MII_PR_Medikation_MedicationRequest (MedicationRequest) | C | | MedicationRequest | Element idMedicationRequest Short descriptionOrdering of medication for patient or group Alternate namesPrescription, Order DefinitionAn order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
CommentsMI-I Medikamentenverordnung
Data typeMedicationRequest Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists() Mappings- rim: Entity. Role, or Act
- workflow: Request
- script10.6: Message/Body/NewRx
- rim: CombinedMedicationRequest
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id | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.id Short descriptionLogical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
CommentsThe only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Data typestring |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationRequest.meta Short descriptionMetadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Data typeMeta Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.meta.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.meta.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationRequest.meta.versionId Short descriptionVersion specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
CommentsThe server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Data typeid Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idMedicationRequest.meta.lastUpdated Short descriptionWhen the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed.
CommentsThis value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Data typeinstant Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idMedicationRequest.meta.source Short descriptionIdentifies where the resource comes from DefinitionA 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.
CommentsIn the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.
This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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profile | S Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idMedicationRequest.meta.profile Short descriptionProfiles this resource claims to conform to DefinitionCommentsIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Data typecanonical(StructureDefinition) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idMedicationRequest.meta.security Short descriptionSecurity Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
CommentsThe security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Data typeCoding BindingSecurity Labels from the Healthcare Privacy and Security Classification System.
All Security Labels (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationRequest.meta.tag Short descriptionTags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
CommentsThe tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Data typeCoding BindingCodes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
CommonTags (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationRequest.implicitRules Short descriptionA set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
CommentsAsserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.language Short descriptionLanguage of the resource content DefinitionThe base language in which the resource is written.
CommentsLanguage is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Data typecode BindingCommonLanguages (preferred) Binding extensionsConstraints- 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 idMedicationRequest.text Short descriptionText summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
CommentsContained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Data typeNarrative Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
contained | | 0..* | Resource | There are no (further) constraints on this element Element idMedicationRequest.contained Short descriptionContained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
CommentsThis should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Data typeResource Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
identifier | S | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationRequest.identifier Short descriptionExternal ids for this request DefinitionIdentifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
CommentsThis is a business identifier, not a resource identifier.
Data typeIdentifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.identifier
- script10.6: Message/Header/PrescriberOrderNumber
- w5: FiveWs.identifier
- v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
- rim: .id
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.status Short descriptionactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown DefinitionA code specifying the current state of the order. Generally, this will be active or completed state.
CommentsThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Data typecode BindingA coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
medicationrequest Status (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.status
- script10.6: no mapping
- w5: FiveWs.status
- rim: .statusCode
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statusReason | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.statusReason Short descriptionReason for current status DefinitionCaptures the reason for the current state of the MedicationRequest.
CommentsThis is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.
Data typeCodeableConcept BindingIdentifies the reasons for a given status.
medicationRequest Status Reason Codes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.statusReason
- rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
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intent | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.intent Short descriptionproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option DefinitionWhether the request is a proposal, plan, or an original order.
CommentsIt is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.
An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.
This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Data typecode BindingThe kind of medication order.
medicationRequest Intent (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.intent
- w5: FiveWs.class
- rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
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category | | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.category Short descriptionType of medication usage DefinitionIndicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
CommentsThe category can be used to include where the medication is expected to be consumed or other types of requests.
Data typeCodeableConcept BindingA coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
medicationRequest Category Codes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Directions
or
Message/Body/NewRx/MedicationPrescribed/StructuredSIG
- w5: FiveWs.class
- rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
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priority | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.priority Short descriptionroutine | urgent | asap | stat DefinitionIndicates how quickly the Medication Request should be addressed with respect to other requests.
Data typecode BindingIdentifies the level of importance to be assigned to actioning the request.
RequestPriority (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.priority
- w5: FiveWs.grade
- rim: .priorityCode
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doNotPerform | Σ ?! | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationRequest.doNotPerform Short descriptionTrue if request is prohibiting action DefinitionIf true indicates that the provider is asking for the medication request not to occur.
