StructureDefinition-UKCore-MedicationRequest

Canonical_URLCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest2.4.02023-04-28

This profile defines the UK constraints and extensions on the International FHIR resource MedicationRequest.


Profile_Purpose

An order or request for both supply of the medication and the instructions for administration of the medication to an individual.

This profile covers inpatient medication orders as well as community orders (whether filled by the prescriber or by a pharmacy). It also includes orders for over-the-counter medications (e.g. Aspirin), total parenteral nutrition and diet/ vitamin supplements, and may be used to support the order of medication-related devices.

It is not intended for use in prescribing particular diets, or for ordering non-medication-related items (eyeglasses, supplies, etc).

medicationRepeatInformationI0..1Extension(Complex)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
statusΣ ?!1..1codeBinding
statusReason0..1CodeableConcept
intentΣ ?!1..1codeBinding
category0..*CodeableConceptBinding
priorityΣ0..1codeBinding
doNotPerformΣ ?!0..1boolean
reportedBooleanboolean
reportedReferenceReference(UK Core Patient | UK Core Practitioner | UK Core PractitionerRole | UK Core RelatedPerson | UK Core Organization)
medicationCodeableConceptCodeableConcept
medicationReferenceReference(UK Core Medication)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
authoredOnΣ0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
performerTypeΣ0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
reasonCode0..*CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
instantiatesCanonicalΣ0..*canonical()
instantiatesUriΣ0..*uri
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
courseOfTherapyType0..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
sequenceΣ0..1integer
textΣ0..1string
additionalInstructionΣ0..*CodeableConcept
patientInstructionΣ0..1string
timingΣ0..1Timing
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
siteΣ0..1CodeableConceptBinding
routeΣ0..1CodeableConceptBinding
methodΣ0..1CodeableConceptBinding
typeΣ0..1CodeableConcept
doseRangeRange
doseQuantitySimpleQuantity
rateRatioRatio
rateRangeRange
rateQuantitySimpleQuantity
maxDosePerPeriodΣ I0..1Ratio
maxDosePerAdministrationΣ I0..1SimpleQuantity
maxDosePerLifetimeΣ I0..1SimpleQuantity
quantityI0..1SimpleQuantity
durationI0..1Duration
dispenseIntervalI0..1Duration
validityPeriodI0..1Period
numberOfRepeatsAllowed0..1unsignedInt
quantityI0..1SimpleQuantity
expectedSupplyDurationI0..1Duration
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
allowedBooleanboolean
allowedCodeableConceptCodeableConcept
reason0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string

