NHS Digital FHIR Medicines

Element Id

MedicationRequest.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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

Data Type

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim:n/a
rim:N/A

medicationRepeatInformation

0..1

Extension(Complex)

There are no (further) constraints on this element

Element Id

MedicationRequest.extension:medicationRepeatInformation

Short description

Medication repeat information

Alternate names

extensions, user content

Definition

Medication repeat information.

Comments

Data Type

Extension(Complex)

Extension 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

rim:n/a
rim:N/A

responsiblePractitioner

0..1

Element Id

MedicationRequest.extension:responsiblePractitioner

Short description

practitioner responsible for the patient

Alternate names

extensions, user content

Definition

A participation used to provide a link to the healthcare professional who has direct responsibility for the patient.

Comments

Data Type

https://fhir.nhs.uk/StructureDefinition/Extension-DM-ResponsiblePractitioner

Extension 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

rim:n/a
rim:N/A

prescriptionStatusHistory

1..*

Extension(Complex)

Element Id

MedicationRequest.extension:prescriptionStatusHistory

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

The status history within EPS is primarily a technical Status and the statusReason will reflect current clinical status of the order.

Comments

Data Type

Extension(Complex)

Extension URL

https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionStatusHistory

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim:n/a
rim:N/A

identifier

1..*

Element Id

MedicationRequest.identifier

Short description

External ids for this request

Definition

Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

Comments

This is a business identifier, not a resource identifier.

Data Type

Sliced:

Unordered, Open, by system(Value)

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
workflow:Request.identifier
script10.6:Message/Header/PrescriberOrderNumber
w5:FiveWs.identifier
v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim:.id

(All Slices)

There are no (further) constraints on this element

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

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

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

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

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

prescriptionOrderItem

1..1

Element Id

MedicationRequest.identifier:prescriptionOrderItem

Short description

Prescription Order Item

Definition

Unique Id of the MedicationRequest within EPS

Comments

This is a business identifier, not a resource identifier.

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
workflow:Request.identifier
script10.6:Message/Header/PrescriberOrderNumber
w5:FiveWs.identifier
v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim:.id

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier:prescriptionOrderItem.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier:prescriptionOrderItem.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

1..1

uriFixed Value

Element Id

MedicationRequest.identifier:prescriptionOrderItem.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Fixed Value

https://fhir.nhs.uk/Id/prescription-order-item-number

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier:prescriptionOrderItem.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier:prescriptionOrderItem.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.identifier:prescriptionOrderItem.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.status

Short description

Definition

A code specifying the current state of the order. Generally, this will be active or completed state.

Comments

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

Data Type

medicationrequest Status (required)

Binding

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

Constraints

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

Mappings

rim:n/a
workflow:Request.status
script10.6:no mapping
w5:FiveWs.status
rim:.statusCode

statusReason

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.statusReason

Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationRequest.

Comments

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

Data Type

medicationRequest Status Reason Codes (example)

Binding

Identifies the reasons for a given status.

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow:Request.statusReason
rim:.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

intent

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.intent

Short description

Definition

Whether the request is a proposal, plan, or an original order.

Comments

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

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

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

Data Type

medicationRequest Intent (required)

Binding

The kind of medication order.

Constraints

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

Mappings

rim:n/a
workflow:Request.intent
w5:FiveWs.class
rim:.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

category

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.category

Short description

Type of medication usage

Definition

Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

Comments

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

Data Type

UKCoreMedicationRequestCategory (extensible)

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6:Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
w5:FiveWs.class
rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

priority

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.priority

Short description

routine | urgent | asap | stat

Definition

Indicates how quickly the Medication Request should be addressed with respect to other requests.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data Type

Binding

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

RequestPriority (required)

Constraints

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

Mappings

rim:n/a
workflow:Request.priority
w5:FiveWs.grade
rim:.priorityCode

doNotPerform

Σ ?!

