Generated Narrative: StructureDefinition ch-emed-epr-medicationrequest Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> MedicationRequest <a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( split-dosage-instruction-unit-must-match-base-dosage-instruction )">C 0..* CHEMEDMedicationRequest CH EMED MedicationRequest (PRE) Constraints: split-dosage-instruction-unit-must-match-base-dosage-instruction #xD; meta #xD; extension D 0..* Extension ✕ This element is not supported #xD; versionId D 0..1 id ✕ This element is not supported #xD; lastUpdated D 0..1 instant ✕ This element is not supported #xD; source D 0..1 uri ✕ This element is not supported #xD; security D 0..* Coding ✕ This element is not supported #xD; tag D 0..* Coding ✕ This element is not supported #xD; implicitRules 0..0 A set of rules under which this content was created #xD; extension 1..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:treatmentplan 1..1 CHEMEDExtTreatmentPlan A reference to the MedicationStatement that introduced this medication #xD; modifierExtension 0..0 Extension #xD; status 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Required Pattern: active #xD; statusReason D 0..1 CodeableConcept ✕ This element is not supported #xD; intent 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order #xD; category D 0..* CodeableConcept ✕ This element is not supported #xD; priority D 0..1 code ✕ This element is not supported #xD; doNotPerform 0..0 True if request is prohibiting action #xD; reported[x] D 0..1 boolean, Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) ✕ This element is not supported #xD; medication[x] 1..1 Reference(CH Core Medication) Medication to be taken #xD; Slices for medication[x] Content/Rules for all slices #xD; medication[x]:medicationReference 0..1 Reference(CH EMED EPR Medication) {c} Reference to the contained medication #xD; subject 1..1 Reference(CH EMED EPR Patient) {r, b} Patient #xD; encounter D 0..1 Reference(Encounter) ✕ This element is not supported #xD; <a style="text-decoration:line-through; text-decoration:line-through" href="StructureDefinition-ch-emed-epr-medicationrequest-definitions.html#MedicationRequest.supportingInformation" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">supportingInformation D 0..0 ✕ This element is not supported #xD; requester 1..1 Reference(CH EMED EPR PractitionerRole) The author of the medical decision, see also 'Guidance - Authorship' #xD; performer D 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) ✕ This element is not supported #xD; performerType D 0..1 CodeableConcept ✕ This element is not supported #xD; reasonCode 0..* CodeableConcept The treatment reason(s) as text, and optionally coded #xD; extension D 0..* Extension ✕ This element is not supported #xD; text 1..1 string Plain text representation of the treatment reason(s) #xD; reasonReference D 0..* Reference(Condition | Observation) ✕ This element is not supported #xD; instantiatesCanonical D 0..* canonical() ✕ This element is not supported #xD; instantiatesUri D 0..* uri ✕ This element is not supported #xD; basedOn D 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) ✕ This element is not supported #xD; groupIdentifier D 0..1 Identifier ✕ This element is not supported #xD; courseOfTherapyType D 0..1 CodeableConcept ✕ This element is not supported #xD; insurance D 0..* Reference(Coverage | ClaimResponse) ✕ This element is not supported #xD; note #xD; id D 0..1 string ✕ This element is not supported #xD; extension D 0..* Extension ✕ This element is not supported #xD; author[x] D 0..1 Reference(Practitioner | Patient | RelatedPerson | Organization), string ✕ The note author is ignored, as it cannot be different than the document and/or entry's author #xD; time D 0..1 dateTime ✕ This element is not supported #xD; text 1..1 markdown The annotation text content (as raw text, no markdown allowed). #xD; Slices for dosageInstruction Content/Rules for all slices #xD; dosageInstruction:baseEntry 1..1 CHEMEDEPRDosageMedicationRequest Base entry of the dosage instruction #xD; dosageInstruction:additionalEntry 0..* CHEMEDEPRDosageSplit Additional entry of the dosage instruction #xD; dispenseRequest #xD; modifierExtension 0..0 Extension #xD; initialFill D 0..1 BackboneElement ✕ This element is not supported #xD; modifierExtension 0..0 Extension #xD; quantity 0..1 CHEMEDEPRAmountQuantity First fill quantity #xD; <a href="StructureDefinition-ch-emed-epr-medicationrequest-definitions.html#MedicationRequest.dispenseRequest.dispenseInterval" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">dispenseInterval D 0..1 Duration ✕ This element is not supported #xD; quantity 0..1 CHEMEDEPRAmountQuantity Number of packages #xD; <a href="StructureDefinition-ch-emed-epr-medicationrequest-definitions.html#MedicationRequest.dispenseRequest.expectedSupplyDuration" title="Implementers should not set or read this element. #xA;This element is only kept as optional to allow submission of documents that would contain a value, #xA;since those documents are still readable by others.#xA;The meaning of this element is undefined in this profile.">expectedSupplyDuration D 0..1 Duration ✕ This element is not supported #xD; performer D 0..1 Reference(Organization) ✕ This element is not supported #xD; substitution 0..1 BackboneElement If absent, substitution is assumed allowed. If present, the value is fixed to none (not allowed). #xD; modifierExtension 0..0 Extension #xD; Slices for allowed[x] Content/Rules for all slices #xD; allowed[x]:allowedCodeableConcept 0..1 CodeableConcept Whether substitution is allowed or not Binding: Substance Administration Substitution Codes (required) #xD; coding 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system 1..1 uri Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: N #xD; display 1..1 string Representation defined by the system Fixed Value: none #xD; reason D 0..1 CodeableConcept ✕ This element is not supported #xD; priorPrescription D 0..1 Reference(MedicationRequest) ✕ This element is not supported #xD; detectedIssue D 0..* Reference(DetectedIssue) ✕ This element is not supported #xD; eventHistory D 0..* Reference(Provenance) ✕ This element is not supported #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
Definition of the medication request for the medication prescription document