Table View

MedicationRequest..
MedicationRequest.extension0..
MedicationRequest.extensionExtension0..
MedicationRequest.identifier..
MedicationRequest.identifier.assignerReference(UK Core Organization)..
MedicationRequest.category..
MedicationRequest.reported[x]boolean, Reference(UK Core Patient | UK Core Practitioner | UK Core PractitionerRole | UK Core RelatedPerson | UK Core Organization)..
MedicationRequest.medication[x]CodeableConcept, Reference(UK Core Medication)..
MedicationRequest.subjectReference(Group | UK Core Patient)..
MedicationRequest.subject.identifier..
MedicationRequest.subject.identifier.assignerReference(UK Core Organization)..
MedicationRequest.encounterReference(UK Core Encounter)..
MedicationRequest.encounter.identifier..
MedicationRequest.encounter.identifier.assignerReference(UK Core Organization)..
MedicationRequest.supportingInformation..
MedicationRequest.supportingInformation.identifier..
MedicationRequest.supportingInformation.identifier.assignerReference(UK Core Organization)..
MedicationRequest.requesterReference(UK Core Device | UK Core Practitioner | UK Core PractitionerRole | UK Core Organization | UK Core Patient | UK Core RelatedPerson)..
MedicationRequest.requester.identifier..
MedicationRequest.requester.identifier.assignerReference(UK Core Organization)..
MedicationRequest.performerReference(UK Core Device | UK Core Practitioner | UK Core PractitionerRole | UK Core Organization | UK Core Patient | UK Core RelatedPerson | UK Core CareTeam)..
MedicationRequest.performer.identifier..
MedicationRequest.performer.identifier.assignerReference(UK Core Organization)..
MedicationRequest.recorderReference(UK Core Practitioner | UK Core PractitionerRole)..
MedicationRequest.recorder.identifier..
MedicationRequest.recorder.identifier.assignerReference(UK Core Organization)..
MedicationRequest.reasonReferenceReference(UK Core Condition | UK Core Observation)..
MedicationRequest.reasonReference.identifier..
MedicationRequest.reasonReference.identifier.assignerReference(UK Core Organization)..
MedicationRequest.basedOnReference(ImmunizationRecommendation | UK Core CarePlan | UK Core MedicationRequest | UK Core ServiceRequest)..
MedicationRequest.basedOn.identifier..
MedicationRequest.basedOn.identifier.assignerReference(UK Core Organization)..
MedicationRequest.groupIdentifier..
MedicationRequest.groupIdentifier.assignerReference(UK Core Organization)..
MedicationRequest.courseOfTherapyType..
MedicationRequest.insurance..
MedicationRequest.insurance.identifier..
MedicationRequest.insurance.identifier.assignerReference(UK Core Organization)..
MedicationRequest.note..
MedicationRequest.note.author[x]Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization), string..
MedicationRequest.dosageInstruction..
MedicationRequest.dosageInstruction.asNeeded[x]..
MedicationRequest.dosageInstruction.site..
MedicationRequest.dosageInstruction.route..
MedicationRequest.dosageInstruction.method..
MedicationRequest.dispenseRequest..
MedicationRequest.dispenseRequest.performerReference(UK Core Organization)..
MedicationRequest.dispenseRequest.performer.identifier..
MedicationRequest.dispenseRequest.performer.identifier.assignerReference(UK Core Organization)..
MedicationRequest.substitution1..
MedicationRequest.substitution.allowed[x]..
MedicationRequest.priorPrescriptionReference(UK Core MedicationRequest)..
MedicationRequest.priorPrescription.identifier..
MedicationRequest.priorPrescription.identifier.assignerReference(UK Core Organization)..
MedicationRequest.detectedIssue..
MedicationRequest.detectedIssue.identifier..
MedicationRequest.detectedIssue.identifier.assignerReference(UK Core Organization)..
MedicationRequest.eventHistoryReference(UK Core Provenance)..
MedicationRequest.eventHistory.identifier..
MedicationRequest.eventHistory.identifier.assignerReference(UK Core Organization)..


XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-MedicationRequest" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    <version value="2.4.0" />
    <name value="UKCoreMedicationRequest" />
    <title value="UK Core MedicationRequest" />
    <status value="active" />
    <date value="2023-04-28" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [MedicationRequest](https://hl7.org/fhir/R4/MedicationRequest.html)." />
    <purpose value="An order or request for both supply of the medication and the instructions for administration of the medication to an individual. \n\nThis profile covers inpatient medication orders as well as community orders (whether filled by the prescriber or by a pharmacy). It also includes orders for over-the-counter medications (e.g. Aspirin), total parenteral nutrition and diet/ vitamin supplements, and may be used to support the order of medication-related devices. \n\nIt is not intended for use in prescribing particular diets, or for ordering non-medication-related items (eyeglasses, supplies, etc)." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="script10.6" />
        <uri value="http://ncpdp.org/SCRIPT10_6" />
        <name value="Mapping to NCPDP SCRIPT 10.6" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationRequest" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationRequest.extension">
            <path value="MedicationRequest.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="0" />
        </element>
        <element id="MedicationRequest.extension:medicationRepeatInformation">
            <path value="MedicationRequest.extension" />
            <sliceName value="medicationRepeatInformation" />
            <min value="0" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation" />
            </type>
        </element>
        <element id="MedicationRequest.identifier.assigner">
            <path value="MedicationRequest.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.category">
            <path value="MedicationRequest.category" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory" />
            </binding>
        </element>
        <element id="MedicationRequest.reported[x]">
            <path value="MedicationRequest.reported[x]" />
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.medication[x]">
            <path value="MedicationRequest.medication[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" />
            </type>
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode" />
            </binding>
        </element>
        <element id="MedicationRequest.subject">
            <path value="MedicationRequest.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
            </type>
        </element>
        <element id="MedicationRequest.subject.identifier.assigner">
            <path value="MedicationRequest.subject.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.encounter">
            <path value="MedicationRequest.encounter" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" />
            </type>
        </element>
        <element id="MedicationRequest.encounter.identifier.assigner">
            <path value="MedicationRequest.encounter.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.supportingInformation.identifier.assigner">
            <path value="MedicationRequest.supportingInformation.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.requester">
            <path value="MedicationRequest.requester" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
            </type>
        </element>
        <element id="MedicationRequest.requester.identifier.assigner">
            <path value="MedicationRequest.requester.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.performer">
            <path value="MedicationRequest.performer" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam" />
            </type>
        </element>
        <element id="MedicationRequest.performer.identifier.assigner">
            <path value="MedicationRequest.performer.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.recorder">
            <path value="MedicationRequest.recorder" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
            </type>
        </element>
        <element id="MedicationRequest.recorder.identifier.assigner">
            <path value="MedicationRequest.recorder.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.reasonReference">
            <path value="MedicationRequest.reasonReference" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
            </type>
        </element>
        <element id="MedicationRequest.reasonReference.identifier.assigner">
            <path value="MedicationRequest.reasonReference.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.basedOn">
            <path value="MedicationRequest.basedOn" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest" />
            </type>
        </element>
        <element id="MedicationRequest.basedOn.identifier.assigner">
            <path value="MedicationRequest.basedOn.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.groupIdentifier.assigner">
            <path value="MedicationRequest.groupIdentifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.courseOfTherapyType">
            <path value="MedicationRequest.courseOfTherapyType" />
            <short value="A course of therapy for a medication request" />
            <definition value="The description of the course of therapy for a medication request." />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCourseOfTherapy" />
            </binding>
        </element>
        <element id="MedicationRequest.insurance.identifier.assigner">
            <path value="MedicationRequest.insurance.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.note.author[x]">
            <path value="MedicationRequest.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
            <type>
                <code value="string" />
            </type>
        </element>
        <element id="MedicationRequest.dosageInstruction.asNeeded[x]">
            <path value="MedicationRequest.dosageInstruction.asNeeded[x]" />
            <binding>
                <strength value="preferred" />
            </binding>
        </element>
        <element id="MedicationRequest.dosageInstruction.site">
            <path value="MedicationRequest.dosageInstruction.site" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite" />
            </binding>
        </element>
        <element id="MedicationRequest.dosageInstruction.route">
            <path value="MedicationRequest.dosageInstruction.route" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" />
            </binding>
        </element>
        <element id="MedicationRequest.dosageInstruction.method">
            <path value="MedicationRequest.dosageInstruction.method" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod" />
            </binding>
        </element>
        <element id="MedicationRequest.dispenseRequest.performer">
            <path value="MedicationRequest.dispenseRequest.performer" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.dispenseRequest.performer.identifier.assigner">
            <path value="MedicationRequest.dispenseRequest.performer.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.substitution">
            <path value="MedicationRequest.substitution" />
            <min value="1" />
        </element>
        <element id="MedicationRequest.substitution.allowed[x]">
            <path value="MedicationRequest.substitution.allowed[x]" />
            <definition value="The purpose of this element is to allow the prescriber to dispense a different drug from what was prescribed." />
        </element>
        <element id="MedicationRequest.priorPrescription">
            <path value="MedicationRequest.priorPrescription" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
            </type>
        </element>
        <element id="MedicationRequest.priorPrescription.identifier.assigner">
            <path value="MedicationRequest.priorPrescription.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.detectedIssue.identifier.assigner">
            <path value="MedicationRequest.detectedIssue.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationRequest.eventHistory">