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.doNotPerform

Short description

True if request is prohibiting action

Definition

If true indicates that the provider is asking for the medication request not to occur.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:SubstanceAdministration.actionNegationInd

reported[x]

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reported[x]

Short description

Reported rather than primary record

Definition

Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

Constraints

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

Mappings

rim:n/a
rim:.participation[typeCode=INF].role

reportedBoolean

There are no (further) constraints on this element

Data Type

NHS Digital Medication Code (extensible)

reportedReference

Reference(UK Core Patient | UK Core Practitioner | UK Core PractitionerRole | UK Core RelatedPerson | UK Core Organization)

There are no (further) constraints on this element

Data Type

Reference(UK Core Patient | UK Core Practitioner | UK Core PractitionerRole | UK Core RelatedPerson | UK Core Organization)

medication[x]

1..1

Binding

Element Id

MedicationRequest.medication[x]

Short description

Medication to be taken

Definition

Only Virtual Medical Products (VMP) and Actual Medical Products (AMP) can be used.

Comments

Any code from the SnomedCT UK DMD subset for VMP, AMP and VTM concepts

dm+d Category	dm+d Description	UK SNOMED Members Of
VMP	Virtual Medical Product	999000561000001109
AMP	Actual Medical Product	999000541000001108

Binding

A coded concept identifying substance or product that can be ordered.

Constraints

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

Mappings

rim:n/a
workflow:Request.code
script10.6:Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
w5:FiveWs.what[x]
v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
rim:consumable.administrableMedication

medicationCodeableConcept

NHSDigitalMedicationRequestCodeableConcept

Data Type

NHSDigitalMedicationRequestCodeableConcept

medicationReference

Reference(NHSDigitalMedicationRequestMedication)

Data Type

Reference(NHSDigitalMedicationRequestMedication)

Allowed aggregation: bundled

subject

Σ I

1..1

Reference(NHSDigitalPatient)

Element Id

MedicationRequest.subject

Short description

Who or group medication request is for

Definition

A link to a resource representing the person or set of individuals to whom the medication will be given.

Comments

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

Data Type

Reference(NHSDigitalPatient)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.subject
script10.6:Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
w5:FiveWs.subject[x]
v2:PID-3-Patient ID List
rim:.participation[typeCode=AUT].role
w5:FiveWs.subject

reference

Σ I

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

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

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier

Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

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

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

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

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.subject.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Reference(UK Core Encounter)

Constraints

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

Mappings

rim:n/a
rim:N/A

encounter

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter

Short description

Encounter created as part of encounter/admission/stay

Definition

The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

Comments

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

Data Type

Reference(UK Core Encounter)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.context
script10.6:no mapping
w5:FiveWs.context
v2:PV1-19-Visit Number
rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.encounter.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation

Short description

Information to support ordering of the medication

Definition

Include additional information (for example, patient height and weight) that supports the ordering of the medication.

Comments

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

Data Type

Reference(Resource)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.supportingInfo
w5:FiveWs.context
rim:.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.supportingInformation.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

authoredOn

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.authoredOn

Short description

When request was initially authored

Definition

The date (and perhaps time) when the prescription was initially written or authored on.

Data Type

Reference(NHSDigitalPractitionerRole)

Constraints

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

Mappings

rim:n/a
workflow:Request.authoredOn
script10.6:Message/Body/NewRx/MedicationPrescribed/WrittenDate
w5:FiveWs.recorded
v2:RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
rim:author.time

requester

Σ I

1..1

Element Id

MedicationRequest.requester

Short description

Who/What requested the Request

Definition

The individual, organization, or device that initiated the request and has responsibility for its activation.

Comments

Data Type

Reference(NHSDigitalPractitionerRole)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.requester
w5:FiveWs.author
rim:.participation[typeCode=AUT].role

reference

Σ I

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.requester.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

performer

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer

Short description

Intended performer of administration

Definition

The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

Comments

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.performer
w5:FiveWs.actor
rim:.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performer.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

performerType

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.performerType

Short description

Desired kind of performer of the medication administration

Definition

Indicates the type of performer of the administration of the medication.

