{
"description": "**CHR:** Medication prescriptions are created in the **Prescriptions** section of the patient chart via the New Prescription button, or within an Encounter. The prescription form includes drug selection, dosage, frequency, route, and signing workflow.",
"_filename": "StructureDefinition-profile-DwMedicationRequest.json",
"package_name": "telus.dw.emr.extract-1-1-21",
"date": "2026-05-29",
"derivation": "constraint",
"publisher": "TELUS Health",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "CA",
"system": "urn:iso:std:iso:3166",
"display": "Canada"
} ]
} ],
"name": "DwMedicationRequest",
"mapping": [ {
"name": "PrescribeIT",
"identity": "PrescribeIT"
}, {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern",
"identity": "workflow"
}, {
"uri": "http://ncpdp.org/SCRIPT10_6",
"name": "Mapping to NCPDP SCRIPT 10.6",
"identity": "script10.6"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
} ],
"abstract": false,
"copyright": "Copyright © 2026 TELUS Health. All rights reserved.",
"type": "MedicationRequest",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "1.1.21",
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-3",
"human": "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",
"xpath": "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='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "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()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "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."
} ],
"expression": "text.`div`.exists()"
} ],
"path": "MedicationRequest",
"min": 0,
"definition": "An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called \"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.",
"isModifier": false,
"short": "Ordering of medication for patient or group",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Request",
"identity": "workflow"
}, {
"map": "Message/Body/NewRx",
"identity": "script10.6"
}, {
"map": "CombinedMedicationRequest",
"identity": "rim"
} ],
"alias": [ "Prescription", "Order" ],
"max": "*",
"id": "MedicationRequest",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest"
},
"isSummary": false
}, {
"path": "MedicationRequest.id",
"min": 1,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
} ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.id",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"path": "MedicationRequest.meta.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.meta.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.meta.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.meta.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta.versionId",
"min": 0,
"definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
"isModifier": false,
"short": "Version specific identifier",
"type": [ {
"code": "id"
} ],
"max": "1",
"id": "MedicationRequest.meta.versionId",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Meta.versionId"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta.lastUpdated",
"min": 1,
"definition": "When the resource last changed - e.g. when the version changed.",
"isModifier": false,
"short": "When the resource version last changed",
"type": [ {
"code": "instant"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.meta.lastUpdated",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Meta.lastUpdated"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta.source",
"min": 1,
"definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
"isModifier": false,
"short": "Identifies where the resource comes from",
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.meta.source",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Meta.source"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta.profile",
"min": 0,
"definition": "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).",
"isModifier": false,
"short": "Profiles this resource claims to conform to",
"type": [ {
"code": "canonical",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition|4.0.1" ]
} ],
"max": "*",
"id": "MedicationRequest.meta.profile",
"comment": "Usage: Each implementation project will determine if this will be supported. It may be useful for validating message instances against this specific profile.\r\n\r\nIt 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.",
"base": {
"max": "*",
"min": 0,
"path": "Meta.profile"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta.security",
"min": 0,
"definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
"isModifier": false,
"short": "Security Labels applied to this resource",
"type": [ {
"code": "Coding"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/security-labels|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SecurityLabels"
} ],
"description": "Security Labels from the Healthcare Privacy and Security Classification System."
},
"max": "*",
"id": "MedicationRequest.meta.security",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Meta.security"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.meta.tag",
"min": 0,
"definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
"isModifier": false,
"short": "Tags applied to this resource",
"type": [ {
"code": "Coding"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/common-tags|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Tags"
} ],
"description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"."
},
"max": "*",
"id": "MedicationRequest.meta.tag",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Meta.tag"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.implicitRules",
"min": 0,
"definition": "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.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationRequest.implicitRules",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "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",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
} ],
"description": "A human language."
},
"max": "1",
"id": "MedicationRequest.language",
"comment": "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).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.text",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"mustSupport": true,
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "MedicationRequest.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"path": "MedicationRequest.contained",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"mustSupport": true,
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "0",
"id": "MedicationRequest.contained",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationRequest.extension",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "DispenserInstructions",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-DispenserInstructions" ]
} ],
"mustSupport": true,
"sliceName": "DispenserInstructions",
"max": "1",
"id": "MedicationRequest.extension:DispenserInstructions",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nAlignment: MedicationOrder.extension:pharmacyInstructions\r\nUsage Note: If available, this should be included",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "NoRenewalsFlag",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-NoRenewalsFlag" ]
} ],
"mustSupport": true,
"sliceName": "NoRenewalsFlag",
"max": "1",
"id": "MedicationRequest.extension:NoRenewalsFlag",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported\n\nAlignment: PrescribeIT: MedicationOrder.extension:noRenewals",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.extension",
"min": 0,
"definition": "The date (and perhaps time) when the status was changed.",
"isModifier": false,
"short": "Extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.statusChanged" ]
} ],
"mustSupport": true,
"sliceName": "StatusChanged",
"max": "1",
"id": "MedicationRequest.extension:StatusChanged",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: This is a pre-adoption of an R5 data element, and reflects the dateTime that the status was changed\r\nhttps://build.fhir.org/medicationrequest-definitions.html#MedicationRequest.statusChanged",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"type": [ {
"code": "Extension",
"profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction" ]
} ],
"mustSupport": true,
"sliceName": "RenderedDosageInstruction",
"max": "1",
"id": "MedicationRequest.extension:RenderedDosageInstruction",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR populates this with the full rendered dosage string (dose, frequency, route) rather than structured dosage sub-elements.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "External ids for this request",
"mapping": [ {
"map": "Request.identifier",
"identity": "workflow"
}, {
"map": "Message/Header/PrescriberOrderNumber",
"identity": "script10.6"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": "ORC-2-Placer Order Number / ORC-3-Filler Order Number",
"identity": "v2"
}, {
"map": ".id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.identifier",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.identifier"
},
"isSummary": false
}, {
"path": "MedicationRequest.identifier.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.identifier.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.identifier.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.identifier.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier.use",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"definition": "The purpose of this identifier.",
"isModifier": true,
"short": "usual | official | temp | secondary | old (If known)",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
} ],
"description": "Identifies the purpose for this identifier, if known ."
},
"max": "1",
"id": "MedicationRequest.identifier.use",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.use"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier.type",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"isModifier": false,
"short": "Description of identifier",
"mapping": [ {
"map": "CX.5",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
} ],
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
},
"max": "1",
"id": "MedicationRequest.identifier.type",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier.system",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"isModifier": false,
"short": "The namespace for the identifier value",
"mapping": [ {
"map": "CX.4 / EI-2-4",
"identity": "v2"
}, {
"map": "II.root or Role.id.root",
"identity": "rim"
}, {
"map": "./IdentifierType",
"identity": "servd"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.identifier.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"example": [ {
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier.value",
"min": 1,
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"isModifier": false,
"short": "The value that is unique",
"mapping": [ {
"map": "MedicationOrder.identifier:EMR-id.value",
"identity": "PrescribeIT"
}, {
"map": "CX.1 / EI.1",
"identity": "v2"
}, {
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)",
"identity": "rim"
}, {
"map": "./Value",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.identifier.value",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"example": [ {
"label": "General",
"valueString": "123456"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier.period",
"min": 0,
"definition": "Time period during which identifier is/was valid for use.",
"isModifier": false,
"short": "Time period when id is/was valid for use",
"mapping": [ {
"map": "CX.7 + CX.8",
"identity": "v2"
}, {
"map": "Role.effectiveTime or implied by context",
"identity": "rim"
}, {
"map": "./StartDate and ./EndDate",
"identity": "servd"
} ],
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "MedicationRequest.identifier.period",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.period"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.identifier.assigner",
"min": 0,
"definition": "Organization that issued/manages the identifier.",
"isModifier": false,
"short": "Organization that issued id (may be just text)",
"mapping": [ {
"map": "CX.4 / (CX.4,CX.9,CX.10)",
"identity": "v2"
}, {
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper",
"identity": "rim"
}, {
"map": "./IdentifierIssuingAuthority",
"identity": "servd"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "1",
"id": "MedicationRequest.identifier.assigner",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.assigner"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.status",
"min": 1,
"definition": "A code specifying the current state of the order. Generally, this will be active or completed state.",
"isModifier": true,
"short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown",
"mapping": [ {
"map": "Request.status",
"identity": "workflow"
}, {
"map": "no mapping",
"identity": "script10.6"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": ".statusCode",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestStatus"
} ],
"description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription."
