HL7 Europe Base and Core FHIR IG
2.0.0-gamma - qa-preview 150

HL7 Europe Base and Core FHIR IG - Downloaded Version 2.0.0-gamma See the Directory of published versions

## Resource Profile: MedicationRequest (EU core)

Official URL: http://hl7.eu/fhir/base/StructureDefinition/medicationRequest-eu-core | Version: 2.0.0-gamma
Standards status: Draft | Maturity Level: 1 | Computable Name: MedicationRequestEuCore
Copyright/Legal: Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0).

This profile introduces essential constraints and extensions for the MedicationRequest resource that apply across multiple use cases.

Usages:

- Examples for this Profile: MedicationRequest/400C-prescription-cefuroxime-singleline

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the request Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
extension:renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier for this request
status | ?!Σ | 1..1 | code | Current state of the order 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 of the order Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | Order, proposal or plan Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Category of the medication request 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.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
medication[x] | Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | Σ | 1..1 | Reference(Patient (EU core) | Group) | Who or group medication request is for
authoredOn | Σ | 0..1 | dateTime | Date when the request was authored
requester | Σ | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | The individual responsible for ordering the medication
reasonCode |  | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Additional Bindings | Purpose
eHDSI Illness and Disorder | candidate
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
groupIdentifier | Σ | 0..1 | Identifier | Group identifier
dosageInstruction |  | 0..* | Dosage | How the medication should be taken.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | Σ | 0..1 | string | Free text dosage instructions
timing | Σ | 0..1 | Timing | Administration schedule
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..1 | CodeableConcept | A code for the timing schedule. Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
substitution |  | 0..1 | BackboneElement | Whether substitution is allowed
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.code | Base | preferred | TimingAbbreviation | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
language |  | 0..1 | code | Language of the request
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
extension:renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
identifier |  | 0..* | Identifier | Business identifier for this request
status |  | 1..1 | code | Current state of the order
statusReason |  | 0..1 | CodeableConcept | Reason for current status of the order
intent |  | 1..1 | code | Order, proposal or plan
category |  | 0..* | CodeableConcept | Category of the medication request
medication[x] |  | 1..1 |  | Medication to be taken
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (EU core)) |
subject |  | 1..1 | Reference(Patient (EU core) | Group) | Who or group medication request is for
authoredOn |  | 0..1 | dateTime | Date when the request was authored
requester |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | The individual responsible for ordering the medication
reasonCode |  | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Additional Bindings | Purpose
eHDSI Illness and Disorder | candidate
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
groupIdentifier |  | 0..1 | Identifier | Group identifier
note |  |  |  |
text |  | 1..1 | markdown | Textual note about the request
dosageInstruction |  | 0..* | Dosage | How the medication should be taken.
text |  | 0..1 | string | Free text dosage instructions
timing |  | 0..1 | Timing | Administration schedule
repeat |  |  |  |
duration |  | 0..1 | decimal | Duration of the treatment
frequency |  | 0..1 | positiveInt | Frequency times per period
period |  | 0..1 | decimal | Duration of time over which repetitions are to occur
periodUnit |  | 0..1 | code | Unit of the period (e.g. day)
code |  | 0..1 | CodeableConcept | A code for the timing schedule.
route |  | 0..1 | CodeableConcept | Route of administration
doseAndRate |  |  |  |
Slices for dose[x] |  | 0..1 | Range, SimpleQuantity(4.0.1) | Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity |  | 0..1 | SimpleQuantity | Amount of medication per dose
dispenseRequest |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
dispenseInterval |  | 0..1 | Duration | Interval between dispenses
validityPeriod |  | 0..1 | Period | Validity period of the dispense request
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of repeats allowed
substitution |  | 0..1 | BackboneElement | Whether substitution is allowed
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
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 request Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
extension:renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier for this request
status | ?!Σ | 1..1 | code | Current state of the order 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 of the order Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | Order, proposal or plan Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Category of the medication request 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) |
medication[x] | Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | Σ | 1..1 | Reference(Patient (EU core) | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | Σ | 0..1 | dateTime | Date when the request was authored
requester | Σ | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | The individual responsible for ordering the medication
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 | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Additional Bindings | Purpose
eHDSI Illness and Disorder | candidate
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
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 | Group identifier
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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Textual note about the request
dosageInstruction |  | 0..* | Dosage | How the medication should be taken.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | Σ | 0..1 | string | Free text dosage instructions
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | Administration schedule
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
event | Σ | 0..* | dateTime | When the event occurs
repeat | Σ C | 0..1 | Element | When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x] | Σ | 0..1 |  | Length/Range of lengths, or (Start and/or end) limits
boundsDuration |  |  | Duration |
boundsRange |  |  | Range |
boundsPeriod |  |  | Period |
count | Σ | 0..1 | positiveInt | Number of times to repeat
countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat
duration | Σ | 0..1 | decimal | Duration of the treatment
durationMax | Σ | 0..1 | decimal | How long when it happens (Max)
durationUnit | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency | Σ | 0..1 | positiveInt | Frequency times per period
frequencyMax | Σ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period
period | Σ | 0..1 | decimal | Duration of time over which repetitions are to occur
periodMax | Σ | 0..1 | decimal | Upper limit of period (3-4 hours)
periodUnit | Σ | 0..1 | code | Unit of the period (e.g. day) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay | Σ | 0..* | time | Time of day for action
when | Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after)
code | Σ | 0..1 | CodeableConcept | A code for the timing schedule. Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x] | Σ | 0..1 |  | Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
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(4.0.1) | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Interval between dispenses
validityPeriod |  | 0..1 | Period | Validity period of the dispense request
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of repeats allowed
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Whether substitution is allowed
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
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
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 | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.durationUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek | Base | required | DaysOfWeek | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.when | Base | required | EventTiming | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.code | Base | preferred | TimingAbbreviation | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.0
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units | `duration.empty() or durationUnit.exists()`
tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units | `period.empty() or periodUnit.exists()`
tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value | `duration.exists() implies duration >= 0`
tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value | `period.exists() implies period >= 0`
tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period | `periodMax.empty() or period.exists()`
tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration | `durationMax.empty() or duration.exists()`
tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count | `countMax.empty() or count.exists()`
tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) | `offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))`
tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa | `timeOfDay.empty() or when.empty()`