CommentsIf do not perform is not specified, the request is a positive request e.g. "do perform".
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: SubstanceAdministration.actionNegationInd
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reported[x] | Σ | 0..1 | | There are no (further) constraints on this element Element idMedicationRequest.reported[x] Short descriptionReported rather than primary record DefinitionIndicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: .participation[typeCode=INF].role
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reportedBoolean | | | boolean | There are no (further) constraints on this element Data typeboolean |
reportedReference | | | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | There are no (further) constraints on this element Data typeReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | S Σ | 1..1 | | Element idMedicationRequest.medication[x] Short descriptionMedication to be taken DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
CommentsIf 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.
SlicingUnordered, Open, by $this(Type) BindingA coded concept identifying substance or product that can be ordered.
SNOMEDCTMedicationCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.code
- script10.6: Message/Body/NewRx/MedicationPrescribed
Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode
Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier
Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
- w5: FiveWs.what[x]
- v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
- rim: consumable.administrableMedication
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medicationReference | S Σ | 0..1 | Reference(Medication) | Element idMedicationRequest.medication[x]:medicationReference Short descriptionMedication to be taken DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
CommentsIf only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Data typeReference(Medication) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.code
- script10.6: Message/Body/NewRx/MedicationPrescribed
Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode
Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier
Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
- w5: FiveWs.what[x]
- v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
- rim: consumable.administrableMedication
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medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Element idMedicationRequest.medication[x]:medicationCodeableConcept Short descriptionMedication to be taken DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
CommentsIf only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Data typeCodeableConcept BindingA coded concept identifying substance or product that can be ordered.
SNOMEDCTMedicationCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.code
- script10.6: Message/Body/NewRx/MedicationPrescribed
Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode
Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier
Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
- w5: FiveWs.what[x]
- v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
- rim: consumable.administrableMedication
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
coding | S Σ | 0..* | Coding | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding SlicingUnordered, Open, by $this(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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Pharmazentralnummer | S Σ | 0..* | CodingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://fhir.de/CodeSystem/ifa/pzn"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://fhir.de/CodeSystem/ifa/pzn Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
RequirementsNeed to refer to a particular code in the system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
RequirementsThis 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.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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atcClassDe | S Σ | 0..* | CodingBindingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe Short descriptionATC Klassifikation deutsche Version DefinitionATC-Codes für Fertigarzneimittel bspw. von Kombiprodukten
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding Bindinghttp://fhir.de/ValueSet/bfarm/atc (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://fhir.de/CodeSystem/bfarm/atc"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://fhir.de/CodeSystem/bfarm/atc Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
RequirementsNeed to refer to a particular code in the system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
RequirementsThis 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.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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atcClassEn | S Σ | 0..* | CodingPattern | Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn Short descriptionAnatomical Therapeutic Chemical Classification System DefinitionATC Classification International WHO Version
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://www.whocc.no/atc"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://www.whocc.no/atc Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
RequirementsNeed to refer to a particular code in the system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
RequirementsThis 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.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.medication[x]:medicationCodeableConcept.text Short descriptionPlain text representation of the concept DefinitionA 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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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subject | S Σ C | 1..1 | MII-Reference(Patient | Group) | Element idMedicationRequest.subject Short descriptionA reference from one resource to another DefinitionA reference from one resource to another.
CommentsReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Data typeMII-Reference(Patient | Group) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) - mii-reference-1: Either reference.reference OR reference.identifier exists
($this.reference.exists() or ($this.identifier.value.exists() and $this.identifier.system.exists())) xor $this.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists() Mappings- workflow: Request.subject
- script10.6: Message/Body/NewRx/Patient
(need detail to link to specific patient … Patient.Identification in SCRIPT)
- w5: FiveWs.subject[x]
- v2: PID-3-Patient ID List
- rim: .participation[typeCode=AUT].role
- w5: FiveWs.subject
- rim: n/a
- rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
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encounter | S | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idMedicationRequest.encounter Short descriptionEncounter created as part of encounter/admission/stay DefinitionThe Encounter during which this [x] was created or to which the creation of this record is tightly associated.