Comments

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

Data Type

ProcedurePerformerRoleCodes (example)

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow:Request.performerType
rim:.participation[typeCode=PRF].role[scoper.determinerCode=KIND].code

recorder

0..1

Reference(UK Core Practitioner | UK Core PractitionerRole)

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder

Short description

Person who entered the request

Definition

The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

Comments

Data Type

Reference(UK Core Practitioner | UK Core PractitionerRole)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5:FiveWs.who
rim:.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.recorder.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

reasonCode

0..*

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonCode

Short description

Reason or indication for ordering or not ordering the medication

Definition

The reason or the indication for ordering or not ordering the medication.

Comments

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

Data Type

Condition/Problem/DiagnosisCodes (example)

Binding

A coded concept indicating why the medication was ordered.

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow:Request.reasonCode
script10.6:Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
w5:FiveWs.why[x]
v2:ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
rim:reason.observation.reasonCode

reasonReference

0..*

Reference(UK Core Condition | UK Core Observation)

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference

Short description

Condition or observation that supports why the prescription is being written

Definition

Condition or observation that supports why the medication was ordered.

Comments

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

Data Type

Reference(UK Core Condition | UK Core Observation)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.reasonReference
script10.6:no mapping
w5:FiveWs.why[x]
rim:reason.observation[code=ASSERTION].value

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.reasonReference.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

instantiatesCanonical

0..*

canonical()

There are no (further) constraints on this element

Element Id

MedicationRequest.instantiatesCanonical

Short description

Instantiates FHIR protocol or definition

Definition

The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

Comments

see Canonical References

Data Type

canonical()

Constraints

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

Mappings

rim:n/a
workflow:Request.instantiates
rim:.outboundRelationship[typeCode=DEFN].target

instantiatesUri

0..*

There are no (further) constraints on this element

Element Id

MedicationRequest.instantiatesUri

Short description

Instantiates external protocol or definition

Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:.outboundRelationship[typeCode=DEFN].target

basedOn

Σ I

0..*

Reference(ImmunizationRecommendation | UK Core CarePlan | UK Core MedicationRequest | UK Core ServiceRequest)

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn

Short description

What request fulfills

Definition

A plan or request that is fulfilled in whole or in part by this medication request.

Comments

Data Type

Reference(ImmunizationRecommendation | UK Core CarePlan | UK Core MedicationRequest | UK Core ServiceRequest)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.basedOn
rim:.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.basedOn.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

groupIdentifier

1..1

Element Id

MedicationRequest.groupIdentifier

Short description

order number for grouped MedicationRequests

Definition

The short form prescription identifier

Requirements

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

Comments

ITK HL7v3 Mapping = The groupIdentifier is equivalent to ParentPrescription.id (prescription-order-number). The extension is used to carry the ParentPrescription.id (UUID).

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
workflow:Request.groupIdentifier
rim:.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.groupIdentifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.groupIdentifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

1..1

uriFixed Value

Element Id

MedicationRequest.groupIdentifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Fixed Value

https://fhir.nhs.uk/Id/prescription-order-number

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.groupIdentifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.groupIdentifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.groupIdentifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

courseOfTherapyType

0..1

CodeableConceptBinding

Element Id

MedicationRequest.courseOfTherapyType

Short description

A course of therapy for a medication request

Definition

"courseOfTherapyType": {
  "coding":  [
      {
          "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy",
          "code": "acute",
          "display": "Short course (acute) therapy"
      }
  ]
},

Comments

The type of prescription e.g. acute, continuous, etc. Was extension in STU3 https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-PrescriptionType-1 and Digital Medicine uses international codes, so continuous in place of repeat.

Data Type

Medication Request Course of Therapy Codes (required)

Binding

Identifies the overall pattern of medication administratio.