This structure is derived from MedicationRequest

Summary

Structures

This structure refers to these other structures:

- Medication (EU core) (http://hl7.eu/fhir/base/StructureDefinition/medication-eu-core)
- Patient (EU core) (http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core)
- Practitioner (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core)
- PractitionerRole (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core)
- Organization (EU core) (http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core)
- SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
- https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.dose[x]

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the request Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
extension:renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier for this request
status | ?!Σ | 1..1 | code | Current state of the order 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 of the order Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | Order, proposal or plan Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Category of the medication request 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.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
medication[x] | Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | Σ | 1..1 | Reference(Patient (EU core) | Group) | Who or group medication request is for
authoredOn | Σ | 0..1 | dateTime | Date when the request was authored
requester | Σ | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | The individual responsible for ordering the medication
reasonCode |  | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Additional Bindings | Purpose
eHDSI Illness and Disorder | candidate
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
groupIdentifier | Σ | 0..1 | Identifier | Group identifier
dosageInstruction |  | 0..* | Dosage | How the medication should be taken.
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | Σ | 0..1 | string | Free text dosage instructions
timing | Σ | 0..1 | Timing | Administration schedule
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..1 | CodeableConcept | A code for the timing schedule. Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
substitution |  | 0..1 | BackboneElement | Whether substitution is allowed
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.code | Base | preferred | TimingAbbreviation | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Differential View