CommentsThis will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.
Data typeReference(Encounter) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.context
- script10.6: no mapping
- w5: FiveWs.context
- v2: PV1-19-Visit Number
- rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
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supportingInformation | | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationRequest.supportingInformation Short descriptionInformation to support ordering of the medication DefinitionInclude additional information (for example, patient height and weight) that supports the ordering of the medication.
Data typeReference(Resource) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.supportingInfo
- w5: FiveWs.context
- rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
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authoredOn | S Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.authoredOn Short descriptionWhen request was initially authored DefinitionThe date (and perhaps time) when the prescription was initially written or authored on.
Data typedateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.authoredOn
- script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate
- w5: FiveWs.recorded
- v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
- rim: author.time
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requester | S Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element idMedicationRequest.requester Short descriptionWho/What requested the Request DefinitionThe individual, organization, or device that initiated the request and has responsibility for its activation.
Data typeReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.requester
- w5: FiveWs.author
- rim: .participation[typeCode=AUT].role
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performer | | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | There are no (further) constraints on this element Element idMedicationRequest.performer Short descriptionIntended performer of administration DefinitionThe specified desired performer of the medication treatment (e.g. the performer of the medication administration).
Data typeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.performer
- w5: FiveWs.actor
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.performerType Short descriptionDesired kind of performer of the medication administration DefinitionIndicates the type of performer of the administration of the medication.
CommentsIf specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.
Data typeCodeableConcept BindingIdentifies the type of individual that is desired to administer the medication.
ProcedurePerformerRoleCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.performerType
- rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
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recorder | S | 0..1 | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idMedicationRequest.recorder Short descriptionPerson who entered the request DefinitionThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Data typeReference(Practitioner | PractitionerRole) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- w5: FiveWs.who
- rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
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reasonCode | S | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.reasonCode Short descriptionReason or indication for ordering or not ordering the medication DefinitionThe reason or the indication for ordering or not ordering the medication.
CommentsThis could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
Data typeCodeableConcept BindingA coded concept indicating why the medication was ordered.
Condition/Problem/DiagnosisCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.reasonCode
- script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
- w5: FiveWs.why[x]
- v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
- rim: reason.observation.reasonCode
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reasonReference | S | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationRequest.reasonReference Short descriptionCondition or observation that supports why the prescription is being written DefinitionCondition or observation that supports why the medication was ordered.
CommentsThis is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Data typeReference(Condition | Observation) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.reasonReference
- script10.6: no mapping
- w5: FiveWs.why[x]
- rim: reason.observation[code=ASSERTION].value
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instantiatesCanonical | Σ | 0..* | canonical() | There are no (further) constraints on this element Element idMedicationRequest.instantiatesCanonical Short descriptionInstantiates FHIR protocol or definition DefinitionThe URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
Data typecanonical() Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.instantiates
- rim: .outboundRelationship[typeCode=DEFN].target
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element idMedicationRequest.instantiatesUri Short descriptionInstantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: .outboundRelationship[typeCode=DEFN].target
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basedOn | S Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | There are no (further) constraints on this element Element idMedicationRequest.basedOn Short descriptionWhat request fulfills DefinitionA plan or request that is fulfilled in whole or in part by this medication request.
Data typeReference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.basedOn
- rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
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groupIdentifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationRequest.groupIdentifier Short descriptionComposite request this is part of DefinitionA shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
RequirementsRequests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Data typeIdentifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.groupIdentifier
- rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
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courseOfTherapyType | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.courseOfTherapyType Short descriptionOverall pattern of medication administration DefinitionThe description of the overall patte3rn of the administration of the medication to the patient.
CommentsThis attribute should not be confused with the protocol of the medication.
Data typeCodeableConcept BindingIdentifies the overall pattern of medication administratio.
medicationRequest Course of Therapy Codes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: Act.code where classCode = LIST and moodCode = EVN
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insurance | | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element idMedicationRequest.insurance Short descriptionAssociated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Data typeReference(Coverage | ClaimResponse) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.insurance
- rim: .outboundRelationship[typeCode=COVBY].target
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note | S | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationRequest.note Short descriptionInformation about the prescription DefinitionExtra information about the prescription that could not be conveyed by the other attributes.