            <path value="MedicationRequest.eventHistory" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance" />
            </type>
        </element>
        <element id="MedicationRequest.eventHistory.identifier.assigner">
            <path value="MedicationRequest.eventHistory.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-MedicationRequest",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest",
    "version": "2.4.0",
    "name": "UKCoreMedicationRequest",
    "title": "UK Core MedicationRequest",
    "status": "active",
    "date": "2023-04-28",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [MedicationRequest](https://hl7.org/fhir/R4/MedicationRequest.html).",
    "purpose": "An order or request for both supply of the medication and the instructions for administration of the medication to an individual. \n\nThis profile covers inpatient medication orders as well as community orders (whether filled by the prescriber or by a pharmacy). It also includes orders for over-the-counter medications (e.g. Aspirin), total parenteral nutrition and diet/ vitamin supplements, and may be used to support the order of medication-related devices. \n\nIt is not intended for use in prescribing particular diets, or for ordering non-medication-related items (eyeglasses, supplies, etc).",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "script10.6",
            "uri": "http://ncpdp.org/SCRIPT10_6",
            "name": "Mapping to NCPDP SCRIPT 10.6"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "MedicationRequest",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationRequest.extension",
                "path": "MedicationRequest.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "min": 0
            },
            {
                "id": "MedicationRequest.extension:medicationRepeatInformation",
                "path": "MedicationRequest.extension",
                "sliceName": "medicationRepeatInformation",
                "min": 0,
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.identifier.assigner",
                "path": "MedicationRequest.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.category",
                "path": "MedicationRequest.category",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory"
                }
            },
            {
                "id": "MedicationRequest.reported[x]",
                "path": "MedicationRequest.reported[x]",
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.medication[x]",
                "path": "MedicationRequest.medication[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication"
                        ]
                    }
                ],
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode"
                }
            },
            {
                "id": "MedicationRequest.subject",
                "path": "MedicationRequest.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Group",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.subject.identifier.assigner",
                "path": "MedicationRequest.subject.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.encounter",
                "path": "MedicationRequest.encounter",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.encounter.identifier.assigner",
                "path": "MedicationRequest.encounter.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.supportingInformation.identifier.assigner",
                "path": "MedicationRequest.supportingInformation.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.requester",
                "path": "MedicationRequest.requester",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.requester.identifier.assigner",
                "path": "MedicationRequest.requester.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.performer",
                "path": "MedicationRequest.performer",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.performer.identifier.assigner",
                "path": "MedicationRequest.performer.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.recorder",
                "path": "MedicationRequest.recorder",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.recorder.identifier.assigner",
                "path": "MedicationRequest.recorder.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.reasonReference",
                "path": "MedicationRequest.reasonReference",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.reasonReference.identifier.assigner",
                "path": "MedicationRequest.reasonReference.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.basedOn",
                "path": "MedicationRequest.basedOn",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.basedOn.identifier.assigner",
                "path": "MedicationRequest.basedOn.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.groupIdentifier.assigner",
                "path": "MedicationRequest.groupIdentifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.courseOfTherapyType",
                "path": "MedicationRequest.courseOfTherapyType",
                "short": "A course of therapy for a medication request",
                "definition": "The description of the course of therapy for a medication request.",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCourseOfTherapy"
                }
            },
            {
                "id": "MedicationRequest.insurance.identifier.assigner",
                "path": "MedicationRequest.insurance.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.note.author[x]",
                "path": "MedicationRequest.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    },
                    {
                        "code": "string"
                    }
                ]
            },
            {
                "id": "MedicationRequest.dosageInstruction.asNeeded[x]",
                "path": "MedicationRequest.dosageInstruction.asNeeded[x]",
                "binding": {
                    "strength": "preferred"
                }
            },
            {
                "id": "MedicationRequest.dosageInstruction.site",
                "path": "MedicationRequest.dosageInstruction.site",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite"
                }
            },
            {
                "id": "MedicationRequest.dosageInstruction.route",
                "path": "MedicationRequest.dosageInstruction.route",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
                }
            },
            {
                "id": "MedicationRequest.dosageInstruction.method",
                "path": "MedicationRequest.dosageInstruction.method",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod"
                }
            },
            {
                "id": "MedicationRequest.dispenseRequest.performer",
                "path": "MedicationRequest.dispenseRequest.performer",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.dispenseRequest.performer.identifier.assigner",
                "path": "MedicationRequest.dispenseRequest.performer.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.substitution",
                "path": "MedicationRequest.substitution",
                "min": 1
            },
            {
                "id": "MedicationRequest.substitution.allowed[x]",
                "path": "MedicationRequest.substitution.allowed[x]",
                "definition": "The purpose of this element is to allow the prescriber to dispense a different drug from what was prescribed."
            },
            {
                "id": "MedicationRequest.priorPrescription",
                "path": "MedicationRequest.priorPrescription",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.priorPrescription.identifier.assigner",
                "path": "MedicationRequest.priorPrescription.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.detectedIssue.identifier.assigner",
                "path": "MedicationRequest.detectedIssue.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.eventHistory",
                "path": "MedicationRequest.eventHistory",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationRequest.eventHistory.identifier.assigner",
                "path": "MedicationRequest.eventHistory.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            }
        ]
    }
}