},
"max": "1",
"id": "MedicationRequest.status",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Status derived from medication state — active for current medications, stopped/cancelled for stopped medications, entered-in-error for deleted records.\r\n\r\nConformance Rule: Sending systems should set all orders should be set to completed. Rationale: The status of an order should not change and therefore all internal prescriptions may be set to completed.\r\n\r\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationRequest.status"
},
"isModifierReason": "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",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.statusReason",
"min": 0,
"definition": "Captures the reason for the current state of the MedicationRequest.",
"isModifier": false,
"short": "Reason for current status",
"mapping": [ {
"map": "Request.statusReason",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestStatusReason"
} ],
"description": "Identifies the reasons for a given status."
},
"max": "1",
"id": "MedicationRequest.statusReason",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Cancellation note when present.\r\n\r\nUsage Note: When radio buttons are used, the status reason is be captured discretely.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.statusReason"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.intent",
"fixedCode": "order",
"min": 1,
"definition": "Whether the request is a proposal, plan, or an original order.",
"isModifier": true,
"short": "proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option",
"mapping": [ {
"map": "Request.intent",
"identity": "workflow"
}, {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestIntent"
} ],
"description": "The kind of medication order."
},
"max": "1",
"id": "MedicationRequest.intent",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Hardcoded value \"order\".",
"base": {
"max": "1",
"min": 1,
"path": "MedicationRequest.intent"
},
"isModifierReason": "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",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category",
"min": 0,
"definition": "Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).",
"isModifier": false,
"short": "Type of medication usage",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category",
"identity": "PrescribeIT"
}, {
"map": "Message/Body/NewRx/MedicationPrescribed/Directions\r\ror \r\rMessage/Body/NewRx/MedicationPrescribed/StructuredSIG",
"identity": "script10.6"
}, {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontype"
},
"max": "1",
"id": "MedicationRequest.category",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nConformance Rule: This should be populated if known",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.category"
},
"isSummary": false
}, {
"path": "MedicationRequest.category.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.category.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.category.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.category.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontype"
},
"max": "*",
"id": "MedicationRequest.category.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.category.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.category.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.category.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.category.coding.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.category.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.category.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.category.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.category.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.category.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.category.text",
"requirements": "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.",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.category.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.priority",
"min": 0,
"definition": "Indicates how quickly the Medication Request should be addressed with respect to other requests.",
"isModifier": false,
"short": "routine | urgent | asap | stat",
"mapping": [ {
"map": "Request.priority",
"identity": "workflow"
}, {
"map": "FiveWs.grade",
"identity": "w5"
}, {
"map": ".priorityCode",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/request-priority|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestPriority"
} ],
"description": "Identifies the level of importance to be assigned to actioning the request."
},
"max": "1",
"id": "MedicationRequest.priority",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.priority"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.doNotPerform",
"min": 0,
"definition": "If true indicates that the provider is asking for the medication request not to occur.",
"isModifier": true,
"short": "True if request is prohibiting action",
"mapping": [ {
"map": "SubstanceAdministration.actionNegationInd",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.doNotPerform",
"comment": "If do not perform is not specified, the request is a positive request e.g. \"do perform\".",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.doNotPerform"
},
"isModifierReason": "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)",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reported[x]",
"min": 0,
"definition": "Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.",
"isModifier": false,
"short": "Reported rather than primary record",
"mapping": [ {
"map": ".participation[typeCode=INF].role",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.reported[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: True when the prescription was externally reported.\n\nConformance Rule: The boolean is mandatory where known, the source resource must be included in the extension:InformationSource. In EMR's this may be derived from the \"external\" prescription indicator — consider it reported and set value = true.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.reported[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.medication[x]",
"min": 1,
"definition": "Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
"isModifier": false,
"short": "Medication to be taken",
"mapping": [ {
"map": "Request.code",
"identity": "workflow"
}, {
"map": "Message/Body/NewRx/MedicationPrescribed\r\rMedication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode\r\rMedication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier\r\rMedication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription",
"identity": "script10.6"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": "RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code",
"identity": "v2"
}, {
"map": "consumable.administrableMedication",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication|4.0.1" ]
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationCode"
} ],
"description": "A coded concept identifying substance or product that can be ordered."
},
"max": "1",
"id": "MedicationRequest.medication[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: In cases where the medication Resource is not available, medication will be provided as a codeableConcept.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationRequest.medication[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.subject",
"min": 1,
"definition": "A link to a resource representing the person or set of individuals to whom the medication will be given.",
"isModifier": false,
"short": "Who or group medication request is for",
"mapping": [ {
"map": "Request.subject",
"identity": "workflow"
}, {
"map": "Message/Body/NewRx/Patient\r\r(need detail to link to specific patient … Patient.Identification in SCRIPT)",
"identity": "script10.6"
}, {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "PID-3-Patient ID List",
"identity": "v2"
}, {
"map": ".participation[typeCode=AUT].role",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.subject",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 1,
"path": "MedicationRequest.subject"
},
"isSummary": true
}, {
"path": "MedicationRequest.subject.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.subject.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.subject.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.subject.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.subject.reference",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.subject.reference",
"condition": [ "ref-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.subject.type",
"min": 0,
"definition": "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.\n\nThe 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).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "MedicationRequest.subject.type",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.subject.identifier",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationRequest.subject.identifier",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.subject.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.subject.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: This should contain the name of the Patient, which can then be used in narrative",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.encounter",
"min": 0,
"definition": "The Encounter during which this [x] was created or to which the creation of this record is tightly associated.",
"isModifier": false,
"short": "Encounter created as part of encounter/admission/stay",
"mapping": [ {
"map": "Request.context",
"identity": "workflow"
}, {
"map": "no mapping",
"identity": "script10.6"
}, {
"map": "FiveWs.context",
"identity": "w5"
}, {
"map": "PV1-19-Visit Number",
"identity": "v2"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwEncounter" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.encounter",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: This should be included if there is a definitive link to an encounter in the EMR.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.encounter"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.supportingInformation",
"min": 0,
"definition": "Include additional information (for example, patient height and weight) that supports the ordering of the medication.",
"isModifier": false,
"short": "Information to support ordering of the medication",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo",
"identity": "PrescribeIT"
}, {
"map": "Request.supportingInfo",
"identity": "workflow"
}, {
"map": "FiveWs.context",
"identity": "w5"
}, {
"map": ".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)]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationVitals", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservation", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults" ]
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.supportingInformation",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Rules: This will be used to support the observations for weight, height, creatinine, eGFR.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.supportingInformation"
},
"isSummary": false
}, {
"path": "MedicationRequest.supportingInformation.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.supportingInformation.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.supportingInformation.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.supportingInformation.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.supportingInformation.reference",
"min": 1,
"definition": "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.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.supportingInformation.reference",
"condition": [ "ref-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.supportingInformation.type",
"min": 0,
"definition": "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.\n\nThe 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).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "MedicationRequest.supportingInformation.type",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.supportingInformation.identifier",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationRequest.supportingInformation.identifier",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.supportingInformation.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.supportingInformation.display",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.authoredOn",
"min": 0,
"definition": "The date (and perhaps time) when the prescription was initially written or authored on.",
"isModifier": false,
"short": "When request was initially authored",
"mapping": [ {
"map": "MedicationOrder.dateWritten",
"identity": "PrescribeIT"
}, {
"map": "Request.authoredOn",
"identity": "workflow"
}, {
"map": "Message/Body/NewRx/MedicationPrescribed/WrittenDate",
"identity": "script10.6"
}, {
"map": "FiveWs.recorded",
"identity": "w5"
}, {
"map": "RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction",
"identity": "v2"
}, {
"map": "author.time",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.authoredOn",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: The prescription start date.\r\n\r\nConformance Rule: In the context of \"order\" this is often the date when the prescription was originally written. If this is an external prescription the date may not be known.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.authoredOn"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.requester",
"min": 0,
"definition": "The individual, organization, or device that initiated the request and has responsibility for its activation.",
"isModifier": false,
"short": "Who/What requested the Request",
"mapping": [ {
"map": "Request.requester",
"identity": "workflow"
}, {
"map": "FiveWs.author",
"identity": "w5"
}, {
"map": ".participation[typeCode=AUT].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPractitioner", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPractitionerRole", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwOrganization" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.requester",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: The original prescriber when known.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.requester"
},
"isSummary": true
}, {
"path": "MedicationRequest.requester.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.requester.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.requester.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.requester.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.requester.reference",
"min": 1,
"definition": "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.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.requester.reference",
"condition": [ "ref-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.requester.type",
"min": 0,
"definition": "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.\n\nThe 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).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "MedicationRequest.requester.type",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.requester.identifier",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationRequest.requester.identifier",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.requester.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.requester.display",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.performer",
"min": 0,
"definition": "The specified desired performer of the medication treatment (e.g. the performer of the medication administration).",
"isModifier": false,
"short": "Intended performer of administration",
"mapping": [ {
"map": "Request.performer",
"identity": "workflow"
}, {
"map": "FiveWs.actor",
"identity": "w5"
}, {
"map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/Device|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/CareTeam|4.0.1" ]
} ],
"max": "1",
"id": "MedicationRequest.performer",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.performer"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.performerType",
"min": 0,
"definition": "Indicates the type of performer of the administration of the medication.",
"isModifier": false,
"short": "Desired kind of performer of the medication administration",
"mapping": [ {
"map": "Request.performerType",
"identity": "workflow"
}, {
"map": ".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/performer-role|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestPerformerType"
} ],
"description": "Identifies the type of individual that is desired to administer the medication."