Data typeAnnotation Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.note
- script10.6: Message/Body/NewRx/MedicationPrescribed/Note
- rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
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dosageInstruction | S C | 0..* | Dosage | Element idMedicationRequest.dosageInstruction Short descriptionHow the medication should be taken DefinitionIndicates how the medication is to be used by the patient.
CommentsThere are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
Data typeDosage Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - dsg-1: If present, dosage must include free text or structured data
text.exists() or doseAndRate.exists() Mappings- workflow: Request.occurrence[x]
- rim: see dosageInstruction mapping
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
sequence | S Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.sequence Short descriptionThe order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted.
RequirementsIf the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.
Data typeinteger Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.text Short descriptionFree text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG.
RequirementsFree text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXO-6; RXE-21
- rim: .text
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additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.additionalInstruction Short descriptionSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" DefinitionSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
RequirementsAdditional 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.
CommentsInformation about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.
Data typeCodeableConcept BindingA coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
SNOMEDCTAdditionalDosageInstructions (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.patientInstruction Short descriptionPatient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
timing | S Σ | 0..1 | Timing | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing Short descriptionWhen medication should be administered DefinitionWhen medication should be administered.
RequirementsThe 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.
CommentsThis attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
Data typeTiming Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
event | S Σ | 0..* | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.event Short descriptionWhen the event occurs DefinitionIdentifies specific times when the event occurs.
RequirementsIn a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
Data typedateTime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
repeat | S Σ C | 0..1 | Element | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat Short descriptionWhen the event is to occur DefinitionA set of rules that describe when the event is scheduled.
RequirementsMany timing schedules are determined by regular repetitions.
Data typeElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - tim-1: if there's a duration, there needs to be duration units
duration.empty() or durationUnit.exists() - tim-2: if there's a period, there needs to be period units
period.empty() or periodUnit.exists() - tim-4: duration SHALL be a non-negative value
duration.exists() implies duration >= 0 - tim-5: period SHALL be a non-negative value
period.exists() implies period >= 0 - tim-6: If there's a periodMax, there must be a period
periodMax.empty() or period.exists() - tim-7: If there's a durationMax, there must be a duration
durationMax.empty() or duration.exists() - tim-8: If there's a countMax, there must be a count
countMax.empty() or count.exists() - tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) - tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
timeOfDay.empty() or when.empty() Mappings- rim: Implies PIVL or EIVL
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
bounds[x] | Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x] Short descriptionLength/Range of lengths, or (Start and/or end) limits DefinitionEither 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.
SlicingUnordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: IVL(TS) used in a QSI
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boundsDuration | S Σ | 0..1 | DurationPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short descriptionLength/Range of lengths, or (Start and/or end) limits DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Data typeDuration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings- rim: IVL(TS) used in a QSI
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
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comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator Short description< | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
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system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
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boundsRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange Short descriptionLength/Range of lengths, or (Start and/or end) limits DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Data typeRange Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: IVL(TS) used in a QSI
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low Short descriptionLow limit DefinitionThe low limit. The boundary is inclusive.
CommentsIf the low element is missing, the low boundary is not known.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
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system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
high | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high Short descriptionHigh limit DefinitionThe high limit. The boundary is inclusive.
CommentsIf the high element is missing, the high boundary is not known.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
boundsPeriod | S Σ | 0..1 | Period | Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod Short descriptionLength/Range of lengths, or (Start and/or end) limits DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Data typePeriod Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: IVL(TS) used in a QSI
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
start | S Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start Short descriptionStarting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive.
CommentsIf the low element is missing, the meaning is that the low boundary is not known.
Data typedateTime ConditionsThe cardinality or value of this element may be affected by these constraints: per-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
end | S Σ C | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end Short descriptionEnd time with inclusive boundary, if not ongoing DefinitionThe 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.