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
rim:Act.code where classCode = LIST and moodCode = EVN

coding

0..1

Coding

There are no (further) constraints on this element

Element Id

MedicationRequest.courseOfTherapyType.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data Type

Coding

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim:CV
orim:fhir:Coding rdfs:subClassOf dt:CDCoding
v2:C*E.1-8, C*E.10-22
rim:union(., ./translation)
orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

text

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.courseOfTherapyType.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data Type

Constraints

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

Mappings

rim:n/a
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

insurance

0..*

Reference(Coverage | ClaimResponse)

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance

Short description

Associated insurance coverage

Definition

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

Comments

Data Type

Reference(Coverage | ClaimResponse)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.insurance
rim:.outboundRelationship[typeCode=COVBY].target

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.insurance.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

note

0..*

Annotation

There are no (further) constraints on this element

Element Id

MedicationRequest.note

Short description

Information about the prescription

Definition

Extra information about the prescription that could not be conveyed by the other attributes.

Comments

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

Data Type

Annotation

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Act
workflow:Request.note
script10.6:Message/Body/NewRx/MedicationPrescribed/Note
rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

author[x]

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

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

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Act.participant[typeCode=AUT].role

authorString

There are no (further) constraints on this element

Data Type

authorReference

Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)

There are no (further) constraints on this element

Data Type

Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)

time

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data Type

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Act.effectiveTime

text

1..1

markdown

There are no (further) constraints on this element

Element Id

MedicationRequest.note.text

Short description

The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

Data Type

markdown

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Act.text

dosageInstruction

0..*

Dosage

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction

Short description

How the medication should be taken

Definition

Indicates how the medication is to be used by the patient.

Comments

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

Data Type

Dosage

Constraints

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

Mappings

rim:n/a
rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
workflow:Request.occurrence[x]
rim:see dosageInstruction mapping

sequence

0..1

integer

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.sequence

Short description

The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Requirements

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

Comments

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

Data Type

integer

Constraints

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

Mappings

rim:n/a
v2:TQ1-1
rim:.text

text

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data Type

Constraints

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

Mappings

rim:n/a
v2:RXO-6; RXE-21
rim:.text

additionalInstruction

0..*

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.additionalInstruction

Short description

Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Requirements

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

Comments

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

Data Type

SNOMEDCTAdditionalDosageInstructions (example)

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:RXO-7
rim:.text

patientInstruction

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.patientInstruction

Short description

Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data Type

UKCoreMedicationPrecondition (preferred)

Constraints

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

Mappings

rim:n/a
v2:RXO-7
rim:.text

timing

0..1

Timing

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.timing

Short description

When medication should be administered

Definition

When medication should be administered.

Requirements

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

Comments

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

Data Type

Timing

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:QSET<TS> (GTS)
rim:.effectiveTime

asNeeded[x]

0..1

Binding

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.asNeeded[x]

Short description

Take "as needed" (for x)

Definition

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Comments

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

Binding

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

Constraints

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

Mappings

rim:n/a
v2:TQ1-9
rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept

asNeededBoolean

There are no (further) constraints on this element

Data Type

asNeededCodeableConcept

There are no (further) constraints on this element

Data Type

site

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.site

Short description

Body site to administer to

Definition

Body site to administer to.

Requirements

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

Comments

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

Data Type

Binding

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

UKCoreBodySite (preferred)

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:RXR-2
rim:.approachSiteCode

route

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.route

Short description

How drug should enter body

Definition

How drug should enter body.

Requirements

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

Comments

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

Data Type

UKCoreSubstanceOrProductAdministrationRoute (preferred)

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:RXR-1
rim:.routeCode

method

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.method

Short description

Technique for administering medication

Definition

Technique for administering medication.

Requirements

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

Comments

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

Data Type

UKCoreMedicationDosageMethod (preferred)

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:RXR-4
rim:.doseQuantity

doseAndRate

0..*

Element

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.doseAndRate

Short description

Amount of medication administered

Definition

The amount of medication administered.