},
"max": "1",
"id": "MedicationRequest.performerType",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.performerType"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.recorder",
"min": 0,
"definition": "The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.",
"isModifier": false,
"short": "Person who entered the request",
"mapping": [ {
"map": "FiveWs.who",
"identity": "w5"
}, {
"map": ".participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1" ]
} ],
"max": "1",
"id": "MedicationRequest.recorder",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.recorder"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode",
"min": 0,
"definition": "The reason or the indication for ordering or not ordering the medication.",
"isModifier": false,
"short": "Reason or indication for ordering or not ordering the medication",
"mapping": [ {
"map": "MedicationOrder.reasonCode",
"identity": "PrescribeIT"
}, {
"map": "Request.reasonCode",
"identity": "workflow"
}, {
"map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value",
"identity": "script10.6"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication",
"identity": "v2"
}, {
"map": "reason.observation.reasonCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
},
"max": "*",
"id": "MedicationRequest.reasonCode",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: linked diagnosis from the medication record when available.\r\n\r\nConformance Rule: In the case where the prescriber wants to send an Indication for Use that is not included in the value set the prescriber must be able to send a text value without a code.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.reasonCode"
},
"isSummary": false
}, {
"path": "MedicationRequest.reasonCode.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.reasonCode.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.reasonCode.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.reasonCode.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.reasonCode.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.reasonCode.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.reasonCode.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.reasonCode.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.reasonCode.coding.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.reasonCode.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.reasonCode.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.reasonCode.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.reasonCode.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.reasonCode.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonCode.text",
"requirements": "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.",
"min": 1,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.reasonCode.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.reasonReference",
"min": 0,
"definition": "Condition or observation that supports why the medication was ordered.",
"isModifier": false,
"short": "Condition or observation that supports why the prescription is being written",
"mapping": [ {
"map": "Request.reasonReference",
"identity": "workflow"
}, {
"map": "no mapping",
"identity": "script10.6"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": "reason.observation[code=ASSERTION].value",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition|4.0.1", "http://hl7.org/fhir/StructureDefinition/Observation|4.0.1" ]
} ],
"max": "*",
"id": "MedicationRequest.reasonReference",
"comment": "This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.reasonReference"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.instantiatesCanonical",
"min": 0,
"definition": "The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.",
"isModifier": false,
"short": "Instantiates FHIR protocol or definition",
"mapping": [ {
"map": "Request.instantiates",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=DEFN].target",
"identity": "rim"
} ],
"type": [ {
"code": "canonical"
} ],
"max": "*",
"id": "MedicationRequest.instantiatesCanonical",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.instantiatesCanonical"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.instantiatesUri",
"min": 0,
"definition": "The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.",
"isModifier": false,
"short": "Instantiates external protocol or definition",
"mapping": [ {
"map": ".outboundRelationship[typeCode=DEFN].target",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "*",
"id": "MedicationRequest.instantiatesUri",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.instantiatesUri"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.basedOn",
"min": 0,
"definition": "A plan or request that is fulfilled in whole or in part by this medication request.",
"isModifier": false,
"short": "What request fulfills",
"mapping": [ {
"map": "Request.basedOn",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwCarePlan", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwServiceRequest" ]
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.basedOn",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.basedOn"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.groupIdentifier",
"requirements": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
"min": 0,
"definition": "A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.",
"isModifier": false,
"short": "Composite request this is part of",
"mapping": [ {
"map": "Request.groupIdentifier",
"identity": "workflow"
}, {
"map": ".outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationRequest.groupIdentifier",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.groupIdentifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType",
"min": 0,
"definition": "The description of the overall pattern of the administration of the medication to the patient.",
"isModifier": false,
"short": "Overall pattern of medication administration",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type",
"identity": "PrescribeIT"
}, {
"map": "Act.code where classCode = LIST and moodCode = EVN",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontreatmentcategory",
"description": "Identifies the overall pattern of medication administration."
},
"max": "1",
"id": "MedicationRequest.courseOfTherapyType",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Derived from medication continuous flag — CHRON for continuous/chronic, ACU for short-term/acute.\n\nUsage Note: This should be included where known\r\nAlignment: PrescribeIT Mapping - Extension - TreatmentType",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.courseOfTherapyType"
},
"isSummary": false
}, {
"path": "MedicationRequest.courseOfTherapyType.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.courseOfTherapyType.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.courseOfTherapyType.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.courseOfTherapyType.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.courseOfTherapyType.coding.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"fixedUri": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.courseOfTherapyType.text",
"requirements": "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.",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.courseOfTherapyType.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.insurance",
"min": 0,
"definition": "Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.",
"isModifier": false,
"short": "Associated insurance coverage",
"mapping": [ {
"map": "Request.insurance",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=COVBY].target",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Coverage|4.0.1", "http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.0.1" ]
} ],
"max": "*",
"id": "MedicationRequest.insurance",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.insurance"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.note",
"min": 0,
"definition": "Extra information about the prescription that could not be conveyed by the other attributes.",
"isModifier": false,
"short": "Information about the prescription",
"mapping": [ {
"map": "Request.note",
"identity": "workflow"
}, {
"map": "Message/Body/NewRx/MedicationPrescribed/Note",
"identity": "script10.6"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.note",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.note"
},
"isSummary": false
}, {
"path": "MedicationRequest.note.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.note.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.note.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.note.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.note.author[x]",
"min": 0,
"definition": "The individual responsible for making the annotation.",
"isModifier": false,
"short": "Individual responsible for the annotation",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act.participant[typeCode=AUT].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1", "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
}, {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.note.author[x]",
"comment": "Organization is used when there's no need for specific attribution as to who made the comment.",
"base": {
"max": "1",
"min": 0,
"path": "Annotation.author[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.note.time",
"min": 0,
"definition": "Indicates when this particular annotation was made.",
"isModifier": false,
"short": "When the annotation was made",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act.effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.note.time",
"base": {
"max": "1",
"min": 0,
"path": "Annotation.time"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.note.text",
"min": 1,
"definition": "The text of the annotation in markdown format.",
"isModifier": false,
"short": "The annotation - text content (as markdown)",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act.text",
"identity": "rim"
} ],
"type": [ {
"code": "markdown"
} ],
"max": "1",
"id": "MedicationRequest.note.text",
"base": {
"max": "1",
"min": 1,
"path": "Annotation.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction",
"min": 0,
"definition": "Indicates how the medication is to be used by the patient.",
"isModifier": false,
"short": "How the medication should be taken",
"mapping": [ {
"map": "Request.occurrence[x]",
"identity": "workflow"
}, {
"map": "see dosageInstruction mapping",
"identity": "rim"
} ],
"type": [ {
"code": "Dosage"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.dosageInstruction",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Dosage is provided as a rendered string via extension[RenderedDosageInstruction] and dosageInstruction.text. Structured sub-elements (timing, route, doseAndRate) are not populated by CHR.\r\n\r\nConformance Rules: if this is available in discrete form, this should be sent. This represents a single dosage line/instruction.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.dosageInstruction"
},
"isSummary": false
}, {
"path": "MedicationRequest.dosageInstruction.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.extension",
"min": 0,
"definition": "This extension will capture the rx_prescription start and end date.",
"isModifier": false,
"short": "Extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-EffectivePeriod" ]
} ],
"sliceName": "effectivePeriod",
"max": "1",
"id": "MedicationRequest.dosageInstruction.extension:effectivePeriod",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.sequence",
"requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.",
"min": 0,
"definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
"isModifier": false,
"short": "The order of the dosage instructions",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence",
"identity": "PrescribeIT"
}, {
"map": "TQ1-1",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "integer"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.sequence",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Rule: This indicates the relationship between instruction lines.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.sequence"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.text",
"requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.",
"min": 0,
"definition": "Free text dosage instructions e.g. SIG.",
"isModifier": false,
"short": "Free text dosage instructions e.g. SIG",
"mapping": [ {
"map": "MedicationOrder.dosageInstruction.text",
"identity": "PrescribeIT"
}, {
"map": "RXO-6; RXE-21",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: The rendered dosage string (dose, dose_unit, frequency, route).",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction",
"requirements": "Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, \"Swallow with plenty of water\" which might or might not be coded.",
"min": 0,
"definition": "Supplemental instructions to the patient on how to take the medication (e.g. \"with meals\" or\"take half to one hour before food\") or warnings for the patient about the medication (e.g. \"may cause drowsiness\" or \"avoid exposure of skin to direct sunlight or sunlamps\").",
"isModifier": false,
"short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"",
"mapping": [ {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdditionalInstruction"
} ],
"description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\"."