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 "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
If one dosage element is present, it SHALL NOT have a sequence number. If more than one dosage element is present, the base entry SHALL have the sequence number 1.
(dosageInstruction.count() > 1 implies dosageInstruction.where($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())
The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
(dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. All modifiers SHALL be documented in the profile, in order to be usable.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
A reference to the MedicationStatement that introduced this medication
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
...All modifiers SHALL be documented in the profile, in order to be usable.
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
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. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
This is a business identifier, not a resource identifier.
ORC-2-Placer Order Number / ORC-3-Filler Order Number
active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
A code specifying the current state of the order. Generally, this will be active or completed state.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
This element is labeled 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
A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
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.
Identifies the reasons for a given status.
.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Whether the request is a proposal, plan, or an original order.
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.
This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
The category can be used to include where the medication is expected to be consumed or other types of requests.
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.
Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
Identifies the level of importance to be assigned to actioning the request.
If true indicates that the provider is asking for the medication request not to occur.
Use a PADV CANCEL/SUSPEND/REFUSE instead
This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
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.
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. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
A link to a resource representing the person or set of individuals to whom the medication will be given.
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.
Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.
.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
The date (and perhaps time) when the prescription was initially written or authored on.
RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
The author of the medical decision, see also 'Guidance - Authorship'
The individual, organization, or device that initiated the request and has responsibility for its activation.
If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.
Identifies the type of individual that is desired to administer the medication.
The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
The treatment reason(s) as text, and optionally coded
The reason or the indication for ordering or not ordering the medication. Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').
This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
A coded concept indicating why the medication was ordered.
ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the treatment reason(s)
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.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
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.
.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
This attribute should not be confused with the protocol of the medication.
Identifies the overall pattern of medication administratio.
Act.code where classCode = LIST and moodCode = EVN
Extra information about the prescription that could not be conveyed by the other attributes.
✕ The note author is ignored, as it cannot be different than the document and/or entry's author
Organization is used when there's no need for specific attribution as to who made the comment.
The annotation text content (as raw text, no markdown allowed).
The text of the annotation in markdown format.
Indicates how the medication is to be used by the patient.
There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
Additional entry of the dosage instruction
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.
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
If populating this element, either the quantity or the duration must be included.
SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
The amount or quantity to provide as part of the first dispense.
The length of time that the first dispense is expected to last.
This indicates the validity period of a prescription (stale dating the Prescription).
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.
Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
Repeated supply per medication (without initial dispense)
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.
If displaying "number of authorized fills", add 1 to this number.
The amount that is to be dispensed for one fill.
RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
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.
.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
If absent, substitution is assumed allowed. If present, the value is fixed to none (not allowed).
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.
specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
True if the prescriber allows a different drug to be dispensed from what was prescribed.
This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Identifies the type of substitution allowed.
RXO-9-Allow Substitutions / RXE-9-Substitution Status
Plain text representation of the concept
A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
Use the XDS mechanism to replace a prescription
.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
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.
This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
...Content creators should keep it as simple and short as possible (e.g. 'blood clog', 'hypertension').