This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
STU
3).
(v3.3.0:
R4
Ballot
2).
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
Pharmacy
Work
Group
|
Maturity Level : 3 | Trial Use | Compartments : Encounter , Patient , Practitioner |
Detailed Descriptions for the elements in the MedicationRequest resource.
| MedicationRequest | |
| Element Id | MedicationRequest |
| Definition |
An
order
or
request
for
both
supply
of
the
medication
and
the
instructions
for
administration
of
the
medication
to
a
patient.
The
resource
is
called
|
| Control | 1..1 |
| Alternate Names | Prescription; Order |
| MedicationRequest.identifier | |
| Element Id | MedicationRequest.identifier |
| Definition |
This
records
identifiers
associated
with
this
medication
request
that
are
defined
by
business
processes
and/or
used
to
refer
to
it
when
a
direct
URL
reference
to
the
resource
itself
is
not
appropriate.
For
example
a
|
| Note | This is a business identifer, not a resource identifier (see discussion ) |
| Control | 0..* |
| Type | Identifier |
|
|
|
|
|
|
| Definition |
A
code
specifying
the
current
state
of
the
order.
|
| Control |
|
| Terminology Binding | MedicationRequestStatus ( Required ) |
| Type | code |
| Is Modifier | true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid) |
| Summary | true |
| Comments |
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
| MedicationRequest.intent | |
| Element Id | MedicationRequest.intent |
| Definition |
Whether the request is a proposal, plan, or an original order. |
| Control | 1..1 |
| Terminology Binding | MedicationRequestIntent ( Required ) |
| Type | code |
| Is Modifier | true (Reason: Not known why this is labelled a modifier) |
| 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. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. |
| MedicationRequest.category | |
| Element Id | MedicationRequest.category |
| Definition |
Indicates
the
type
of
medication
|
| Control |
|
| Terminology Binding |
MedicationRequestCategory
(
|
| Type | CodeableConcept |
| Comments | The category can be used to include treatment types (e.g. chemotherapy or endocrine) or where the medication is expected to be consumed or other types of requests. Invariants can be used to bind to different value sets when profiling to bind. |
| MedicationRequest.priority | |
| Element Id | MedicationRequest.priority |
| Definition |
Indicates how quickly the Medication Request should be addressed with respect to other requests. |
| Control | 0..1 |
| Terminology Binding |
|
| Type | code |
| Summary | true |
| MedicationRequest.medication[x] | |
| Element Id | MedicationRequest.medication[x] |
| Definition |
Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. |
| 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
|
| MedicationRequest.subject | |
| Element Id | MedicationRequest.subject |
| Definition |
A link to a resource representing the person or set of individuals to whom the medication will be given. |
| Control | 1..1 |
| Type | Reference ( Patient | Group ) |
| Summary | true |
| Comments |
The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. |
| MedicationRequest.context | |
| Element Id | MedicationRequest.context |
| Definition |
A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider. |
| Control | 0..1 |
| Type | Reference ( Encounter | EpisodeOfCare ) |
| Comments |
SubstanceAdministration->component->EncounterEvent. |
| MedicationRequest.supportingInformation | |
| Element Id | 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.authoredOn | |
| Element Id | MedicationRequest.authoredOn |
| Definition |
The date (and perhaps time) when the prescription was initially written or authored on. |
| Control | 0..1 |
| Type | dateTime |
| Summary | true |
| MedicationRequest.requester | |
| Element Id | MedicationRequest.requester |
| Definition |
The
individual,
|
| Control | 0..1 |
|
|
|
|
|
true |
|
|
|
| Element Id | MedicationRequest.performer |
| Definition |
The
|
| Control |
|
| Type |
Reference
(
Practitioner
|
PractitionerRole
|
Organization
|
Patient
|
Device
|
RelatedPerson
|
|
|
|
|
|
|
|
| Definition |
|
| Control | 0..1 |
|
|
|
|
|
|
| Summary | true |
|
|
If
specified
without
indicating
a
performer,
this
|
| MedicationRequest.recorder | |
| Element Id | MedicationRequest.recorder |
| Definition |
The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. |
| Control | 0..1 |
| Type | Reference ( Practitioner ) |
| MedicationRequest.reasonCode | |
| Element Id | MedicationRequest.reasonCode |
| Definition |
The reason or the indication for ordering the medication. |
| 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 | |
| Element Id | MedicationRequest.reasonReference |
| Definition |