},
"max": "*",
"id": "MedicationRequest.dosageInstruction.additionalInstruction",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: To convey explicit instructions to the Pharmacist/dispenser related to this medication order.",
"base": {
"max": "*",
"min": 0,
"path": "Dosage.additionalInstruction"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.additionalInstruction.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.additionalInstruction.text",
"requirements": "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.",
"min": 1,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.additionalInstruction.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.patientInstruction",
"min": 0,
"definition": "Instructions in terms that are understood by the patient or consumer.",
"isModifier": false,
"short": "Patient or consumer oriented instructions",
"mapping": [ {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.patientInstruction",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.patientInstruction"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing",
"requirements": "The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"definition": "When medication should be administered.",
"isModifier": false,
"short": "When medication should be administered",
"mapping": [ {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "Timing"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Includes dosage duration and frequency.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.timing"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.timing.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.timing.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.timing.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.event",
"requirements": "In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.",
"min": 0,
"definition": "Identifies specific times when the event occurs.",
"isModifier": false,
"short": "When the event occurs",
"mapping": [ {
"map": "QLIST",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.event",
"base": {
"max": "*",
"min": 0,
"path": "Timing.event"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "tim-1",
"human": "if there's a duration, there needs to be duration units",
"xpath": "not(exists(f:duration)) or exists(f:durationUnit)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "duration.empty() or durationUnit.exists()"
}, {
"key": "tim-2",
"human": "if there's a period, there needs to be period units",
"xpath": "not(exists(f:period)) or exists(f:periodUnit)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "period.empty() or periodUnit.exists()"
}, {
"key": "tim-4",
"human": "duration SHALL be a non-negative value",
"xpath": "f:duration/@value >= 0 or not(f:duration/@value)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "duration.exists() implies duration >= 0"
}, {
"key": "tim-5",
"human": "period SHALL be a non-negative value",
"xpath": "f:period/@value >= 0 or not(f:period/@value)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "period.exists() implies period >= 0"
}, {
"key": "tim-6",
"human": "If there's a periodMax, there must be a period",
"xpath": "not(exists(f:periodMax)) or exists(f:period)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "periodMax.empty() or period.exists()"
}, {
"key": "tim-7",
"human": "If there's a durationMax, there must be a duration",
"xpath": "not(exists(f:durationMax)) or exists(f:duration)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "durationMax.empty() or duration.exists()"
}, {
"key": "tim-8",
"human": "If there's a countMax, there must be a count",
"xpath": "not(exists(f:countMax)) or exists(f:count)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "countMax.empty() or count.exists()"
}, {
"key": "tim-9",
"human": "If there's an offset, there must be a when (and not C, CM, CD, CV)",
"xpath": "not(exists(f:offset)) or exists(f:when)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))"
}, {
"key": "tim-10",
"human": "If there's a timeOfDay, there cannot be a when, or vice versa",
"xpath": "not(exists(f:timeOfDay)) or not(exists(f:when))",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"severity": "error",
"expression": "timeOfDay.empty() or when.empty()"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat",
"requirements": "Many timing schedules are determined by regular repetitions.",
"min": 0,
"definition": "A set of rules that describe when the event is scheduled.",
"isModifier": false,
"short": "When the event is to occur",
"mapping": [ {
"map": "Implies PIVL or EIVL",
"identity": "rim"
} ],
"type": [ {
"code": "Element"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.timing.repeat.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.repeat.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.bounds[x]",
"min": 0,
"definition": "Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.",
"isModifier": false,
"short": "Length/Range of lengths, or (Start and/or end) limits",
"mapping": [ {
"map": "IVL(TS) used in a QSI",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
}, {
"code": "Range"
}, {
"code": "Period"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.bounds[x]",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.bounds[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.count",
"requirements": "Repetitions may be limited by end time or total occurrences.",
"min": 0,
"definition": "A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.",
"isModifier": false,
"short": "Number of times to repeat",
"mapping": [ {
"map": "PIVL.count",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.count",
"comment": "If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.count"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.countMax",
"min": 0,
"definition": "If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.",
"isModifier": false,
"short": "Maximum number of times to repeat",
"mapping": [ {
"map": "PIVL.count",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.countMax",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.countMax"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.duration",
"requirements": "Some activities are not instantaneous and need to be maintained for a period of time.",
"min": 0,
"definition": "How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.",
"isModifier": false,
"short": "How long when it happens",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.duration",
"comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.duration"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.durationMax",
"requirements": "Some activities are not instantaneous and need to be maintained for a period of time.",
"min": 0,
"definition": "If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.",
"isModifier": false,
"short": "How long when it happens (Max)",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.durationMax",
"comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.durationMax"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"min": 0,
"definition": "The units of time for the duration, in UCUM units.",
"isModifier": false,
"short": "s | min | h | d | wk | mo | a - unit of time (UCUM)",
"mapping": [ {
"map": "PIVL.phase.unit",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "UnitsOfTime"
} ],
"description": "A unit of time (units from UCUM)."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.durationUnit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"min": 0,
"definition": "The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.",
"isModifier": false,
"short": "Event occurs frequency times per period",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"mustSupport": true,
"meaningWhenMissing": "If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this",
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.frequency"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.frequencyMax",
"min": 0,
"definition": "If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.",
"isModifier": false,
"short": "Event occurs up to frequencyMax times per period",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.frequencyMax",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.frequencyMax"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.period",
"min": 0,
"definition": "Indicates the duration of time over which repetitions are to occur; e.g. to express \"3 times per day\", 3 would be the frequency and \"1 day\" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.",
"isModifier": false,
"short": "Event occurs frequency times per period",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.period",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.period"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.periodMax",
"min": 0,
"definition": "If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as \"do this once every 3-5 days.",
"isModifier": false,
"short": "Upper limit of period (3-4 hours)",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.periodMax",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.periodMax"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.periodUnit",
"min": 0,
"definition": "The units of time for the period in UCUM units.",
"isModifier": false,
"short": "s | min | h | d | wk | mo | a - unit of time (UCUM)",
"mapping": [ {
"map": "PIVL.phase.unit",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "UnitsOfTime"
} ],
"description": "A unit of time (units from UCUM)."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.periodUnit",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.periodUnit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek",
"min": 0,
"definition": "If one or more days of week is provided, then the action happens only on the specified day(s).",
"isModifier": false,
"short": "mon | tue | wed | thu | fri | sat | sun",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/days-of-week|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DayOfWeek"
} ]
},
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek",
"comment": "If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.",
"base": {
"max": "*",
"min": 0,
"path": "Timing.repeat.dayOfWeek"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.timeOfDay",
"min": 0,
"definition": "Specified time of day for action to take place.",
"isModifier": false,
"short": "Time of day for action",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "time"
} ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.repeat.timeOfDay",
"comment": "When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.",
"base": {
"max": "*",
"min": 0,
"path": "Timing.repeat.timeOfDay"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.when",
"requirements": "Timings are frequently determined by occurrences such as waking, eating and sleep.",
"min": 0,
"definition": "An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.",
"isModifier": false,
"short": "Code for time period of occurrence",
"mapping": [ {
"map": "EIVL.event",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/event-timing|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "EventTiming"
} ],
"description": "Real world event relating to the schedule."