Examples

Eye drops - An example to illustrate a request for eye drops.
Example UKCore-MedicationRequest-EyeDrops

Repeat Information - An example to illustrate the RepeatInformation extension.
Example UKCore-Extension-RepeatInformation

Usage

This Profile has the following derived profiles:


This Profile is referenced in the following Extensions:


This Profile is referenced in the following Profiles:
idtargetProfile
UKCore-DiagnosticReporthttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation; http://hl7.org/fhir/StructureDefinition/NutritionOrder; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ImagingStudy; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
UKCore-MedicationAdministrationhttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-EpisodeOfCare; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
UKCore-MedicationDispensehttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-EpisodeOfCare; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
UKCore-MedicationRequesthttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
UKCore-MedicationStatementhttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-EpisodeOfCare; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson
UKCore-Observationhttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/DeviceRequest; http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation; http://hl7.org/fhir/StructureDefinition/NutritionOrder; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ImagingStudy; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/DeviceMetric; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/MolecularSequence; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/Media; http://hl7.org/fhir/StructureDefinition/MolecularSequence; https://fhir.hl7.org.uk/StructureDefinition/UKCore-DocumentReference; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ImagingStudy; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
UKCore-ServiceRequesthttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan; https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition; https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport; https://fhir.hl7.org.uk/StructureDefinition/UKCore-DocumentReference; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization

Example Usage Scenarios

The following are example usage scenarios for the UK Core MedicationRequest profile:

  • Query for a patient's specific requested medication
  • Record or update a requested medication.

Profile Specific Implementation Guidance:

Minimum Viable Content

A minimum viable content that all provider and consumer systems SHALL support are the following elements.

Element Reason
MedicationRequest.identifier Allow the resource to be referenced within/by other resources
MedicationRequest.status A code specifying the current state of the order.
MedicationRequest.intent Whether the request is a proposal, plan, or an original order.
MedicationRequest.category Provides the business context for the relevant dispensing processes
MedicationRequest.medication[x] Identifies the medication being requested.
MedicationRequest.subject Who medication request is for
MedicationRequest.authoredOn To timestamp the event
MedicationRequest.requester Who is requesting the medication
MedicationRequest.dosageInstruction Dosage instructions for the medication
MedicationRequest.dosageInstruction.text Free text dosage instructions.
MedicationRequest.dosageInstruction.timing When medication should be administered.
MedicationRequest.dosageInstruction.doseAndRate Dosage instructions for the medication
MedicationRequest.dosageInstruction.doseAndRate.dose[x] Quantity of medication administered.
MedicationRequest.dosageInstruction.doseAndRate.rate[x] Rate at which the medication is to be administered.
MedicationRequest.dosageInstruction Dosage instructions for the medication.
MedicationRequest.dispenseRequest Specific dispensing quantity instructions.
MedicationRequest.dispenseRequest.quantity Amount of medication to supply per dispense.
MedicationRequest.substitution Any restrictions on medication substitution.

Extensions

More information about the extensions can be found using the links below.

Extension Context Link Comment
medicationRepeatInformation MedicationRequest Extension UKCore-MedicationRepeatInformation

Bindings (differential)

More information about the bindings to UK Core ValueSets can be found below.

Context Strength Link
MedicationRequest.category Extensible ValueSet UKCore-MedicationRequestCategory
MedicationRequest.courseOfTherapyType Extensible ValueSet UKCore-MedicationRequestCourseOfTherapy
MedicationRequest.dosageInstruction.method Preferred ValueSet UKCore-MedicationDosageMethod
MedicationRequest.dosageInstruction.route Preferred ValueSet UKCore-SubstanceOrProductAdministrationRoute
MedicationRequest.dosageInstruction.site Preferred ValueSet UKCore-BodySite
MedicationRequest.medication Preferred ValueSet UKCore-MedicationCode

status

The scope of MedicationRequest.status MAY vary depending on the nature of the implementation. The FHIR standard defines the MedicationRequest.status of completed as “All actions that are implied by the prescription have occurred”.

This allows for different design decisions for tracking a medication request status.

  • An implementation MAY track the MedicationRequest.status through to the receipt of the medication request at the pharmacy, after which the MedicationRequest.status is completed

  • An implementation MAY track the MedicationRequest.status through to completion of dispensing events, after which the MedicationRequest.status is completed

  • An implementation MAY track the MedicationRequest.status through to completion of administration events for the medication that has been dispensed, after which the MedicationRequest.status is completed.

The following guidance is based on an implementation tracking the status through to completion of dispensing events.