Condition or observation that supports why the medication was ordered. |
| Control | 0..* |
| Type | Reference ( Condition | Observation ) |
| Comments |
This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. |
| MedicationRequest.instantiates | |
| Element Id | MedicationRequest.instantiates |
| Definition | The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. |
| Control | 0..* |
| Type | uri |
| Summary | true |
| MedicationRequest.basedOn | |
| Element Id | MedicationRequest.basedOn |
| Definition | A plan or request that is fulfilled in whole or in part by this medication request. |
| Control | 0..* |
| Type | Reference ( CarePlan | MedicationRequest | ServiceRequest ) |
| Summary | true |
| MedicationRequest.groupIdentifier | |
| Element Id | MedicationRequest.groupIdentifier |
| Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. |
| Control | 0..1 |
| Type | Identifier |
| Requirements | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. |
| Summary | true |
| MedicationRequest.statusReason | |
| Element Id | MedicationRequest.statusReason |
| Definition | Captures the reason for the current state of the MedicationRequest. |
| Control | 0..1 |
| Terminology Binding | MedicationRequestStatusReason ( Example ) |
| Type | CodeableConcept |
| Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here. |
| MedicationRequest.insurance | |
| Element Id | MedicationRequest.insurance |
| Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. |
| Control | 0..* |
| Type | Reference ( Coverage | ClaimResponse ) |
| MedicationRequest.note | |
| Element Id | MedicationRequest.note |
| Definition |
Extra information about the prescription that could not be conveyed by the other attributes. |
| Control | 0..* |
| Type | Annotation |
| MedicationRequest.dosageInstruction | |
| Element Id | MedicationRequest.dosageInstruction |
| Definition |
Indicates how the medication is to be used by the patient. |
| Control | 0..* |
| Type | Dosage |
| Comments |
There
are
examples
where
a
medication
request
may
include
the
option
of
an
oral
dose
or
an
Intravenous
or
Intramuscular
dose.
For
example,
|
| MedicationRequest.dispenseRequest | |
| Element Id | MedicationRequest.dispenseRequest |
| Definition |
Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. |
| Control | 0..1 |
| MedicationRequest.dispenseRequest.validityPeriod | |
| Element Id | 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 prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. |
| MedicationRequest.dispenseRequest.numberOfRepeatsAllowed | |
| Element Id | 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
|
| Control | 0..1 |
| Type |
|
| Comments |
If
displaying
|
| MedicationRequest.dispenseRequest.quantity | |
| Element Id | MedicationRequest.dispenseRequest.quantity |
| Definition |
The amount that is to be dispensed for one fill. |
| Control | 0..1 |
| Type | SimpleQuantity |
| MedicationRequest.dispenseRequest.expectedSupplyDuration | |
| Element Id | 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
|
| MedicationRequest.dispenseRequest.performer | |
| Element Id | MedicationRequest.dispenseRequest.performer |
| Definition |
Indicates the intended dispensing Organization specified by the prescriber. |
| Control | 0..1 |
| Type | Reference ( Organization ) |
| MedicationRequest.substitution | |
| Element Id | 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. This block explains the prescriber's intent. If nothing is specified substitution may be done. |
| Control | 0..1 |
| MedicationRequest.substitution.allowed | |
| Element Id | 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 (Reason: The inclusion of this element changes the way that the medicationRequest is handled and cannot be ignored) |
| Comments |
This element is labeled as a modifer because whether substitution is allow or not cannot be ignored. |
| MedicationRequest.substitution.reason | |
| Element Id | 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 | |
| Element Id | MedicationRequest.priorPrescription |
| Definition |
A link to a resource representing an earlier order related order or prescription. |
| Control | 0..1 |
| Type | Reference ( MedicationRequest ) |
| MedicationRequest.detectedIssue | |
| Element Id | MedicationRequest.detectedIssue |
| Definition |
Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. |
| Control | 0..* |
| Type | Reference ( DetectedIssue ) |
| Alternate Names | Contraindication; Drug Utilization Review (DUR); Alert |
| Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. |
| MedicationRequest.eventHistory | |
| Element Id | MedicationRequest.eventHistory |
| Definition |
Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. |
| Control | 0..* |
| Type | Reference ( Provenance ) |
| Comments |
This
|