FOFAR Medicamentos Programados y Dispensados

Aquí se presentan todos los recursos que se utilizaron para mapear la información de FOFAR Medicamentos Programados y Dispensados.

  1. Definición de estructura para los datos de FOFAR Medicamentos Programados y Dispensados, aqui se definen principalmente los campos utilizados del recurso MedicationRequest de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/medicationrequestmedicamentosv3.

medicationReferenceReference(Medication_apimin)
subjectReference(Patient_apimin_v3)
authoredOn
rateQuantitySimpleQuantity
rateRatioRatio_apimin_v3
end
numberOfRepeatsAllowed

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/patientapimin.

system
valueS
birthDateS

  1. Definición de estructura para los datos de los medicamentos. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/medicationapiminv3.

system
code
text

  1. Definición del tipo de dato Ratio para la utilización en MedicationRequest. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/ratioapiminv3.

value
value

Búsquedas

Parámetros de Búsqueda Medicamentos

Nombre Tipo Descripción Expresión Ejemplo
patient token Utilizado como el rut del paciente sin dígito verificador MedicationRequest.subject patient.identifier=1111111
authoredOn date Fecha de la emisión de la receta YYYY-MM-DD MedicationRequest.authoredOn date=2018-10-12 date=ge2018-10-12 date=lt2018-10-12

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/MedicationRequest?patient.identifer=10029459
    
  • Búsqueda por rut y rango de fechas
    GET [base]/MedicationRequest?patient.identifer=10029459&authoredon=ge2014-04-24&authoredon=lt2018-01-03
    

Referencia: Documentación completa en FHIR

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "fb23e782-b968-4aa5-80d5-2af06ebac9dc",
    "meta": {
        "lastUpdated": "2019-01-14T23:28:33.363-03:00"
    },
    "type": "searchset",
    "total": 5,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest?authoredon=ge2017-11-24&authoredon=lt2017-12-24&patient.identifer=10029459"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387266",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387266",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "C08CA05"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1951"
                                }
                            ],
                            "text": "nifedipino 20 mg comprimido liberación modificada"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 2,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387271",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387271",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "C03AA03"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1805"
                                }
                            ],
                            "text": "hidroclorotiazida 50 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 0,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 1,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387290",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387290",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "B01AC06"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1968"
                                }
                            ],
                            "text": "ácido acetilsalicílico 100 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 1,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387343",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387343",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "C09CA01"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "1692"
                                }
                            ],
                            "text": "losartán potásico 50 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 2,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        },
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/MedicationRequest/35387605",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "35387605",
                "contained": [
                    {
                        "resourceType": "Medication",
                        "id": "med1",
                        "code": {
                            "coding": [
                                {
                                    "system": "https://www.whocc.no/atc_ddd_index/",
                                    "code": "A10BA02"
                                },
                                {
                                    "system": "http://www.minsal.cl/",
                                    "code": "88"
                                }
                            ],
                            "text": "metformina 850 mg comprimido"
                        }
                    },
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10029459"
                            }
                        ]
                    }
                ],
                "medicationReference": {
                    "reference": "#med1"
                },
                "subject": {
                    "reference": "#p1"
                },
                "authoredOn": "2017-12-23T00:00:00-03:00",
                "dosageInstruction": [
                    {
                        "rateRatio": {
                            "numerator": {
                                "value": 1,
                                "unit": "Dosis"
                            },
                            "denominator": {
                                "value": 2,
                                "unit": "Frecuencia"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "validityPeriod": {
                        "end": "2018-12-23T00:00:00-03:00"
                    },
                    "numberOfRepeatsAllowed": 23
                }
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de MedicationRequest

MedicationRequest
DefinitionAn order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Cardinality0...*
AliasPrescription, Order
Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim:Entity. Role, or Act
  • workflow:..Request
  • script10.6:Message/Body/NewRx
  • rim:CombinedMedicationRequest
  • w5:clinical.medication
MedicationRequest.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
MedicationRequest.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

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

A human language.

languages (extensible)
Comments

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

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

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

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

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.identifier
DefinitionThis records 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. For example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.
Cardinality0...*
TypeIdentifier
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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:…identifer
  • script10.6:Message/Header/PrescriberOrderNumber
  • v2:ORC-2-Placer Order Number / ORC-3-Filler Order Number
  • rim:.id
  • w5:id
MedicationRequest.definition
DefinitionProtocol or definition followed by this request.
Cardinality0...*
TypeReference(ActivityDefinition | PlanDefinition)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…definition
  • rim:.outboundRelationship[typeCode=DEFN].target[classCode=unspecified]
MedicationRequest.basedOn
DefinitionA plan or request that is fulfilled in whole or in part by this medication request.
Cardinality0...*
TypeReference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…basedOn
  • rim:.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
MedicationRequest.groupIdentifier
DefinitionA shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
Cardinality0...1
TypeIdentifier
SummaryTrue
Requirements