},
"max": "*",
"id": "MedicationRequest.dosageInstruction.timing.repeat.when",
"comment": "When more than one event is listed, the event is tied to the union of the specified events.",
"base": {
"max": "*",
"min": 0,
"path": "Timing.repeat.when"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.repeat.offset",
"min": 0,
"definition": "The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.",
"isModifier": false,
"short": "Minutes from event (before or after)",
"mapping": [ {
"map": "EIVL.offset",
"identity": "rim"
} ],
"type": [ {
"code": "unsignedInt"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.repeat.offset",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.offset"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.timing.code",
"min": 0,
"definition": "A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).",
"isModifier": false,
"short": "BID | TID | QID | AM | PM | QD | QOD | +",
"mapping": [ {
"map": "QSC.code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "TimingAbbreviation"
} ],
"description": "Code for a known / defined timing pattern."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.timing.code",
"comment": "BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is \"always at 7am and 6pm\". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).",
"base": {
"max": "1",
"min": 0,
"path": "Timing.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.asNeeded[x]",
"min": 0,
"definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
"isModifier": false,
"short": "Take \"as needed\" (for x)",
"mapping": [ {
"map": "TQ1-9",
"identity": "v2"
}, {
"map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
}, {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAsNeededReason"
} ],
"description": "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."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.asNeeded[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nConformance Rule: This is ONLY populated when the medication is prescribed on an as needed (i.e. PRN) basis.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.asNeeded[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site",
"requirements": "A coded specification of the anatomic site where the medication first enters the body.",
"min": 0,
"definition": "Body site to administer to.",
"isModifier": false,
"short": "Body site to administer to",
"mapping": [ {
"map": "RXR-2",
"identity": "v2"
}, {
"map": ".approachSiteCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionadministrationsite"
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.site",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.site"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.site.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.site.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.site.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.site.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.site.coding.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 1,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.site.text",
"requirements": "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.",
"min": 1,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.site.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route",
"requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
"min": 0,
"definition": "How drug should enter body.",
"isModifier": false,
"short": "How drug should enter body",
"mapping": [ {
"map": "RXR-1",
"identity": "v2"
}, {
"map": ".routeCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.route",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Route mapped to SNOMED CT CA (routeSCTCA) and EMR-specific codes (routeEMRCode); route.text always populated.\n\nConformance Rule: Coding should be populated if a code is available. However, text is always required.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.route"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.route.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.route.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.route.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "system",
"type": "value"
} ]
},
"type": [ {
"code": "Coding"
} ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.route.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"sliceName": "routeSCTCA",
"binding": {
"strength": "required",
"valueSet": "http://snomed.info/sct"
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.route.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"fixedUri": "http://snomed.info/sct",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"sliceName": "routeEMRCode",
"max": "*",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.route.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "dw-medicationrequest-route-emrcode-system",
"human": "EMR route coding system must follow pattern urn:telus:emr:{emrType}:{instanceId}:medication-route or urn:telus:emr:{emrType}:{region}:{instanceId}:medication-route",
"source": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest",
"severity": "warning",
"expression": "matches('urn:telus:emr:([^:]+:){2,3}medication-route')"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 1,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.route.text",
"requirements": "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.",
"min": 1,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.route.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.method",
"requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.",
"min": 0,
"definition": "Technique for administering medication.",
"isModifier": false,
"short": "Technique for administering medication",
"mapping": [ {
"map": "RXR-4",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAdministrationMethod"
} ],
"description": "A coded concept describing the technique by which the medicine is administered."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.method",
"comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.method"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.doseAndRate",
"min": 0,
"definition": "The amount of medication administered.",
"isModifier": false,
"short": "Amount of medication administered",
"mapping": [ {
"map": "TQ1-2",
"identity": "v2"
} ],
"type": [ {
"code": "Element"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.dosageInstruction.doseAndRate",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Includes dose value and unit.",
"base": {
"max": "*",
"min": 0,
"path": "Dosage.doseAndRate"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.doseAndRate.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.doseAndRate.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.doseAndRate.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.doseAndRate.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.doseAndRate.type",
"requirements": "If the type is not populated, assume to be \"ordered\".",
"min": 0,
"definition": "The kind of dose or rate specified, for example, ordered or calculated.",
"isModifier": false,
"short": "The kind of dose or rate specified",
"mapping": [ {
"map": "RXO-21; RXE-23",
"identity": "v2"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DoseAndRateType"
} ],
"description": "The kind of dose or rate specified."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.doseAndRate.type",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "Amount of medication per dose.",
"isModifier": false,
"short": "Amount of medication per dose",
"mapping": [ {
"map": "RXO-2, RXE-3",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.dose[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.doseAndRate.rate[x]",
"requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"definition": "Amount of medication per unit of time.",
"isModifier": false,
"short": "Amount of medication per unit of time",
"mapping": [ {
"map": "RXE22, RXE23, RXE-24",
"identity": "v2"
}, {
"map": ".rateQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
}, {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.doseAndRate.rate[x]",
"comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\r\rIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.rate[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.",
"min": 0,
"definition": "Upper limit on medication per unit of time.",
"isModifier": false,
"short": "Upper limit on medication per unit of time",
"mapping": [ {
"map": "RXO-23, RXE-19",
"identity": "v2"
}, {
"map": ".maxDoseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerPeriod"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator",
"min": 0,
"definition": "The value of the numerator.",
"isModifier": false,
"short": "Numerator value",
"mapping": [ {
"map": ".numerator",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator",
"base": {
"max": "1",
"min": 0,
"path": "Ratio.numerator"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit"
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator",
"min": 0,
"definition": "The value of the denominator.",
"isModifier": false,
"short": "Denominator value",
"mapping": [ {
"map": ".denominator",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator",
"base": {
"max": "1",
"min": 0,
"path": "Ratio.denominator"
},
"isSummary": true
}, {
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"fixedUri": "http://unitsofmeasure.org",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerAdministration",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
"min": 0,
"definition": "Upper limit on medication per administration.",
"isModifier": false,
"short": "Upper limit on medication per administration",
"mapping": [ {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerAdministration",
"comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerAdministration"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dosageInstruction.maxDosePerLifetime",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
"min": 0,
"definition": "Upper limit on medication per lifetime of the patient.",
"isModifier": false,
"short": "Upper limit on medication per lifetime of the patient",
"mapping": [ {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"max": "1",
"id": "MedicationRequest.dosageInstruction.maxDosePerLifetime",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerLifetime"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest",
"min": 0,
"definition": "Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
"isModifier": false,
"short": "Medication supply authorization",
"mapping": [ {
"map": "Message/Body/NewRx/MedicationPrescribed/ExpirationDate",
"identity": "script10.6"
}, {
"map": "component.supplyEvent",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Rule: This will be mandatory for internally created prescriptions (source system is the reported source).",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-TotalQuantity" ]
} ],
"sliceName": "TotalQuantity",
"max": "1",
"id": "MedicationRequest.dispenseRequest.extension:TotalQuantity",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nAlignment Note: PrescribeIT - MedicationOrder.dispenseRequest.extension:totalPrescribedQuantity",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-DispenseTrial" ]
} ],
"sliceName": "DispenseTrial",
"max": "1",
"id": "MedicationRequest.dispenseRequest.extension:DispenseTrial",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nAlignment: PrescribeIT: Maps to extension MedicationOrder.dispenseRequest.extension:trialEligibility",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill",
"min": 0,
"definition": "Indicates the quantity or duration for the first dispense of the medication.",
"isModifier": false,
"short": "First fill details",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill",
"identity": "PrescribeIT"
}, {
"map": "SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.initialFill"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.initialFill.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.initialFill.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.initialFill.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity",