CommentsThe high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Meaning when missingIf the end of the period is missing, it means that the period is ongoing
Data typedateTime ConditionsThe cardinality or value of this element may be affected by these constraints: per-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
count | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.count Short descriptionNumber of times to repeat DefinitionA 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.
RequirementsRepetitions may be limited by end time or total occurrences.
CommentsIf you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
Data typepositiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
countMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.countMax Short descriptionMaximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.
Data typepositiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
duration | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.duration Short descriptionHow long when it happens DefinitionHow 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.
RequirementsSome activities are not instantaneous and need to be maintained for a period of time.
CommentsFor some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
durationMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.durationMax Short descriptionHow long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.
RequirementsSome activities are not instantaneous and need to be maintained for a period of time.
CommentsFor some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
durationUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.durationUnit Short descriptions | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units.
Data typecode BindingA unit of time (units from UCUM).
UnitsOfTime (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
frequency | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.frequency Short descriptionEvent occurs frequency times per period DefinitionThe number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.
Meaning when missingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Data typepositiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
frequencyMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.frequencyMax Short descriptionEvent occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.
Data typepositiveInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
period | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.period Short descriptionEvent occurs frequency times per period DefinitionIndicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
periodMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.periodMax Short descriptionUpper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
periodUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.periodUnit Short descriptions | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units.
Data typecode BindingA unit of time (units from UCUM).
UnitsOfTime (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
dayOfWeek | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.dayOfWeek Short descriptionmon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s).
CommentsIf no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.
Data typecode BindingDaysOfWeek (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
timeOfDay | S Σ | 0..* | time | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.timeOfDay Short descriptionTime of day for action DefinitionSpecified time of day for action to take place.
CommentsWhen time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.
Data typetime Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
when | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.when Short descriptionCode for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.
RequirementsTimings are frequently determined by occurrences such as waking, eating and sleep.
CommentsWhen more than one event is listed, the event is tied to the union of the specified events.
Data typecode BindingReal world event relating to the schedule.
EventTiming (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
offset | S Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.repeat.offset Short descriptionMinutes from event (before or after) DefinitionThe number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.
Data typeunsignedInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.timing.code Short descriptionBID | TID | QID | AM | PM | QD | QOD | + DefinitionA 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).
CommentsBID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).
Data typeCodeableConcept BindingCode for a known / defined timing pattern.
TimingAbbreviation (preferred) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
asNeeded[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.asNeeded[x] Short descriptionTake "as needed" (for x) DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
CommentsCan 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".
SlicingUnordered, Open, by $this(Type) BindingA coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: TQ1-9
- rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
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asNeededBoolean | S Σ | 0..1 | boolean | Element idMedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean Short descriptionTake "as needed" (for x) DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
CommentsCan express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: TQ1-9
- rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
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asNeededCodeableConcept | S Σ | 0..1 | CodeableConcept | Element idMedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept Short descriptionTake "as needed" (for x) DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
CommentsCan express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Data typeCodeableConcept BindingA coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: TQ1-9
- rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
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site | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site Short descriptionBody site to administer to DefinitionBody site to administer to.
RequirementsA coded specification of the anatomic site where the medication first enters the body.
CommentsIf the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.
Data typeCodeableConcept BindingA coded concept describing the site location the medicine enters into or onto the body.
SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXR-2
- rim: .approachSiteCode
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
coding | S Σ | 0..* | Coding | Element idMedicationRequest.dosageInstruction.site.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding SlicingUnordered, Open, by $this(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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SNOMED | S Σ | 0..* | CodingPattern | Element idMedicationRequest.dosageInstruction.site.coding:SNOMED Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding BindingTargetSiteCodeUvIps (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://snomed.info/sct"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://snomed.info/sct Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
RequirementsNeed to refer to a particular code in the system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.coding:SNOMED.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
RequirementsThis 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.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.site.text Short descriptionPlain text representation of the concept DefinitionA 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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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route | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route Short descriptionHow drug should enter body DefinitionHow drug should enter body.
RequirementsA code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.