Data Type

Element

Constraints

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

Mappings

rim:n/a
v2:TQ1-2

type

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.doseAndRate.type

Short description

The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Requirements

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

Comments

Data Type

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:RXO-21; RXE-23

dose[x]

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.doseAndRate.dose[x]

Short description

Amount of medication per dose

Definition

Amount of medication per dose.

Requirements

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

Comments

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

Constraints

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

Mappings

rim:n/a
v2:RXO-2, RXE-3
rim:.doseQuantity

doseRange

There are no (further) constraints on this element

Data Type

doseQuantity

There are no (further) constraints on this element

Data Type

rate[x]

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.doseAndRate.rate[x]

Short description

Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Requirements

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

Comments

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

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

Constraints

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

Mappings

rim:n/a
v2:RXE22, RXE23, RXE-24
rim:.rateQuantity

rateRatio

There are no (further) constraints on this element

Data Type

rateRange

There are no (further) constraints on this element

Data Type

rateQuantity

There are no (further) constraints on this element

Data Type

maxDosePerPeriod

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.maxDosePerPeriod

Short description

Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Requirements

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

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
rat-1:Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Mappings

rim:n/a
v2:N/A
rim:RTO
v2:RXO-23, RXE-19
rim:.maxDoseQuantity

maxDosePerAdministration

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.maxDosePerAdministration

Short description

Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Requirements

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

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
rim:not supported

maxDosePerLifetime

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dosageInstruction.maxDosePerLifetime

Short description

Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Requirements

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

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
rim:not supported

dispenseRequest

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest

Short description

Medication supply authorization

Definition

Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

Data Type

Constraints

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

Mappings

rim:n/a
script10.6:Message/Body/NewRx/MedicationPrescribed/ExpirationDate
rim:component.supplyEvent

initialFill

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.initialFill

Short description

First fill details

Definition

Indicates the quantity or duration for the first dispense of the medication.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply

quantity

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.initialFill.quantity

Short description

First fill quantity

Definition

The amount or quantity to provide as part of the first dispense.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
rim:Supply.quantity[moodCode=RQO]

duration

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.initialFill.duration

Short description

First fill duration

Definition

The length of time that the first dispense is expected to last.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
rim:PQ, IVL<PQ> depending on the values
rim:Supply.effectivetime[moodCode=RQO]

dispenseInterval

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.dispenseInterval

Short description

Minimum period of time between dispenses

Definition

The minimum period of time that must occur between dispenses of the medication.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
rim:PQ, IVL<PQ> depending on the values
rim:Supply.effectivetime[moodCode=RQO]

validityPeriod

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.validityPeriod

Short description

Time period supply is authorized for

Definition

This indicates the validity period of a prescription (stale dating the Prescription).

Requirements

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

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
script10.6:Message/Body/NewRx/MedicationPrescribed/Refills
rim:effectiveTime

numberOfRepeatsAllowed

0..1

unsignedInt

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.numberOfRepeatsAllowed

Short description

Number of refills authorized

Definition

An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

Comments

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

Data Type

unsignedInt

Constraints

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

Mappings

rim:n/a
script10.6:Message/Body/NewRx/MedicationPrescribed/Quantity
v2:RXE-12-Number of Refills
rim:repeatNumber

quantity

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.quantity

Short description

Amount of medication to supply per dispense

Definition

The amount that is to be dispensed for one fill.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
script10.6:Message/Body/NewRx/MedicationPrescribed/DaysSupply
v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim:quantity

expectedSupplyDuration

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.expectedSupplyDuration

Short description

Number of days supply per dispense

Definition

Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1:There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim:n/a
v2:SN (see also Range) or CQ
rim:PQ, IVL<PQ>, MO, CO, depending on the values
rim:PQ, IVL<PQ> depending on the values
script10.6:Message/Body/NewRx/MedicationPrescribed/Substitutions
rim:expectedUseTime

performer

0..1

Element Id

MedicationRequest.dispenseRequest.performer

Short description

Intended dispenser

Definition

Indicates the intended dispensing Pharmacy specified by the patient. Can be sourced from nominatedPharmacy in the Patient Demographics Service (PDS)