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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:…groupIdentifier
  • rim:.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
MedicationRequest.status
DefinitionA code specifying the current state of the order. Generally this will be active or completed state.
Cardinality0...1
Typecode
Binding

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

medication-request-status (required)
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…status
  • script10.6:no mapping
  • rim:.statusCode
  • w5:status
MedicationRequest.intent
DefinitionWhether the request is a proposal, plan, or an original order.
Cardinality1...1
Typecode
Binding

The kind of medication order

medication-request-intent (required)
ModifierTrue
SummaryTrue
Comments

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

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

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…intent
  • rim:.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
  • w5:class
MedicationRequest.category
DefinitionIndicates the type of medication order and where the medication is expected to be consumed or administered.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept identifying where the medication ordered is expected to be consumed or administered

medication-request-category (preferred)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
  • w5:class
MedicationRequest.priority
DefinitionIndicates how quickly the Medication Request should be addressed with respect to other requests.
Cardinality0...1
Typecode
Binding

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

medication-request-priority (required)
SummaryTrue
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…priority
  • rim:.priorityCode
  • w5:grade
MedicationRequest.medication[x]:medicationReference
DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Cardinality1...1
TypeReference(Medication_apimin)
Binding

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

medication-codes (example)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…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
  • v2:RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
  • rim:consumable.administrableMedication
  • w5:what
MedicationRequest.subject
DefinitionReferencia a quien se le entrega el medicamento.
Cardinality1...1
TypeReference(Patient_apimin_v3)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…subject
  • script10.6:Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
  • v2:PID-3-Patient ID List
  • rim:.participation[typeCode=AUT].role
  • w5:who.focus
MedicationRequest.context
DefinitionA link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider.
Cardinality0...1
TypeReference(Encounter | EpisodeOfCare)
Comments

SubstanceAdministration->component->EncounterEvent.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…context
  • script10.6:no mapping
  • v2:PV1-19-Visit Number
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
  • w5:context
MedicationRequest.supportingInformation
DefinitionInclude additional information (for example, patient height and weight) that supports the ordering of the medication.
Cardinality0...*
TypeReference(Resource)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:.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)]
  • w5:context
MedicationRequest.authoredOn
DefinitionFecha en que el médico emitió la receta.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:…authoredOn
  • script10.6:Message/Body/NewRx/MedicationPrescribed/WrittenDate
  • v2:RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
  • rim:author.time
  • w5:when.recorded
  • api-minsal:FEC_EMI_RECETA
MedicationRequest.requester
DefinitionThe individual, organization or device that initiated the request and has responsibility for its activation.
Cardinality0...1
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • mps-1:onBehalfOf can only be specified if agent is practitioner or device
    (agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()
Mappings
  • rim:n/a
  • workflow:…requester
  • rim:.participation[typeCode=AUT].role
  • w5:who.author
MedicationRequest.requester.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.requester.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.requester.agent
DefinitionThe healthcare professional responsible for authorizing the initial prescription.
Cardinality1...1
TypeReference(Practitioner | Organization | Patient | RelatedPerson | Device)
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:….agent
  • script10.6:Message/Body/NewRx/Prescriber (need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)
  • v2:RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)
  • rim:.player
MedicationRequest.requester.onBehalfOf
DefinitionThe organization the device or practitioner was acting on behalf of.
Cardinality0...1
TypeReference(Organization)
SummaryTrue
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:….onBehalfOf
  • rim:.scoper
MedicationRequest.recorder
DefinitionThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Cardinality0...1
TypeReference(Practitioner)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
  • w5:who
MedicationRequest.reasonCode
DefinitionThe reason or the indication for ordering the medication.
Cardinality0...*
TypeCodeableConcept
Binding

A coded concept indicating why the medication was ordered.

condition-code (example)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow:…reasonCode
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value
  • 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
  • w5:why
MedicationRequest.reasonReference
DefinitionCondition or observation that supports why the medication was ordered.
Cardinality0...*
TypeReference(Condition | Observation)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…reasonReference
  • script10.6:no mapping
  • rim:reason.observation[code=ASSERTION].value
  • w5:why
MedicationRequest.note
DefinitionExtra information about the prescription that could not be conveyed by the other attributes.
Cardinality0...*
TypeAnnotation
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:N/A
  • rim:Act
  • workflow:…note
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Note
  • rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationRequest.dosageInstruction
DefinitionIndicates how the medication is to be used by the patient.
Cardinality0...*
TypeDosage
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • workflow:…occurrence[x]
  • rim:see dosageInstruction mapping
MedicationRequest.dosageInstruction.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