Data typeCodeableConcept BindingA coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
SNOMEDCTRouteCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
coding | S Σ | 0..* | Coding | Element idMedicationRequest.dosageInstruction.route.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding SlicingUnordered, Open, by $this(Pattern) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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EDQM | S Σ | 0..1 | CodingBindingPattern | Element idMedicationRequest.dosageInstruction.route.coding:EDQM Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding BindingRouteOfAdminUvIps (preferred) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://standardterms.edqm.eu"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://standardterms.edqm.eu Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
RequirementsNeed to refer to a particular code in the system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:EDQM.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
RequirementsThis 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.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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SNOMED | S Σ | 0..1 | CodingPattern | Element idMedicationRequest.dosageInstruction.route.coding:SNOMED Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
RequirementsAllows for alternative encodings within a code system, and translations to other code systems.
CommentsCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Data typeCoding Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://snomed.info/sct"
} Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
system | S Σ | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
RequirementsNeed to be unambiguous about the source of the definition of the symbol.
CommentsThe URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://snomed.info/sct Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.version Short descriptionVersion of the system - if relevant DefinitionThe 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.
CommentsWhere the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.code Short descriptionSymbol in syntax defined by the system DefinitionA 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).
RequirementsNeed to refer to a particular code in the system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
RequirementsNeed to be able to carry a human-readable meaning of the code for readers that do not know the system.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.coding:SNOMED.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
RequirementsThis 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.
CommentsAmongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.route.text Short descriptionPlain text representation of the concept DefinitionA 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.
RequirementsThe 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.
CommentsVery often the text is the same as a displayName of one of the codings.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.method Short descriptionTechnique for administering medication DefinitionTechnique for administering medication.
RequirementsA 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.
CommentsTerminologies used often pre-coordinate this term with the route and or form of administration.
Data typeCodeableConcept BindingA coded concept describing the technique by which the medicine is administered.
SNOMEDCTAdministrationMethodCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXR-4
- rim: .doseQuantity
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doseAndRate | S Σ | 0..* | Element | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate Short descriptionAmount of medication administered DefinitionThe amount of medication administered.
Data typeElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.type Short descriptionThe kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated.
RequirementsIf the type is not populated, assume to be "ordered".
Data typeCodeableConcept BindingThe kind of dose or rate specified.
DoseAndRateType (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
dose[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x] Short descriptionAmount of medication per dose DefinitionAmount of medication per dose.
RequirementsThe amount of therapeutic or other substance given at one administration event.
CommentsNote 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.
SlicingUnordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXO-2, RXE-3
- rim: .doseQuantity
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doseRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Short descriptionAmount of medication per dose DefinitionAmount of medication per dose.
RequirementsThe amount of therapeutic or other substance given at one administration event.
CommentsNote that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.
Data typeRange Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXO-2, RXE-3
- rim: .doseQuantity
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short descriptionLow limit DefinitionThe low limit. The boundary is inclusive.
CommentsIf the low element is missing, the low boundary is not known.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
high | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short descriptionHigh limit DefinitionThe high limit. The boundary is inclusive.
CommentsIf the high element is missing, the high boundary is not known.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
doseQuantity | S Σ C | 0..1 | SimpleQuantity | Element idMedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short descriptionA fixed quantity (no comparator) DefinitionThe comparator is not used on a SimpleQuantity
RequirementsThe amount of therapeutic or other substance given at one administration event.
CommentsThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Data typeSimpleQuantity ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty() Mappings- v2: RXO-2, RXE-3
- rim: .doseQuantity
- rim: n/a
- v2: SN (see also Range) or CQ
- rim: PQ, IVL<PQ>, MO, CO, depending on the values
|
rate[x] | S Σ | 0..1 | | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x] Short descriptionAmount of medication per unit of time DefinitionAmount of medication per unit of time.
RequirementsIdentifies 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.
CommentsIt 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.
SlicingUnordered, Open, by $this(Type) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
rateRatio | S Σ | 0..1 | Ratio | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio Short descriptionAmount of medication per unit of time DefinitionAmount of medication per unit of time.
RequirementsIdentifies 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.
CommentsIt is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.