"min": 0,
"definition": "The amount or quantity to provide as part of the first dispense.",
"isModifier": false,
"short": "First fill quantity",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/dtprofile-quantity-drug",
"identity": "PrescribeIT"
}, {
"map": "Supply.quantity[moodCode=RQO]",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescribedquantityunit"
},
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.initialFill.quantity"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 1,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "Not allowed to be used in this context",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "0",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration",
"min": 0,
"definition": "The length of time that the first dispense is expected to last.",
"isModifier": false,
"short": "First fill duration",
"mapping": [ {
"map": "Supply.effectivetime[moodCode=RQO]",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.initialFill.duration"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.initialFill.duration.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 1,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"fixedUri": "http://unitsofmeasure.org",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.initialFill.duration.code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval",
"min": 0,
"definition": "The minimum period of time that must occur between dispenses of the medication.",
"isModifier": false,
"short": "Minimum period of time between dispenses",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval",
"identity": "PrescribeIT"
}, {
"map": "Supply.effectivetime[moodCode=RQO]",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.dispenseInterval"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.dispenseInterval.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.dispenseInterval.code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.validityPeriod",
"requirements": "Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.",
"min": 0,
"definition": "This indicates the validity period of a prescription (stale dating the Prescription).",
"isModifier": false,
"short": "Time period supply is authorized for",
"mapping": [ {
"map": "Message/Body/NewRx/MedicationPrescribed/Refills",
"identity": "script10.6"
}, {
"map": "effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "Period"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.validityPeriod",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: End date of the prescription when set.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.validityPeriod"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.validityPeriod.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.validityPeriod.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.validityPeriod.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.validityPeriod.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.validityPeriod.start",
"min": 0,
"definition": "The start of the period. The boundary is inclusive.",
"isModifier": false,
"short": "Starting time with inclusive boundary",
"mapping": [ {
"map": "DR.1",
"identity": "v2"
}, {
"map": "./low",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.validityPeriod.start",
"condition": [ "per-1" ],
"comment": "If the low element is missing, the meaning is that the low boundary is not known.",
"base": {
"max": "1",
"min": 0,
"path": "Period.start"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.validityPeriod.end",
"min": 0,
"definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
"isModifier": false,
"short": "End time with inclusive boundary, if not ongoing",
"mapping": [ {
"map": "DR.2",
"identity": "v2"
}, {
"map": "./high",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
"max": "1",
"id": "MedicationRequest.dispenseRequest.validityPeriod.end",
"condition": [ "per-1" ],
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
"base": {
"max": "1",
"min": 0,
"path": "Period.end"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"min": 0,
"definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.",
"isModifier": false,
"short": "Number of refills authorized",
"mapping": [ {
"map": "Message/Body/NewRx/MedicationPrescribed/Quantity",
"identity": "script10.6"
}, {
"map": "RXE-12-Number of Refills",
"identity": "v2"
}, {
"map": "repeatNumber",
"identity": "rim"
} ],
"type": [ {
"code": "unsignedInt"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nConformance Rule: This must be populated when the number of repeats is 1 or more. As this field only allows a positive integer, this is not populated if there are no refills allowed.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.quantity",
"min": 0,
"definition": "The amount that is to be dispensed for one fill.",
"isModifier": false,
"short": "Amount of medication to supply per dispense",
"mapping": [ {
"map": "Message/Body/NewRx/MedicationPrescribed/DaysSupply",
"identity": "script10.6"
}, {
"map": "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system",
"identity": "v2"
}, {
"map": "quantity",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.quantity",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.quantity"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.quantity.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.quantity.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.quantity.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.quantity.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.quantity.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.quantity.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.quantity.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "Not allowed to be used in this context",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "0",
"id": "MedicationRequest.dispenseRequest.quantity.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.quantity.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.quantity.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.quantity.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.quantity.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.quantity.code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.quantity.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"min": 0,
"definition": "Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.",
"isModifier": false,
"short": "Number of days supply per dispense",
"mapping": [ {
"map": "Message/Body/NewRx/MedicationPrescribed/Substitutions",
"identity": "script10.6"
}, {
"map": "expectedUseTime",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Dosage duration value and unit.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"isModifier": false,
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "1",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"isModifier": false,
"short": "Unit representation",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"fixedString": "days",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.unit",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 1,
"definition": "The identification of the system that provides the coded form of the unit.",
"isModifier": false,
"short": "System that defines coded unit form",
"fixedUri": "http://unitsofmeasure.org",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"condition": [ "qty-3" ],
"base": {
"max": "1",
"min": 0,
"path": "Quantity.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"fixedCode": "d",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"isModifier": false,
"short": "Coded form of the unit",
"mapping": [ {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.performer",
"min": 0,
"definition": "Indicates the intended dispensing Organization specified by the prescriber.",
"isModifier": false,
"short": "Intended dispenser",
"mapping": [ {
"map": "FiveWs.who",
"identity": "w5"
}, {
"map": ".outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwOrganization" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.dispenseRequest.performer",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: The pharmacy should be included when known.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.performer"
},
"isSummary": false
}, {
"path": "MedicationRequest.dispenseRequest.performer.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.performer.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.dispenseRequest.performer.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.dispenseRequest.performer.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.performer.reference",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.performer.reference",
"condition": [ "ref-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.performer.type",
"min": 0,
"definition": "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.\n\nThe 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).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "MedicationRequest.dispenseRequest.performer.type",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.performer.identifier",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.performer.identifier",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.dispenseRequest.performer.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.performer.display",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution",
"min": 0,
"definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
"isModifier": false,
"short": "Any restrictions on medication substitution",
"mapping": [ {
"map": "specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions",
"identity": "script10.6"
}, {
"map": "subjectOf.substitutionPersmission",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.substitution",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported\n\nCHR: Based on the medication substitution-not-allowed flag.\n\nConformance Rule: This MUST be included when the prescriber specifies \"no substitution\" (boolean = false)",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.substitution"
},
"isSummary": false
}, {
"path": "MedicationRequest.substitution.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.substitution.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.substitution.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.substitution.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.substitution.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationRequest.substitution.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.allowed[x]",
"min": 1,
"definition": "True if the prescriber allows a different drug to be dispensed from what was prescribed.",
"isModifier": false,
"short": "Whether substitution is allowed or not",
"mapping": [ {
"map": "specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions",
"identity": "script10.6"
}, {
"map": "RXO-9-Allow Substitutions / RXE-9-Substitution Status",
"identity": "v2"
}, {
"map": "code",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
}, {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestSubstitution"
} ],
"description": "Identifies the type of substitution allowed."
},
"max": "1",
"id": "MedicationRequest.substitution.allowed[x]",
"comment": "This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationRequest.substitution.allowed[x]"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason",
"min": 0,
"definition": "Indicates the reason for the substitution, or why substitution must or must not be performed.",
"isModifier": false,
"short": "Why should (not) substitution be made",
"mapping": [ {
"map": "not mapped",
"identity": "script10.6"
}, {
"map": "RXE-9 Substition status",
"identity": "v2"
}, {
"map": "reasonCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationIntendedSubstitutionReason"
} ],
"description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed."