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
language |  | 0..1 | code | Language of the request
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
extension:renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
identifier |  | 0..* | Identifier | Business identifier for this request
status |  | 1..1 | code | Current state of the order
statusReason |  | 0..1 | CodeableConcept | Reason for current status of the order
intent |  | 1..1 | code | Order, proposal or plan
category |  | 0..* | CodeableConcept | Category of the medication request
medication[x] |  | 1..1 |  | Medication to be taken
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (EU core)) |
subject |  | 1..1 | Reference(Patient (EU core) | Group) | Who or group medication request is for
authoredOn |  | 0..1 | dateTime | Date when the request was authored
requester |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | The individual responsible for ordering the medication
reasonCode |  | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Additional Bindings | Purpose
eHDSI Illness and Disorder | candidate
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
groupIdentifier |  | 0..1 | Identifier | Group identifier
note |  |  |  |
text |  | 1..1 | markdown | Textual note about the request
dosageInstruction |  | 0..* | Dosage | How the medication should be taken.
text |  | 0..1 | string | Free text dosage instructions
timing |  | 0..1 | Timing | Administration schedule
repeat |  |  |  |
duration |  | 0..1 | decimal | Duration of the treatment
frequency |  | 0..1 | positiveInt | Frequency times per period
period |  | 0..1 | decimal | Duration of time over which repetitions are to occur
periodUnit |  | 0..1 | code | Unit of the period (e.g. day)
code |  | 0..1 | CodeableConcept | A code for the timing schedule.
route |  | 0..1 | CodeableConcept | Route of administration
doseAndRate |  |  |  |
Slices for dose[x] |  | 0..1 | Range, SimpleQuantity(4.0.1) | Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity |  | 0..1 | SimpleQuantity | Amount of medication per dose
dispenseRequest |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
dispenseInterval |  | 0..1 | Duration | Interval between dispenses
validityPeriod |  | 0..1 | Period | Validity period of the dispense request
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of repeats allowed
substitution |  | 0..1 | BackboneElement | Whether substitution is allowed
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
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 request Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
extension:renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business identifier for this request
status | ?!Σ | 1..1 | code | Current state of the order 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 of the order Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | Order, proposal or plan Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Category of the medication request 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) |
medication[x] | Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | Σ | 1..1 | Reference(Patient (EU core) | Group) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | Σ | 0..1 | dateTime | Date when the request was authored
requester | Σ | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | The individual responsible for ordering the medication
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 | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Additional Bindings | Purpose
eHDSI Illness and Disorder | candidate
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
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 | Group identifier
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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Textual note about the request
dosageInstruction |  | 0..* | Dosage | How the medication should be taken.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | Σ | 0..1 | string | Free text dosage instructions
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | Administration schedule
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
event | Σ | 0..* | dateTime | When the event occurs
repeat | Σ C | 0..1 | Element | When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x] | Σ | 0..1 |  | Length/Range of lengths, or (Start and/or end) limits
boundsDuration |  |  | Duration |
boundsRange |  |  | Range |
boundsPeriod |  |  | Period |
count | Σ | 0..1 | positiveInt | Number of times to repeat
countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat
duration | Σ | 0..1 | decimal | Duration of the treatment
durationMax | Σ | 0..1 | decimal | How long when it happens (Max)
durationUnit | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency | Σ | 0..1 | positiveInt | Frequency times per period
frequencyMax | Σ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period
period | Σ | 0..1 | decimal | Duration of time over which repetitions are to occur
periodMax | Σ | 0..1 | decimal | Upper limit of period (3-4 hours)
periodUnit | Σ | 0..1 | code | Unit of the period (e.g. day) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay | Σ | 0..* | time | Time of day for action
when | Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after)
code | Σ | 0..1 | CodeableConcept | A code for the timing schedule. Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x] | Σ | 0..1 |  | Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
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(4.0.1) | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Interval between dispenses
validityPeriod |  | 0..1 | Period | Validity period of the dispense request
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of repeats allowed
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Whether substitution is allowed
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
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
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 | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.durationUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek | Base | required | DaysOfWeek | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.when | Base | required | EventTiming | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.code | Base | preferred | TimingAbbreviation | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.0
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units | `duration.empty() or durationUnit.exists()`
tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units | `period.empty() or periodUnit.exists()`
tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value | `duration.exists() implies duration >= 0`
tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value | `period.exists() implies period >= 0`
tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period | `periodMax.empty() or period.exists()`
tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration | `durationMax.empty() or duration.exists()`
tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count | `countMax.empty() or count.exists()`
tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) | `offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))`
tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa | `timeOfDay.empty() or when.empty()`

This structure is derived from MedicationRequest

Summary

Structures

This structure refers to these other structures:

- Medication (EU core) (http://hl7.eu/fhir/base/StructureDefinition/medication-eu-core)
- Patient (EU core) (http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core)
- Practitioner (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core)
- PractitionerRole (EU core) (http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core)
- Organization (EU core) (http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core)
- SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
- https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.dose[x]

Maturity: 1

Other representations of profile: CSV, Excel, Schematron