Status FHIR Definition Implementation Guidance
draft The prescription is not yet "actionable", e.g. it is a work in progress, requires sign-off, verification or needs to be run through decision support process. The order is work in progress within the ePMA system and has not yet sent to the pharmacy.
active The prescription is "actionable", but not all actions that are implied by it have occurred yet. The order has been sent and accepted by the pharmacy. Dispensing and administration activities may have been started but are not yet `Complete`.
completed All actions that are implied by the prescription have occurred. Dispensing activities have been completed for the medication defined within the order.
on-hold Actions implied by the prescription are to be temporarily halted but are expected to continue later. May also be called `Suspended`. Will prevent the order being sent to the pharmacy. If already sent, an update needs to be sent to the pharmacy to temporarily halt further dispensing.
cancelled The prescription has been withdrawn before any administrations have occurred. Will prevent the order being sent to the pharmacy. If already sent, an update needs to be sent to the pharmacy so that no further medication is dispensed.
stopped Actions implied by the prescription are to be permanently halted before all of the administrations occurred. This SHOULD NOT be used if the original order was entered in error. The order needs to be stopped on clinical grounds. An update needs to be sent to the pharmacy so that no further medication is dispensed.
entered-in-error Some of the actions that are implied by the medication request may have occurred. For example, the medication may have been dispensed and the patient may have taken some of the medication. Clinical decision support systems SHOULD take this status into account. The order needs to be stopped due to human data entry error. An update needs to be sent to the pharmacy so that no further medication is dispensed.
unknown The authoring/source system does not know which of the status values currently applies for this observation. Note: This concept is not to be used for ‘other’ - one of the listed statuses is presumed to apply, but the authoring/source system does not know which. Recommended not to be supported as the use case for this status value is unclear.

Logical MedicationRequest status transitions

This state transition diagram is an enhancement over the generic State Machine defined within the FHIR specification. It includes the MedicationRequest.status values associated with a medication request with transitions applicable to a UK implementation.


medication-request-status-flow

Status transitions explained

Previous Future Interoperability Recommendation
draft active This transition will trigger the sending / sharing of the MedicationRequest from the prescribing system to the pharmacy system to start dispensing activities.
draft cancelled Contained within the prescribing system.
draft on-hold Contained within the prescribing system.
draft entered-in-error Contained within the prescribing system.
on-hold draft Contained within the prescribing system.
on-hold active This transition will trigger an update to the MedicationRequest from the prescribing system to the pharmacy system to restart dispensing activities.
on-hold cancelled Contained within the prescribing system.
on-hold stopped Contained within the prescribing system.
on-hold entered-in-error Contained within the prescribing system.
active active Not a MedicationRequest status transition but the pharmacy system could send / share dispensing activities with the prescribing system, typically using a FHIR profile based on MedicationDispense.
active on-hold This transition will trigger an update to the MedicationRequest from the prescribing system to the pharmacy system to suspend dispensing activities.

If dispensing has already occurred but meds have not been delivered to the ward then they can stay within the pharmacy until the request is re-activated. If meds have been delivered to the ward then there is no action required by the pharmacy system.
active entered-in-error This transition will trigger an update to the MedicationRequest from the prescribing system to the pharmacy system to stop dispensing activities.
active stopped This transition will trigger an update to the MedicationRequest from the prescribing system to the pharmacy system to stop dispensing activities.
active completed Contained within the prescribing system. All requested medication has been received from pharmacy and has been recorded / confirmed within the ePMA system.

statusReason

A coded reason for the current state of the medication request.

SHOULD only be populated when the MedicationRequest.status is on-hold, cancelled or stopped.


intent

The value order SHOULD be used to denote this is a medication request order.


category

It is expected that any implementation will need to distinguish between medication orders for processes for dispensing and / or administration so this element is business required.

Category values mapped to target use-cases

Example use cases for each category:

Category Use-case Scenario
inpatient Inpatient medication requests, for a named patient, to be dispensed by the hospital pharmacy and intended for administration on a hospital ward. Patient Anne Teak is admitted as an inpatient is prescribed Amoxicillin 500mg orally three times daily for a suspected chest infection.
leave Medication requests, for a named patient who is on short-term leave from an inpatient stay (but is not discharged), to be dispensed by the hospital pharmacy and intended for administration at home. Current inpatient Jackie Taitor is going home for weekend leave and is prescribed 3 days supply of Citalopram 20mg tablets one to be taken in the morning.
discharge Discharge medications requests, for a named patient, to be dispensed by the hospital pharmacy and issued on discharge for administration at home. Patient Bill Ding is discharged from hospital following an admission where they were diagnosed as being diabetic. They were prescribed 4 weeks quantity of Metformin 500mg tablets to take twice daily on an on-going basis. Their GP will be instructed to continue this course of medication within a discharge note.
outpatient Outpatient medication requests, for a named patient, to be dispensed by the hospital pharmacy and intended for administration in the Outpatients department, Accident and Emergency department, or Day unit. Patient Moe DeGrasse is prescribed a Goserelin 3.6mg implant to be administered by IM injection in the Outpatients department on 1st May 2020.
community Outpatient medication requests, for a named patient, to be dispensed by the hospital pharmacy for administration at home. Patient Lorna Mower has attended the dermatology outpatients clinic and is prescribed Betamethasone 0.1% cream to be applied sparingly twice daily for 2 weeks.

Note: A community medication request would trigger the printing and signing of a paper FP10HNC prescription, or (when implemented by the Trust) an electronic prescription sent to the NHS Electronic Prescription Service.


priority

Recommendation: not to be used within an implementation - or used with caution.

The stating of a priority, in any business context including healthcare, is often de-valued as given the choice, every clinician wants medication urgently for their patients.

If MedicationRequest.priority is used, consider only initially supporting the routine and urgent request priorities, and set clear criteria for when a MedicationRequest should be marked and handled as urgent.

Usage of the value "stat"

The stat request priority is potentially confusing as it has two meanings:

  1. to indicate a "here and now" order going to pharmacy
  2. used within a MedicationRequest.dosageInstruction can also mean "give once immediately".

Avoid using stat and asap where possible.


doNotPerform

At this time it is advised that providers to not support this element within an implementation.

Consumers SHALL check the value of this element prior to processing and, if MedicationRequest.doNotPerform is true, either appropriately process doNotPerform MedicationRequests (e.g. notify the user) or reject the resource.


medication[x]

Medication WITH dm+d code

Where a dm+d code exists it SHALL be used either as MedicationRequest.medicationCodeableConcept.coding or as MedicationRequest.medicationReference.Medication.code

Where CodeableConcept is used, MedicationRequest.medicationCodeableConcept.coding is the dm+d code and MedicationRequest.medicationCodeableConcept.text is dm+d concept name/description.

Can be either a dm+d code as a CodeableConcept or reference to UK Core Profile UKCore-Medication resource. Using a CodeableConcept is preferred unless additional data if required that would be contained within a UK Core Profile UKCore-Medication resource.

The elements MedicationRequest.medicationCodeableConcept.coding and MedicationRequest.medicationReference.Medication.code are both bound to ValueSet UKCore-MedicationCode

Examples where a reference to a UK Core Profile UKCore-Medication would be applicable include:

  • Record a VTM with a specific form
  • Record manufacturer with a concept as described in ValueSet UKCore-MedicationCode
  • Record batch number
  • Record ingredients (for example with a magisterial prescription or an excipient).

Medication WITHOUT dm+d code

Medication not published within the dm+d may be requested in the Acute care setting.

In this scenario it is recommended to use the MedicationRequest.medicationCodeableConcept variant for this element.

If the prescribing system has both a locally assigned code and description for the medication then;

  • The MedicationRequest.medicationCodeableConcept.text SHOULD be the description for the medication.
  • The MedicationRequest.medicationCodeableConcept.coding.code SHOULD be the code for the medication.
  • The MedicationRequest.medicationCodeableConcept.coding.display SHOULD be the description for the medication, i.e. the same value as MedicationRequest.medicationCodeableConcept.text.

If the prescribing system only has a description for the medication then;

  • The MedicationRequest.medicationCodeableConcept.text SHOULD be the locally assigned description for the medication.

subject

The resource being referenced SHALL conform to one of the following:


encounter

Encounter created as part of encounter/admission/stay by reference to the encounter. The resource being referenced SHALL conform to Profile UKCore-Encounter


supportingInformation

Where a UK Core profile exists, the resource being referenced SHALL conform to the profile.