It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Data typeRatio Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
numerator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator Short descriptionNumerator value DefinitionThe value of the numerator.
Data typeQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.comparator Short description< | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
denominator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator Short descriptionDenominator value DefinitionThe value of the denominator.
Data typeQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.comparator Short description< | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
rateRange | S Σ | 0..1 | Range | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange Short descriptionAmount of medication per unit of time DefinitionAmount of medication per unit of time.
RequirementsIdentifies 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.
CommentsIt is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.
It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Data typeRange Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
low | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Short descriptionLow limit DefinitionThe low limit. The boundary is inclusive.
CommentsIf the low element is missing, the low boundary is not known.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
high | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high Short descriptionHigh limit DefinitionThe high limit. The boundary is inclusive.
CommentsIf the high element is missing, the high boundary is not known.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
rateQuantity | S Σ C | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity Short descriptionA fixed quantity (no comparator) DefinitionThe comparator is not used on a SimpleQuantity
RequirementsIdentifies 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.
CommentsThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Data typeSimpleQuantity ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty() Pattern{
"system": "http://unitsofmeasure.org"
} Mappings- v2: RXE22, RXE23, RXE-24
- rim: .rateQuantity
- rim: n/a
- v2: SN (see also Range) or CQ
- rim: PQ, IVL<PQ>, MO, CO, depending on the values
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
maxDosePerPeriod | S Σ | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod Short descriptionUpper limit on medication per unit of time DefinitionUpper limit on medication per unit of time.
RequirementsThe 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.
CommentsThis is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
Data typeRatio Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXO-23, RXE-19
- rim: .maxDoseQuantity
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
numerator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator Short descriptionNumerator value DefinitionThe value of the numerator.
Data typeQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.comparator Short description< | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
denominator | S Σ | 0..1 | QuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator Short descriptionDenominator value DefinitionThe value of the denominator.
Data typeQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.comparator Short description< | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
|
unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
maxDosePerAdministration | S Σ | 0..1 | SimpleQuantityPattern | Element idMedicationRequest.dosageInstruction.maxDosePerAdministration Short descriptionUpper limit on medication per administration DefinitionUpper limit on medication per administration.
RequirementsThe maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
CommentsThis is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Pattern{
"system": "http://unitsofmeasure.org"
} Mappings |
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.value Short descriptionNumerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
RequirementsPrecision is handled implicitly in almost all cases of measurement.
CommentsThe implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Data typedecimal Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.2 / CQ - N/A
- rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.comparator Short description< | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context
RequirementsNeed a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning when missingIf there is no comparator, then there is no modification of the value
Data typecode BindingHow the Quantity should be understood and represented.
QuantityComparator (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: SN.1 / CQ.1
- rim: IVL properties
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.unit Short descriptionUnit representation DefinitionA human-readable form of the unit.
RequirementsThere are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.unit
|
system | S Σ C | 1..1 | uriPattern | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.system Short descriptionSystem that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit.
RequirementsNeed to know the system that defines the coded form of the unit.
Data typeuri ConditionsThe cardinality or value of this element may be affected by these constraints: qty-3 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Patternhttp://unitsofmeasure.org Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: CO.codeSystem, PQ.translation.codeSystem
|
code | S Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerAdministration.code Short descriptionCoded form of the unit DefinitionA computer processable form of the unit in some unit representation system.
RequirementsNeed 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.
CommentsThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Data typecode Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: (see OBX.6 etc.) / CQ.2
- rim: PQ.code, MO.currency, PQ.translation.code
|
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dosageInstruction.maxDosePerLifetime Short descriptionUpper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient.
RequirementsThe maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
dispenseRequest | | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest Short descriptionMedication supply authorization DefinitionIndicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Data typeBackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate
- rim: component.supplyEvent
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
initialFill | | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill Short descriptionFirst fill details DefinitionIndicates the quantity or duration for the first dispense of the medication.
CommentsIf populating this element, either the quantity or the duration must be included.