},
"max": "1",
"id": "MedicationRequest.substitution.reason",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.substitution.reason"
},
"isSummary": false
}, {
"path": "MedicationRequest.substitution.reason.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.substitution.reason.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.substitution.reason.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.substitution.reason.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationRequest.substitution.reason.coding",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationRequest.substitution.reason.coding.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.substitution.reason.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.substitution.reason.coding.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.substitution.reason.coding.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"isModifier": false,
"short": "Identity of the terminology system",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.substitution.reason.coding.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"isModifier": false,
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.substitution.reason.coding.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.coding.code",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"isModifier": false,
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.substitution.reason.coding.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"isModifier": false,
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.substitution.reason.coding.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationRequest.substitution.reason.coding.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.substitution.reason.text",
"requirements": "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.",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.substitution.reason.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.priorPrescription",
"min": 0,
"definition": "A link to a resource representing an earlier order related order or prescription.",
"isModifier": false,
"short": "An order/prescription that is being replaced",
"mapping": [ {
"map": "Request.replaces",
"identity": "workflow"
}, {
"map": "not mapped",
"identity": "script10.6"
}, {
"map": ".outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationRequest.priorPrescription",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.priorPrescription"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.detectedIssue",
"min": 0,
"definition": "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.",
"isModifier": false,
"short": "Clinical Issue with action",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue",
"identity": "PrescribeIT"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DetectedIssue|4.0.1" ]
} ],
"mustSupport": true,
"alias": [ "Contraindication", "Drug Utilization Review (DUR)", "Alert" ],
"max": "*",
"id": "MedicationRequest.detectedIssue",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported\n\nConformance Rule: Detected Issue will be used to convey managed drug interactions. If available, this must be sent.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.detectedIssue"
},
"isSummary": false
}, {
"path": "MedicationRequest.detectedIssue.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationRequest.detectedIssue.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationRequest.detectedIssue.extension",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationRequest.detectedIssue.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.detectedIssue.reference",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationRequest.detectedIssue.reference",
"condition": [ "ref-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.detectedIssue.type",
"min": 0,
"definition": "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.\n\nThe 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).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "MedicationRequest.detectedIssue.type",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.detectedIssue.identifier",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationRequest.detectedIssue.identifier",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.detectedIssue.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationRequest.detectedIssue.display",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationRequest.eventHistory",
"min": 0,
"definition": "Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.",
"isModifier": false,
"short": "A list of events of interest in the lifecycle",
"mapping": [ {
"map": "Request.relevantHistory",
"identity": "workflow"
}, {
"map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Provenance|4.0.1" ]
} ],
"max": "*",
"id": "MedicationRequest.eventHistory",
"comment": "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.).",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.eventHistory"
},
"isSummary": false
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "4.0.1"
} ]
},
"status": "draft",
"id": "1ba933bc-8b8d-4477-9354-85318b475a35",
"kind": "resource",
"url": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest",
"version": "2.0.0",
"differential": {
"element": [ {
"id": "MedicationRequest",
"path": "MedicationRequest"
}, {
"id": "MedicationRequest.id",
"min": 1,
"path": "MedicationRequest.id",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.meta",
"path": "MedicationRequest.meta",
"mustSupport": true
}, {
"id": "MedicationRequest.meta.lastUpdated",
"min": 1,
"path": "MedicationRequest.meta.lastUpdated",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.meta.source",
"min": 1,
"path": "MedicationRequest.meta.source",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.meta.profile",
"path": "MedicationRequest.meta.profile",
"comment": "Usage: Each implementation project will determine if this will be supported. It may be useful for validating message instances against this specific profile.\r\n\r\nIt 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."
}, {
"id": "MedicationRequest.text",
"path": "MedicationRequest.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.contained",
"max": "0",
"path": "MedicationRequest.contained",
"mustSupport": true
}, {
"id": "MedicationRequest.extension",
"path": "MedicationRequest.extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.extension:DispenserInstructions",
"max": "1",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-DispenserInstructions" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nAlignment: MedicationOrder.extension:pharmacyInstructions\r\nUsage Note: If available, this should be included",
"sliceName": "DispenserInstructions",
"mustSupport": true
}, {
"id": "MedicationRequest.extension:NoRenewalsFlag",
"max": "1",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-NoRenewalsFlag" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported\n\nAlignment: PrescribeIT: MedicationOrder.extension:noRenewals",
"sliceName": "NoRenewalsFlag",
"mustSupport": true
}, {
"path": "MedicationRequest.extension",
"min": 0,
"definition": "The date (and perhaps time) when the status was changed.",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.statusChanged" ]
} ],
"mustSupport": true,
"sliceName": "StatusChanged",
"max": "1",
"id": "MedicationRequest.extension:StatusChanged",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: This is a pre-adoption of an R5 data element, and reflects the dateTime that the status was changed\r\nhttps://build.fhir.org/medicationrequest-definitions.html#MedicationRequest.statusChanged"
}, {
"id": "MedicationRequest.extension:RenderedDosageInstruction",
"max": "1",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR populates this with the full rendered dosage string (dose, frequency, route) rather than structured dosage sub-elements.",
"sliceName": "RenderedDosageInstruction",
"mustSupport": true
}, {
"id": "MedicationRequest.identifier",
"path": "MedicationRequest.identifier",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.identifier.system",
"min": 1,
"path": "MedicationRequest.identifier.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.identifier.value",
"min": 1,
"path": "MedicationRequest.identifier.value",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mapping": [ {
"map": "MedicationOrder.identifier:EMR-id.value",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.status",
"path": "MedicationRequest.status",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Status derived from medication state — active for current medications, stopped/cancelled for stopped medications, entered-in-error for deleted records.\r\n\r\nConformance Rule: Sending systems should set all orders should be set to completed. Rationale: The status of an order should not change and therefore all internal prescriptions may be set to completed.\r\n\r\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"mustSupport": true
}, {
"id": "MedicationRequest.statusReason",
"path": "MedicationRequest.statusReason",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Cancellation note when present.\r\n\r\nUsage Note: When radio buttons are used, the status reason is be captured discretely.",
"mustSupport": true
}, {
"id": "MedicationRequest.intent",
"path": "MedicationRequest.intent",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Hardcoded value \"order\".",
"fixedCode": "order",
"mustSupport": true
}, {
"id": "MedicationRequest.category",
"max": "1",
"path": "MedicationRequest.category",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontype"
},
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nConformance Rule: This should be populated if known",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.category.coding",
"path": "MedicationRequest.category.coding",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontype"
},
"mustSupport": true
}, {
"id": "MedicationRequest.category.coding.system",
"path": "MedicationRequest.category.coding.system",
"mustSupport": true
}, {
"id": "MedicationRequest.category.coding.code",
"path": "MedicationRequest.category.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.category.text",
"path": "MedicationRequest.category.text",
"mustSupport": true
}, {
"id": "MedicationRequest.reported[x]",
"path": "MedicationRequest.reported[x]",
"type": [ {
"code": "boolean"
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: True when the prescription was externally reported.\n\nConformance Rule: The boolean is mandatory where known, the source resource must be included in the extension:InformationSource. In EMR's this may be derived from the \"external\" prescription indicator — consider it reported and set value = true.",
"mustSupport": true
}, {
"id": "MedicationRequest.medication[x]",
"path": "MedicationRequest.medication[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: In cases where the medication Resource is not available, medication will be provided as a codeableConcept.",
"mustSupport": true
}, {
"id": "MedicationRequest.subject",
"path": "MedicationRequest.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.subject.display",
"path": "MedicationRequest.subject.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: This should contain the name of the Patient, which can then be used in narrative",
"mustSupport": true
}, {
"id": "MedicationRequest.encounter",
"path": "MedicationRequest.encounter",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwEncounter" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: This should be included if there is a definitive link to an encounter in the EMR.",
"mustSupport": true
}, {
"id": "MedicationRequest.supportingInformation",
"path": "MedicationRequest.supportingInformation",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationVitals", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservation", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Rules: This will be used to support the observations for weight, height, creatinine, eGFR.",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.supportingInformation.reference",
"min": 1,
"path": "MedicationRequest.supportingInformation.reference",
"mustSupport": true
}, {
"id": "MedicationRequest.supportingInformation.display",
"path": "MedicationRequest.supportingInformation.display",
"mustSupport": true
}, {
"id": "MedicationRequest.authoredOn",
"path": "MedicationRequest.authoredOn",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: The prescription start date.\r\n\r\nConformance Rule: In the context of \"order\" this is often the date when the prescription was originally written. If this is an external prescription the date may not be known.",
"mapping": [ {
"map": "MedicationOrder.dateWritten",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.requester",
"path": "MedicationRequest.requester",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPractitioner", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPractitionerRole", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwOrganization" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: The original prescriber when known.",
"mustSupport": true
}, {
"id": "MedicationRequest.requester.reference",
"min": 1,
"path": "MedicationRequest.requester.reference",
"mustSupport": true
}, {
"id": "MedicationRequest.requester.display",
"path": "MedicationRequest.requester.display",
"mustSupport": true
}, {
"id": "MedicationRequest.reasonCode",
"path": "MedicationRequest.reasonCode",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
},
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: linked diagnosis from the medication record when available.\r\n\r\nConformance Rule: In the case where the prescriber wants to send an Indication for Use that is not included in the value set the prescriber must be able to send a text value without a code.",
"mapping": [ {
"map": "MedicationOrder.reasonCode",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.reasonCode.coding",
"path": "MedicationRequest.reasonCode.coding",
"mustSupport": true
}, {
"id": "MedicationRequest.reasonCode.coding.system",
"path": "MedicationRequest.reasonCode.coding.system",
"mustSupport": true
}, {
"id": "MedicationRequest.reasonCode.coding.code",
"path": "MedicationRequest.reasonCode.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.reasonCode.text",
"min": 1,
"path": "MedicationRequest.reasonCode.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.basedOn",
"path": "MedicationRequest.basedOn",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwCarePlan", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwServiceRequest" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.courseOfTherapyType",
"path": "MedicationRequest.courseOfTherapyType",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontreatmentcategory",
"description": "Identifies the overall pattern of medication administration."