Some examples of use include:

  • Reference an Observation resource to share data like the patient’s height and weight.
  • Reference a Condition resource to share a patient’s condition if this influences the pharmacy dispensing process. For example; 105502003 Dependence on renal dialysis (finding) or 46177005 End stage renal disease (disorder) would justify an unusual dosage on a prescription.
  • Reference an AllergyIntolerance resource to share a patient’s allergy to make it clear why certain medication is being requested. For example, a Penicillin allergy.
  • Reference a CarePlan resource where medication dispensing is considered as part of a specific treatment regimen. For example, care plans for stroke patients.

authoredOn

SHOULD be populated with the date and time that the medication request was authored.


requester

A business required element identifying the clinically qualified human prescriber referenced by a Practitioner or PractitionerRole resource. They may be other possible references depending on the use case the full list is below.

The resource being referenced SHALL conform to one of the following:


performer

Intended performer of administration by reference.

The resource being referenced SHALL conform to one of the following:


recorder

The identification of the MedicationRequest.recorder where this is a different person to the MedicationRequest.requester provides an additional point of contact for any queries related to the medication request and is done by a reference.

The resource being referenced SHALL conform to one of the following:


reasonCode

Useful to the wider clinical team as an additional safety check, especially if the requested medication is normally prescribed for different reasons, to avoid confusion between clinical teams. Recording an indication against a medication request also gives valuable insight when data is collated for secondary uses, especially if linked with outcome data.

Where possible this SHOULD be a coded term from the SNOMED CT hierarchy as a descendant of the concept 404684003 (Clinical finding); however, free-text reasons are also acceptable.


reasonReference

Reference to Condition or Observation that supports why the prescription is being written by reference.

The resource being referenced SHALL conform to one of the following:

If the clinical system has recorded the reason for medication (often known as the indication) as either a Condition or Observation resource then a logical link to that resource has business benefit.


basedOn

Any resource being referenced SHALL conform to the following profiles/resources:

Recommendation: To reference a previous medication request use MedicationRequest.priorPrescription instead of this element.

If the clinical system has implemented the CarePlan resource, a logical link to the care plan for which the medication request is based has business benefit.


groupIdentifier

Gives the ability to logically link/group medication requests.

For example, the FHIR interface for the NHS England Electronic Prescription Service uses the MedicationRequest.groupIdentifier to group medication requests for the same patient and prescribed at the same time.


courseOfTherapyType

An element defining the course of therapy, such as 'continuous' or 'acute'.


note

Use when the prescriber wishes to provide supporting textual information to the dispenser.


dosageInstruction

Consider aligning to the Implementation Guide for Digital Medicines, but as a minimum, MedicationRequest.dosageInstruction.text.

Where a structured dosage is provided, populate MedicationRequest.dosageInstruction.text with a human readable dosage string that is clinically equivalent to the coded dosage instruction. This is for interoperability with consuming systems that do not yet support fully structured dosing instructions.


dispenseRequest

Used to convey specific dispensing requests to the pharmacy that are not otherwise detailed within the MedicationRequest.dosageInstruction.

For most medication requests the hospital pharmacy will typically dispense a quantity of medication appropriate for the medication and dosage, as per their local agreed best practice, to balance the quantity of medication held in pharmacy to that held on the ward.

The inclusion of a MedicationRequest.dispenseRequest MAY be useful when requesting discharge medication requests.

Use Case Original Medication Discharge Medication dispense Request
Instruction to the pharmacy to dispense a specific quantity of medication, either expressed as a number of days or as a dose form quantity. Paracetamol - 1g - four times a day Paracetamol - 1g - four times a day

One week supplied on discharge.
7 days or 28 tablets
Any inpatient scenario where the pharmacy is instructed to dispense a specific quantity of medication. For example, if the patient is known to be discharged soon. Atenolol - 50mg - daily Atenolol - 50mg - daily

Two weeks supplied on discharge, GP to continue.
14 days or 14 tablets

dispenseRequest.validityPeriod

In electronic repeat dispensing, the MedicationRequest.dispenseRequest.validityPeriod.end is used to record when an eRD prescription cycle ends. This is different to the extension medicationRepeatInformation.authorisationExpiryDate which is the date the prescriber must review the prescription with the patient.


substitution

Allowing substitution

Where substitution to be be allowed, set to true. The inclusion of the coded reason is optional as the ValueSet defined in FHIR is of limited benefit to UK healthcare.


priorPrescription

A reference to previous request.

The resource being referenced SHALL conform to Profile UKCore-MedicationRequest.

Useful when the clinical system would benefit from being able to link re-supply requests with a previous request.


eventHistory

A list of events of interest in the lifecycle and SHALL conform to Profile UKCore-Provenance.