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

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

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

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.text
MedicationRequest.dosageInstruction.text
DefinitionFree text dosage instructions e.g. SIG.
Cardinality0...1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.text
MedicationRequest.dosageInstruction.additionalInstruction
DefinitionSupplemental instruction - e.g. "with meals".
Cardinality0...*
TypeCodeableConcept
Binding

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

additional-instruction-codes (example)
SummaryTrue
Requirements

Additional instruction such as "Swallow with plenty of water" which may or may not be coded.

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim:.text
MedicationRequest.dosageInstruction.patientInstruction
DefinitionInstructions in terms that are understood by the patient or consumer.
Cardinality0...1
Typestring
SummaryTrue
Comments

Note that FHIR strings may not exceed 1MB in size

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

The timing schedule for giving the medication to the patient. The Schedule 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 may not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

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

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

medication-as-needed-reason (example)
SummaryTrue
Comments

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

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

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

approach-site-codes (example)
SummaryTrue
Requirements

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

Comments

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

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

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

route-codes (example)
SummaryTrue
Requirements

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

Comments

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

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

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

administration-method-codes (example)
SummaryTrue
Requirements

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

Comments

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

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

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

Comments

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

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

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

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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
  • rim:.maxDoseQuantity
MedicationRequest.dosageInstruction.maxDosePerAdministration
DefinitionUpper limit on medication per administration.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

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

Comments

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

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

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

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • rim:not supported
MedicationRequest.dosageInstruction.rate[x]
DefinitionCantidad de medicamento por cantidad de tiempo.
Cardinality0...1
TypeSimpleQuantity, Ratio_apimin_v3
SummaryTrue
Requirements

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

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.rateQuantity
MedicationRequest.dispenseRequest
DefinitionIndicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Cardinality0...1
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:Message/Body/NewRx/MedicationPrescribed/ExpirationDate
  • rim:component.supplyEvent
MedicationRequest.dispenseRequest.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

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

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

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.dispenseRequest.validityPeriod
DefinitionThis indicates the validity period of a prescription (stale dating the Prescription).
Cardinality0...1
TypePeriod
Requirements

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

Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1:If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim:n/a
  • v2:DR
  • rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Refills
  • rim:effectiveTime
MedicationRequest.dispenseRequest.validityPeriod.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
MedicationRequest.dispenseRequest.validityPeriod.start
DefinitionThe start of the period. The boundary is inclusive.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.1
  • rim:./low
MedicationRequest.dispenseRequest.validityPeriod.end
DefinitionFecha hasta que la receta se mantiene vigente, según la duración del tratamiento señalada en las prescripciones.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:DR.2
  • rim:./high
  • api-minsal:FEC_VIG_RECETA
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
DefinitionNúmero de veces que la receta se debe despachar.
Cardinality0...1
TypepositiveInt
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:Message/Body/NewRx/MedicationPrescribed/Quantity
  • v2:RXE-12-Number of Refills
  • rim:repeatNumber
  • api-minsal:REPETICION_RECETA
MedicationRequest.dispenseRequest.quantity
DefinitionThe amount that is to be dispensed for one fill.
Cardinality0...1
TypeSimpleQuantity
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • script10.6:Message/Body/NewRx/MedicationPrescribed/DaysSupply
  • v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
  • rim:quantity
MedicationRequest.dispenseRequest.expectedSupplyDuration
DefinitionIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
Cardinality0...1
TypeDuration
Comments

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

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

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
  • w5:who
MedicationRequest.substitution
DefinitionIndicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Cardinality0...1
TypeBackboneElement
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • script10.6:specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
  • rim:subjectOf.substitutionPersmission
MedicationRequest.substitution.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

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

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

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

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

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

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

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

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

HL7 v3 Value Set SubstanceAdminSubstitutionReason (example)
Comments

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

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

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…replaces
  • script10.6:not mapped
  • rim:.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
MedicationRequest.detectedIssue
DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
Cardinality0...*
TypeReference(DetectedIssue)
AliasContraindication, Drug Utilization Review (DUR), Alert
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
MedicationRequest.eventHistory
DefinitionLinks to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
Cardinality0...*
TypeReference(Provenance)
Comments

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (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 %resource.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:…relevantHistory
  • rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]