Data typeBackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
quantity | | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.quantity Short descriptionFirst fill quantity DefinitionThe amount or quantity to provide as part of the first dispense.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: Supply.quantity[moodCode=RQO]
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duration | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.initialFill.duration Short descriptionFirst fill duration DefinitionThe length of time that the first dispense is expected to last.
Data typeDuration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: Supply.effectivetime[moodCode=RQO]
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dispenseInterval | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.dispenseInterval Short descriptionMinimum period of time between dispenses DefinitionThe minimum period of time that must occur between dispenses of the medication.
Data typeDuration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: Supply.effectivetime[moodCode=RQO]
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validityPeriod | | 0..1 | Period | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.validityPeriod Short descriptionTime period supply is authorized for DefinitionThis indicates the validity period of a prescription (stale dating the Prescription).
RequirementsIndicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
CommentsIt reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.
Data typePeriod Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Refills
- rim: effectiveTime
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numberOfRepeatsAllowed | | 0..1 | unsignedInt | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short descriptionNumber of refills authorized DefinitionAn integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
CommentsIf displaying "number of authorized fills", add 1 to this number.
Data typeunsignedInt Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity
- v2: RXE-12-Number of Refills
- rim: repeatNumber
|
quantity | | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.quantity Short descriptionAmount of medication to supply per dispense DefinitionThe amount that is to be dispensed for one fill.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply
- v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
- rim: quantity
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expectedSupplyDuration | | 0..1 | Duration | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.expectedSupplyDuration Short descriptionNumber of days supply per dispense DefinitionIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
CommentsIn some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.
Data typeDuration Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions
- rim: expectedUseTime
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performer | | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idMedicationRequest.dispenseRequest.performer Short descriptionIntended dispenser DefinitionIndicates the intended dispensing Organization specified by the prescriber.
Data typeReference(Organization) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- w5: FiveWs.who
- rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
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substitution | S | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationRequest.substitution Short descriptionAny restrictions on medication substitution DefinitionIndicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Data typeBackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- rim: subjectOf.substitutionPersmission
|
id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationRequest.substitution.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationRequest.substitution.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier 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.
CommentsThere can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
allowed[x] | S | 1..1 | | Element idMedicationRequest.substitution.allowed[x] Short descriptionWhether substitution is allowed or not DefinitionTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
CommentsThis element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
SlicingUnordered, Open, by $this(Type) BindingIdentifies the type of substitution allowed.
v3.ActSubstanceAdminSubstitutionCode (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim: code
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allowedBoolean | S | 0..1 | boolean | Element idMedicationRequest.substitution.allowed[x]:allowedBoolean Short descriptionWhether substitution is allowed or not DefinitionTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
CommentsThis element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Data typeboolean Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim: code
|
allowedCodeableConcept | S | 0..1 | CodeableConcept | Element idMedicationRequest.substitution.allowed[x]:allowedCodeableConcept Short descriptionWhether substitution is allowed or not DefinitionTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
CommentsThis element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Data typeCodeableConcept BindingIdentifies the type of substitution allowed.
v3.ActSubstanceAdminSubstitutionCode (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
- v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim: code
|
reason | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationRequest.substitution.reason Short descriptionWhy should (not) substitution be made DefinitionIndicates the reason for the substitution, or why substitution must or must not be performed.
Data typeCodeableConcept BindingA coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
v3.SubstanceAdminSubstitutionReason (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- script10.6: not mapped
- v2: RXE-9 Substition status
- rim: reasonCode
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priorPrescription | S | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationRequest.priorPrescription Short descriptionAn order/prescription that is being replaced DefinitionA link to a resource representing an earlier order related order or prescription.
Data typeReference(MedicationRequest) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.replaces
- script10.6: not mapped
- rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
|
detectedIssue | S | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element idMedicationRequest.detectedIssue Short descriptionClinical Issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
CommentsThis element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
Data typeReference(DetectedIssue) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
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eventHistory | | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationRequest.eventHistory Short descriptionA list of events of interest in the lifecycle DefinitionLinks to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
CommentsThis might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
Data typeReference(Provenance) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Request.relevantHistory
- rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
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