This page is part of the CH EMED (R4) (v5.0.0-ballot: STU 5 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Resource Profile: CH EMED MedicationRequest Changed

Definition of the changed medication request for the pharmaceutical advice document

Usage:

• Use this Resource Profile: CH EMED Medication List Document and CH EMED Pharmaceutical Advice Document
• Refer to this Resource Profile: CH EMED Extension MedicationRequest Changed
• Examples for this Resource Profile: MedicationRequest/MedReq-ChangeMedication

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CHEMEDMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CH EMED MedicationRequest Changed (PADV)
Slices for supportingInformation		1..*	Reference(Resource)	Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:partOf		1..1	Reference(CH EMED Observation (PADV)) {r, b}	Reference to the Observation from type 'CHANGE'
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	CHEMEDMedicationRequest	CH EMED MedicationRequest Changed (PADV) ch-dosage-medreq: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		1..*	Resource	Contained, inline Resources
Slices for extension				Content/Rules for all slices
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
Slices for medication[x]	Σ	1..1		Medication to be taken Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(CH Core Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication) {c}	Reference to the contained medication
subject	Σ	1..1	Reference(CH Core Patient)	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for supportingInformation		1..*	Reference(Resource)	Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:partOf		1..1	Reference(CH EMED Observation (PADV)) {r, b}	Reference to the Observation from type 'CHANGE'
authoredOn	Σ	1..1	dateTime	When request was initially authored
requester	Σ	1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-medreq	error	MedicationRequest	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-medicationrequest') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	CHEMEDMedicationRequest	CH EMED MedicationRequest Changed (PADV) ch-dosage-medreq: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
Slices for medication[x]	Σ	1..1		Medication to be taken Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(CH Core Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication) {c}	Reference to the contained medication
subject	Σ	1..1	Reference(CH Core Patient)	Patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
Slices for supportingInformation		1..*	Reference(Resource)	Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:partOf		1..1	Reference(CH EMED Observation (PADV)) {r, b}	Reference to the Observation from type 'CHANGE'
authoredOn	Σ	1..1	dateTime	When request was initially authored
requester	Σ	1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Treatment reason Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Period of validity of the prescription
numberOfRepeatsAllowed		0..1	unsignedInt	Repeated supply per medication (without initial dispense)
quantity		0..1	SimpleQuantity	Number of packages
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for allowed[x]		1..1	CodeableConcept	Whether substitution is allowed or not Slice: Unordered, Closed by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowed[x]:allowedCodeableConcept		0..1	CodeableConcept	Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (preferred)
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationRequest.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationRequest.requester.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.allowed[x]:allowedCodeableConcept	preferred	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-medreq	error	MedicationRequest	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-medicationrequest') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CHEMEDMedicationRequest

Summary

Mandatory: 2 elements

Structures

This structure refers to these other structures:

• CH EMED Observation (PADV) (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-observation)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.supportingInformation

Differential View

This structure is derived from CHEMEDMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CH EMED MedicationRequest Changed (PADV)
Slices for supportingInformation		1..*	Reference(Resource)	Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:partOf		1..1	Reference(CH EMED Observation (PADV)) {r, b}	Reference to the Observation from type 'CHANGE'
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	CHEMEDMedicationRequest	CH EMED MedicationRequest Changed (PADV) ch-dosage-medreq: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		1..*	Resource	Contained, inline Resources
Slices for extension				Content/Rules for all slices
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
Slices for medication[x]	Σ	1..1		Medication to be taken Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(CH Core Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication) {c}	Reference to the contained medication
subject	Σ	1..1	Reference(CH Core Patient)	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for supportingInformation		1..*	Reference(Resource)	Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:partOf		1..1	Reference(CH EMED Observation (PADV)) {r, b}	Reference to the Observation from type 'CHANGE'
authoredOn	Σ	1..1	dateTime	When request was initially authored
requester	Σ	1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-medreq	error	MedicationRequest	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-medicationrequest') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	CHEMEDMedicationRequest	CH EMED MedicationRequest Changed (PADV) ch-dosage-medreq: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
Slices for medication[x]	Σ	1..1		Medication to be taken Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(CH Core Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication) {c}	Reference to the contained medication
subject	Σ	1..1	Reference(CH Core Patient)	Patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
Slices for supportingInformation		1..*	Reference(Resource)	Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:partOf		1..1	Reference(CH EMED Observation (PADV)) {r, b}	Reference to the Observation from type 'CHANGE'
authoredOn	Σ	1..1	dateTime	When request was initially authored
requester	Σ	1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Treatment reason Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Period of validity of the prescription
numberOfRepeatsAllowed		0..1	unsignedInt	Repeated supply per medication (without initial dispense)
quantity		0..1	SimpleQuantity	Number of packages
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for allowed[x]		1..1	CodeableConcept	Whether substitution is allowed or not Slice: Unordered, Closed by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowed[x]:allowedCodeableConcept		0..1	CodeableConcept	Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (preferred)
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationRequest.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationRequest.requester.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.allowed[x]:allowedCodeableConcept	preferred	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-medreq	error	MedicationRequest	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-medicationrequest') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CHEMEDMedicationRequest

Summary

Mandatory: 2 elements

Structures

This structure refers to these other structures:

• CH EMED Observation (PADV) (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-observation)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.supportingInformation

Other representations of profile: CSV, Excel, Schematron