STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Detailed Descriptions for the elements in the MedicationRequest resource.

MedicationRequest
Definition

An order for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings as well as for care plans, etc and to harmonize with workflow patterns.

Control 1..1
Alternate Names Prescription; Order
MedicationRequest.identifier
Definition

External identifier - one that would be used by another non-FHIR system - for example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records have to be tracked through an entire system.

Note This is a business identifer, not a resource identifier (see discussion )
Control 0..*
Type Identifier
MedicationRequest.definition
Definition

Protocol or definition followed by this request.

Control 0..*
Type Reference ( ActivityDefinition | PlanDefinition )
Summary true
MedicationRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

Control 0..*
Type Reference ( CarePlan | DiagnosticRequest | MedicationRequest | ProcedureRequest | ReferralRequest )
Summary true
MedicationRequest.requisition
Definition

Composite request this is part of.

Control 0..1
Type Identifier
Summary true
MedicationRequest.status
Definition

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

Control 0..1
Terminology Binding MedicationRequestStatus ( Required )
Type code
Is Modifier true
Summary true
MedicationRequest.stage
Definition

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

Control 1..1
Terminology Binding MedicationRequestStage ( Example )
Type CodeableConcept
Is Modifier true
Summary true
Comments

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

MedicationRequest.medication[x]
Definition

Identifies the medication being administered. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

Control 1..1
Terminology Binding SNOMED CT Medication Codes ( Example )
Type CodeableConcept | Reference ( Medication )
[x] Note See Choice of Data Types for further information about how to use [x]
Summary true
Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. Note: do not use Medication.name to describe the prescribed medication. When the only available information is a text description of the medication, Medication.code.text should be used.

MedicationRequest.patient
Definition

A link to a resource representing the person to whom the medication will be given.

Control 1..1
Type Reference ( Patient )
Summary true
Comments

The patient on a medicationRequest is mandatory. For the secondary use case where the actual patient is not provided, there still must be an anonymyzed patient specified.

MedicationRequest.context
Definition

A link to a resource that identifies the particular occurrence or set oc occurences of contact between patient and health care provider.

Control 0..1
Type Reference ( Encounter | EpisodeOfCare )
Comments

SubstanceAdministration->component->EncounterEvent.

MedicationRequest.supportingInformation
Definition

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

Control 0..*
Type Reference ( Any )
MedicationRequest.dateWritten
Definition

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

Control 0..1
Type dateTime
Summary true
MedicationRequest.requester
Definition

The healthcare professional responsible for authorizing the initial prescription.

Control 0..1
Type Reference ( Practitioner | Organization | Patient | RelatedPerson | Device )
Summary true
Comments

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

MedicationRequest.reasonCode
Definition

Can be the reason or the indication for writing the prescription.

Control 0..*
Terminology Binding Condition/Problem/Diagnosis Codes ( Example )
Type CodeableConcept
Comments

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

MedicationRequest.reasonReference
Definition

Condition or observation that supports why the prescription is being written.

Control 0..*
Type Reference ( Condition | Observation )
Comments

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

MedicationRequest.note
Definition

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

Control 0..*
Type Annotation
MedicationRequest.category
Definition

Indicates where type of medication order and where the medication is expected to be consumed or administered.

Control 0..1
Terminology Binding MedicationRequestCategory ( Example )
Type CodeableConcept
MedicationRequest.dosageInstruction
Definition

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

Control 0..*
Type DosageInstruction
MedicationRequest.dispenseRequest
Definition

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

Control 0..1
MedicationRequest.dispenseRequest.validityPeriod
Definition

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

Control 0..1
Type Period
Requirements

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

Comments

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

MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
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.

Control 0..1
Type positiveInt
Comments

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

MedicationRequest.dispenseRequest.quantity
Definition

The amount that is to be dispensed for one fill.

Control 0..1
Type SimpleQuantity
MedicationRequest.dispenseRequest.expectedSupplyDuration
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.

Control 0..1
Type Duration
Comments

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

MedicationRequest.dispenseRequest.performer
Definition

Indicates the intended dispensing Organization specified by the prescriber.

Control 0..1
Type Reference ( Organization )
MedicationRequest.substitution
Definition

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

Control 0..1
MedicationRequest.substitution.allowed
Definition

True if the prescriber allows a different drug to be dispensed from what was prescribed.

Control 1..1
Type boolean
Is Modifier true
MedicationRequest.substitution.reason
Definition

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

Control 0..1
Terminology Binding SubstanceAdminSubstitutionReason ( Example )
Type CodeableConcept
MedicationRequest.priorPrescription
Definition

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

Control 0..1
Type Reference ( MedicationRequest )
MedicationRequest.eventHistory
Definition

A summary of the events of interest that have occurred as the request is processed; e.g. when the order was verified or when it was completed.

Control 0..*
Type Reference ( Provenance )
Comments

See usage notes in Request pattern in request history.