Comments

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5:FiveWs.who
rim:.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

extension

0..*

Element Id

MedicationRequest.dispenseRequest.performer.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

Data Type

Sliced:

Unordered, Open, by url(Value)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim:n/a
rim:N/A

practitionerRole

0..1

Element Id

MedicationRequest.dispenseRequest.performer.extension:practitionerRole

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data Type

https://fhir.nhs.uk/StructureDefinition/Extension-DM-DispensingPerformer

Extension 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

rim:n/a
rim:N/A

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

uriFixed Value

Element Id

MedicationRequest.dispenseRequest.performer.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Fixed Value

https://fhir.nhs.uk/Id/ods-organization-code

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.dispenseRequest.performer.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

substitution

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.substitution

Short description

Any restrictions on medication substitution

Definition

Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

Data Type

v3.ActSubstanceAdminSubstitutionCode (example)

Constraints

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

Mappings

rim:n/a
script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
rim:subjectOf.substitutionPersmission

allowed[x]

1..1

There are no (further) constraints on this element

Element Id

MedicationRequest.substitution.allowed[x]

Short description

Whether substitution is allowed or not

Definition

The purpose of this element is to allow the prescriber to dispense a different drug from what was prescribed.

Comments

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

Binding

Identifies the type of substitution allowed.

Constraints

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

Mappings

rim:n/a
script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
v2:RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim:code

allowedBoolean

There are no (further) constraints on this element

Data Type

allowedCodeableConcept

There are no (further) constraints on this element

Data Type

reason

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.substitution.reason

Short description

Why should (not) substitution be made

Definition

Indicates the reason for the substitution, or why substitution must or must not be performed.

Comments

Data Type

v3.SubstanceAdminSubstitutionReason (example)

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
script10.6:not mapped
v2:RXE-9 Substition status
rim:reasonCode

priorPrescription

0..1

Reference(UK Core MedicationRequest)

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription

Short description

An order/prescription that is being replaced

Definition

A link to a resource representing an earlier order related order or prescription.

Comments

Data Type

Reference(UK Core MedicationRequest)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.replaces
script10.6:not mapped
rim:.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.priorPrescription.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

detectedIssue

0..*

Reference(DetectedIssue)

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue

Short description

Clinical Issue with action

Alternate names

Contraindication, Drug Utilization Review (DUR), Alert

Definition

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

Comments

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

Data Type

Reference(DetectedIssue)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.detectedIssue.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type

Reference(UK Core Provenance)

Constraints

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

Mappings

rim:n/a
rim:N/A

eventHistory

0..*

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

Comments

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

Data Type

Reference(UK Core Provenance)

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow:Request.relevantHistory
rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

reference

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data Type

Constraints

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

Mappings

rim:n/a
rim:N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
rim:N/A

identifier

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

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

Data Type

Constraints

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

Mappings

rim:n/a
v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd:Identifier
rim:.identifier

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data Type

Binding

Identifies the purpose for this identifier, if known .

Constraints

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

Mappings

rim:n/a
v2:N/A
rim:Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

Data Type

Binding

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

Constraints

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

Mappings

rim:n/a
v2:CE/CNE/CWE
rim:CD
orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
v2:CX.5
rim:Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

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

Comments

Identifier.system is always case sensitive.

Data Type

Constraints

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

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim:n/a
v2:CX.4 / EI-2-4
rim:II.root or Role.id.root
servd:./IdentifierType

value

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data Type

Constraints

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

Examples

General

Mappings

rim:n/a
v2:CX.1 / EI.1
rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd:./Value

period

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim:n/a
v2:DR
rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2:CX.7 + CX.8
rim:Role.effectiveTime or implied by context
servd:./StartDate and ./EndDate

assigner

Σ I

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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

Data Type

Constraints

ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim:n/a
rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2:CX.4 / (CX.4,CX.9,CX.10)
rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd:./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element Id

MedicationRequest.eventHistory.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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

Data Type