<status value="draft" /> <date value="2021-10-24T23:07:03.5529097+00:00" /> <publisher value="HL7 Canada" /> <description value="Proposed constraints and extensions on the MedicationRequest resource. Generated as a first step toward creating a set of Canadian Baseline FHIR profiles." /> <fhirVersion value="4.0.1" /> <mapping> <identity value="CDSS5.1" /> <uri value="www.ontariomd.com" /> <name value="CDS-S 5.1" /> </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"> <path value="MedicationRequest" /> <short value="MedicationRequest Profile" /> <definition value="The Canadian Baseline MedicationRequest Profile is based upon the core FHIR MedicationRequest Resource" /> </element> <element id="MedicationRequest.identifier.value"> <path value="MedicationRequest.identifier.value" /> <definition value="BASE RESOURCE DEFINITION: The portion of the identifier typically relevant to the user and which is unique within the context of the system. CDS-S PROFILE DEFINITION: A unique identifier for the prescription within the EMR." /> <comment value="A unique identifier for the prescription within the EMR (e.g., Rx or prescription number)." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.023" /> <comment value="Prescription Identifier" /> </mapping> </element> <element id="MedicationRequest.status"> <path value="MedicationRequest.status" /> <definition value="BASE RESOURCE DEFINITION: A code specifying the current state of the order. Generally, this will be active or completed state. CDS-S PROFILE DEFINITION: Describes the lifecycle of the prescription (e.g., new, active, suspended)." /> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. CODE SET TABLE: CT-035: Prescription Status" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.026" /> <comment value="Prescription Status" /> </mapping> </element> <element id="MedicationRequest.intent"> <path value="MedicationRequest.intent" /> <definition value="BASE RESOURCE DEFINITION: Whether the request is a proposal, plan, or an original order. CDS-S PROFILE DEFINITION: Indicates if a paper copy of the prescription must be viewed before the medication can be dispensed. Whether or not an electronically retrieved prescription is authoritative all by itself is a notion that must be explicitly stated." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.027" /> <comment value="Non Authoritative Indicator" /> </mapping> </element> <element id="MedicationRequest.category.text"> <path value="MedicationRequest.category.text" /> <definition value="BASE RESOURCE DEFINITION: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. CDS-S PROFILE DEFINITION: Describes the categorization of the treatment (e.g., continuous, one-time)." /> <mustSupport value="true" /> <binding> <strength value="required" /> <description value="Refer to CT-034: Treatment Types" /> <valueSet value="https://simplifier.net/guide/CoreDataSetStandardCDS-SImplementationGuidance/ReportsFlagsDataTypesCodeTablesCT-027toCT-038" /> </binding> <mapping> <identity value="CDSS5.1" /> <map value="DE09.025" /> <comment value="Treatment Type" /> </mapping> </element> <element id="MedicationRequest.reported[x]"> <path value="MedicationRequest.reported[x]" /> <type> <code value="boolean" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" /> </type> <mustSupport value="true" /> </element> <element id="MedicationRequest.medication[x]"> <path value="MedicationRequest.medication[x]" /> <type> <code value="CodeableConcept" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication" /> </type> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time." /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" /> </binding> </element> <element id="MedicationRequest.subject"> <path value="MedicationRequest.subject" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient" /> </type> <mustSupport value="true" /> </element> <element id="MedicationRequest.encounter"> <path value="MedicationRequest.encounter" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter" /> </type> </element> <element id="MedicationRequest.supportingInformation"> <path value="MedicationRequest.supportingInformation" /> <definition value="BASE RESOURCE DEFINITION: Include additional information (for example, patient height and weight) that supports the ordering of the medication. CDS-S PROFILE DEFINITION: A unique identifier for a specific protocol or guideline which the prescription has been written in accordance with. Enables the communication of a reference to a protcol, study or guideline ID that is specific to the jurisdiction." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.035" /> <comment value="Protocol Identifier" /> </mapping> </element> <element id="MedicationRequest.authoredOn"> <path value="MedicationRequest.authoredOn" /> <definition value="BASE RESOURCE DEFINITION: The date (and perhaps time) when the prescription was initially written or authored on. CDS-S PROFILE DEFINITION: The writtn date of the prescription. This is not the date the prescription was added/inserted into the EMR." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.001" /> <comment value="Prescription Written Date" /> </mapping> </element> <element id="MedicationRequest.requester"> <path value="MedicationRequest.requester" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device" /> </type> <mustSupport value="true" /> </element> <element id="MedicationRequest.performer"> <path value="MedicationRequest.performer" /> <definition value="BASE RESOURCE DEFINITION: The specified desired performer of the medication treatment (e.g. the performer of the medication administration). CDS-S PROFILE DEFINITION (Prescribed by Name): The First Name and Last Name of the prescriber. CDS-S PROFILE DEFINITION (Prescribed by Name): The "OHIP Billing Number" number of the prescriber." /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" /> </type> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.021" /> <comment value="Prescribed by Name" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE09.022" /> <comment value="Prescribed by Identifier" /> </mapping> </element> <element id="MedicationRequest.recorder"> <path value="MedicationRequest.recorder" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole" /> </type> </element> <element id="MedicationRequest.reasonCode.coding.code"> <path value="MedicationRequest.reasonCode.coding.code" /> <definition value="BASE RESOURCE DEFINITION: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). CDS-S PROFILE DEFINITION: A coded form of the problem that is the reason for the current prescription. Facilities cross-checking the use of a therapy against its indication." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.034" /> <comment value="Problem Code" /> </mapping> </element> <element id="MedicationRequest.reasonReference"> <path value="MedicationRequest.reasonReference" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-condition" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </type> </element> <element id="MedicationRequest.basedOn"> <path value="MedicationRequest.basedOn" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-immunizationrecommendation" /> </type> </element> <element id="MedicationRequest.note.text"> <path value="MedicationRequest.note.text" /> <definition value="BASE RESOURCE DEFINITION: The text of the annotation in markdown format. CDS-S PROFILE DEFINITION: Notes the provider adds to the prescription that are not visible on the printed prescription." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.019" /> <comment value="Notes" /> </mapping> </element> <element id="MedicationRequest.dosageInstruction"> <path value="MedicationRequest.dosageInstruction" /> <mustSupport value="true" /> </element> <element id="MedicationRequest.dosageInstruction.text"> <path value="MedicationRequest.dosageInstruction.text" /> <mustSupport value="true" /> </element> <element id="MedicationRequest.dosageInstruction.patientInstruction"> <path value="MedicationRequest.dosageInstruction.patientInstruction" /> <comment value="Notes the provider adds to the prescription to communicate with the pharmacist." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.020" /> <comment value="Prescription Instructions" /> </mapping> </element> <element id="MedicationRequest.dosageInstruction.timing"> <path value="MedicationRequest.dosageInstruction.timing" /> <definition value="BASE RESOURCE DEFINITION: When medication should be administered. CDS-S PROFILE DEFINITION: The frequency by which the prescribed medication is to be consumed." /> <comment value="This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. CODE SET TABLE: CT-024 Medication Frequency" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.010" /> <comment value="Frequency" /> </mapping> </element> <element id="MedicationRequest.dosageInstruction.route"> <path value="MedicationRequest.dosageInstruction.route" /> <definition value="BASE RESOURCE DEFINITION: How drug should enter body. CDS-S PROFILE DEFINITION: The means by which the dispensed drug is to be administered to the patient. Can be the route of the administration as suggested by the manufacturer and provided by the EMR's Drug Database or as typed in by the provider." /> <comment value="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. CODE SET TABLE: CT-022: Medication and Immunization Route" /> <mustSupport value="true" /> <binding> <strength value="extensible" /> <description value="the route or physiological path of administration of a therapeutic agent into or onto the body of a subject." /> <valueSet value="https://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration" /> </binding> <mapping> <identity value="CDSS5.1" /> <map value="DE09.009" /> <comment value="Route" /> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate"> <path value="MedicationRequest.dosageInstruction.doseAndRate" /> <definition value="BASE RESOURCE DEFINITION: The amount of medication administered. CDS-S PROFILE DEFINITION: Dose amount and unit of measure of the medication intended to be consumed during a single administration as prescribed by the provider. The dosage is characterized by a numeric value and an associated unit of measure. Examples: 1 tsp, 2 tabs." /> <comment value="CODE SET TABLE: CT-026: Medication - Dosage Unit of Measure" /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.007" /> <comment value="Dosage" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.quantity"> <path value="MedicationRequest.dispenseRequest.initialFill.quantity" /> <definition value="BASE RESOURCE DEFINITION: The amount or quantity to provide as part of the first dispense. CDS-S PROFILE DEFINITION: The quantity of medication to be dispensed for the first administration of the prescription (inital dispense)." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.013" /> <comment value="Quantity" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.duration"> <path value="MedicationRequest.dispenseRequest.initialFill.duration" /> <definition value="BASE RESOURCE DEFINITION: The length of time that the first dispense is expected to last. CDS-S PROFILE DEFINITION: The duration of medication to be dispensed for the first administration of the prescription (initial dispense)." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.011" /> <comment value="Duration" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.dispenseInterval"> <path value="MedicationRequest.dispenseRequest.dispenseInterval" /> <definition value="BASE RESOURCE DEFINITION: The minimum period of time that must occur between dispenses of the medication. CDS-S PROFILE DEFINITION: Indicates the minimum amount of time that must occur between dispenses." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.028" /> <comment value="Dispense Interval" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.validityPeriod.start"> <path value="MedicationRequest.dispenseRequest.validityPeriod.start" /> <definition value="BASE RESOURCE DEFINITION: The start of the period. The boundary is inclusive. CDS-S PROFILE DEFINITION: The start date of the prescription." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.002" /> <comment value="Start Date" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"> <path value="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed" /> <definition value="BASE RESOURCE DEFINITION: An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. CDS-S PROFILE DEFINITION: The subsequent fills that follow the initial dispense of the prescription." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.015" /> <comment value="Number of Refills/Repeats" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.quantity"> <path value="MedicationRequest.dispenseRequest.quantity" /> <definition value="BASE RESOURCE DEFINITION: The amount that is to be dispensed for one fill. CDS-S PROFILE DEFINITION: The quantity of medication to be dispensed for the refills of the prescription. Supports the use cases when refill quantity differs from initial dispense." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.014" /> <comment value="Refill Quantity" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.expectedSupplyDuration"> <path value="MedicationRequest.dispenseRequest.expectedSupplyDuration" /> <definition value="BASE RESOURCE DEFINITION: Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. CDS-S PROFILE DEFINITION: The duration of medication to be dispensed for the refills of the prescription. Supports the use cases when refill duration differs from initial dispense." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.012" /> <comment value="Refill Duration" /> </mapping> </element> <element id="MedicationRequest.dispenseRequest.performer"> <path value="MedicationRequest.dispenseRequest.performer" /> <definition value="BASE RESOURCE DEFINITION: Indicates the intended dispensing Organization specified by the prescriber. CDS-S PROFILE DEFINITION (Target Dispensing Facility - Service Location Address): Identifies the physical location of a dispensing service location and also allows for the location to be contacted. CDS-S PROFILE DEFINITION (Target Dispensing Facility - Service Location Name): The name assigned to the dispensing service location. Used for human communication, and for cross-checking of the Targeted Dispensing Facility - Service Location Identifier. CDS-S PROFILE DEFINITION (Target Dispensing Facility - Service Location Identifier): Unique identifier for a dispensing location. Allows for lookup and retrieval of detailed information about a specific service location. Also ensures unique identification of service location." /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization" /> </type> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.030" /> <comment value="Target Dispensing Facility - Service Location Address" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE09.031" /> <comment value="Target Dispensing Facility - Service Location Name" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE09.032" /> <comment value="Target Dispensing Facility - Service Location Identifier" /> </mapping> </element> <element id="MedicationRequest.substitution.allowed[x]"> <path value="MedicationRequest.substitution.allowed[x]" /> <definition value="BASE RESOURCE DEFINITION: True if the prescriber allows a different drug to be dispensed from what was prescribed. CDS-S PROFILE DEFINITION: A prescribers instruction that a specific prescribed product must be dispensed as-is, or not." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.029" /> <comment value="Substitution Not Allowed" /> </mapping> </element> <element id="MedicationRequest.priorPrescription"> <path value="MedicationRequest.priorPrescription" /> <definition value="BASE RESOURCE DEFINITION: A link to a resource representing an earlier order related order or prescription. CDS-S PROFILE DEFINITION: A reference to a previous prescription which the current prescription replaces." /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest" /> </type> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE09.024" /> <comment value="Prior Prescription Reference" /> </mapping> </element> </differential> </StructureDefinition>