofmeasure.org"
} |
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.extension 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.
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.
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()
|
| value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.value Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Precision is handled implicitly in almost all cases of measurement.
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).
decimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
code Binding How the Quantity should be understood and represented.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Unit representation Definition A human-readable form of the unit.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
string Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
uri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
http://unitsofmeasure.org - 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 Coded form of the unit Definition A computer processable form of the unit in some unit representation system.
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.
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.
code Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient.
The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| dispenseRequest | | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest 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.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.extension 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.
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.
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()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.modifierExtension 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).
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.
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.
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()
|
| initialFill | | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill First fill details Definition Indicates the quantity or duration for the first dispense of the medication.
If populating this element, either the quantity or the duration must be included.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.id 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.extension 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.
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.
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()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.modifierExtension 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).
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.
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.
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()
|
| quantity | | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.quantity First fill quantity Definition The amount or quantity to provide as part of the first dispense.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: Supply.quantity[moodCode=RQO]
|
| duration | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.duration First fill duration Definition The length of time that the first dispense is expected to last.
Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: Supply.effectivetime[moodCode=RQO]
|
| dispenseInterval | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.dispenseInterval Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication.
Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim: Supply.effectivetime[moodCode=RQO]
|
| validityPeriod | | 0..1 | Period | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.validityPeriod Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription).
Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
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.
Period Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
If displaying "number of authorized fills", add 1 to this number.
unsignedInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Amount of medication to supply per dispense Definition The amount that is to be dispensed for one fill.
SimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
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.
Duration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber.
Reference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
string Mappings |
| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.extension 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.
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.
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()
|
| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.modifierExtension 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).
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.
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.
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()
|
| allowed[x] | S | 1..1 | | Element idMedicationRequest.substitution.allowed[x] Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed.
This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Unordered, Open, by $this(Type) Binding Identifies the type of substitution allowed.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed.
This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
boolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed.
This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
CodeableConcept Binding Identifies the type of substitution allowed.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed.
CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription.
Reference(MedicationRequest) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
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.
Reference(DetectedIssue) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 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.
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.).
Reference(Provenance) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- workflow: Request.relevantHistory
- rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
|