},
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Derived from medication continuous flag — CHRON for continuous/chronic, ACU for short-term/acute.\n\nUsage Note: This should be included where known\r\nAlignment: PrescribeIT Mapping - Extension - TreatmentType",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type",
"identity": "PrescribeIT"
} ],
"definition": "The description of the overall pattern of the administration of the medication to the patient."
}, {
"id": "MedicationRequest.courseOfTherapyType.coding",
"max": "1",
"min": 1,
"path": "MedicationRequest.courseOfTherapyType.coding",
"mustSupport": true
}, {
"id": "MedicationRequest.courseOfTherapyType.coding.system",
"min": 1,
"path": "MedicationRequest.courseOfTherapyType.coding.system",
"fixedUri": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"mustSupport": true
}, {
"id": "MedicationRequest.courseOfTherapyType.coding.code",
"min": 1,
"path": "MedicationRequest.courseOfTherapyType.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.courseOfTherapyType.text",
"path": "MedicationRequest.courseOfTherapyType.text",
"mustSupport": true
}, {
"id": "MedicationRequest.note",
"path": "MedicationRequest.note",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.note.author[x]",
"path": "MedicationRequest.note.author[x]",
"mustSupport": true
}, {
"id": "MedicationRequest.note.time",
"path": "MedicationRequest.note.time",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction",
"path": "MedicationRequest.dosageInstruction",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Dosage is provided as a rendered string via extension[RenderedDosageInstruction] and dosageInstruction.text. Structured sub-elements (timing, route, doseAndRate) are not populated by CHR.\r\n\r\nConformance Rules: if this is available in discrete form, this should be sent. This represents a single dosage line/instruction.",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.extension:effectivePeriod",
"max": "1",
"min": 0,
"path": "MedicationRequest.dosageInstruction.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-EffectivePeriod" ]
} ],
"sliceName": "effectivePeriod"
}, {
"id": "MedicationRequest.dosageInstruction.sequence",
"path": "MedicationRequest.dosageInstruction.sequence",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Rule: This indicates the relationship between instruction lines.",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.text",
"path": "MedicationRequest.dosageInstruction.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: The rendered dosage string (dose, dose_unit, frequency, route).",
"mapping": [ {
"map": "MedicationOrder.dosageInstruction.text",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.additionalInstruction",
"path": "MedicationRequest.dosageInstruction.additionalInstruction",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: To convey explicit instructions to the Pharmacist/dispenser related to this medication order.",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"max": "1",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"min": 1,
"path": "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.additionalInstruction.text",
"min": 1,
"path": "MedicationRequest.dosageInstruction.additionalInstruction.text",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.patientInstruction",
"path": "MedicationRequest.dosageInstruction.patientInstruction",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported"
}, {
"id": "MedicationRequest.dosageInstruction.timing",
"path": "MedicationRequest.dosageInstruction.timing",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Includes dosage duration and frequency.",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat",
"path": "MedicationRequest.dosageInstruction.timing.repeat",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.bounds[x]",
"path": "MedicationRequest.dosageInstruction.timing.repeat.bounds[x]",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.count",
"path": "MedicationRequest.dosageInstruction.timing.repeat.count",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.countMax",
"path": "MedicationRequest.dosageInstruction.timing.repeat.countMax",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.duration",
"path": "MedicationRequest.dosageInstruction.timing.repeat.duration",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.durationMax",
"path": "MedicationRequest.dosageInstruction.timing.repeat.durationMax",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"path": "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"path": "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.frequencyMax",
"path": "MedicationRequest.dosageInstruction.timing.repeat.frequencyMax",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.period",
"path": "MedicationRequest.dosageInstruction.timing.repeat.period",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.periodMax",
"path": "MedicationRequest.dosageInstruction.timing.repeat.periodMax",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.periodUnit",
"path": "MedicationRequest.dosageInstruction.timing.repeat.periodUnit",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.asNeeded[x]",
"path": "MedicationRequest.dosageInstruction.asNeeded[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nConformance Rule: This is ONLY populated when the medication is prescribed on an as needed (i.e. PRN) basis.",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.site",
"path": "MedicationRequest.dosageInstruction.site",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionadministrationsite"
},
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.site.coding",
"max": "1",
"code": [ {
"system": "http://snomed.info/sct"
}, {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActSite"
} ],
"path": "MedicationRequest.dosageInstruction.site.coding",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.site.coding.system",
"min": 1,
"path": "MedicationRequest.dosageInstruction.site.coding.system",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.site.coding.code",
"min": 1,
"path": "MedicationRequest.dosageInstruction.site.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.site.text",
"min": 1,
"path": "MedicationRequest.dosageInstruction.site.text",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route",
"path": "MedicationRequest.dosageInstruction.route",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
},
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Route mapped to SNOMED CT CA (routeSCTCA) and EMR-specific codes (routeEMRCode); route.text always populated.\n\nConformance Rule: Coding should be populated if a code is available. However, text is always required.",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding",
"path": "MedicationRequest.dosageInstruction.route.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "system",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA",
"max": "1",
"min": 0,
"path": "MedicationRequest.dosageInstruction.route.coding",
"binding": {
"strength": "required",
"valueSet": "http://snomed.info/sct"
},
"sliceName": "routeSCTCA",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.system",
"min": 1,
"path": "MedicationRequest.dosageInstruction.route.coding.system",
"fixedUri": "http://snomed.info/sct",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.version",
"path": "MedicationRequest.dosageInstruction.route.coding.version",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.code",
"path": "MedicationRequest.dosageInstruction.route.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.display",
"path": "MedicationRequest.dosageInstruction.route.coding.display",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeSCTCA.userSelected",
"path": "MedicationRequest.dosageInstruction.route.coding.userSelected",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode",
"max": "*",
"min": 0,
"path": "MedicationRequest.dosageInstruction.route.coding",
"sliceName": "routeEMRCode",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.system",
"min": 1,
"path": "MedicationRequest.dosageInstruction.route.coding.system",
"constraint": [ {
"key": "dw-medicationrequest-route-emrcode-system",
"human": "EMR route coding system must follow pattern urn:telus:emr:{emrType}:{instanceId}:medication-route or urn:telus:emr:{emrType}:{region}:{instanceId}:medication-route",
"source": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest",
"severity": "warning",
"expression": "matches('urn:telus:emr:([^:]+:){2,3}medication-route')"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.code",
"path": "MedicationRequest.dosageInstruction.route.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.display",
"path": "MedicationRequest.dosageInstruction.route.coding.display",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.coding:routeEMRCode.userSelected",
"path": "MedicationRequest.dosageInstruction.route.coding.userSelected",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route.text",
"min": 1,
"path": "MedicationRequest.dosageInstruction.route.text",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate",
"path": "MedicationRequest.dosageInstruction.doseAndRate",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Includes dose value and unit.",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit"
},
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system",
"fixedUri": "http://unitsofmeasure.org",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code",
"path": "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest",
"path": "MedicationRequest.dispenseRequest",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Rule: This will be mandatory for internally created prescriptions (source system is the reported source).",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.extension",
"path": "MedicationRequest.dispenseRequest.extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.dispenseRequest.extension:TotalQuantity",
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-TotalQuantity" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nAlignment Note: PrescribeIT - MedicationOrder.dispenseRequest.extension:totalPrescribedQuantity",
"sliceName": "TotalQuantity"
}, {
"id": "MedicationRequest.dispenseRequest.extension:DispenseTrial",
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-DispenseTrial" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nAlignment: PrescribeIT: Maps to extension MedicationOrder.dispenseRequest.extension:trialEligibility",
"sliceName": "DispenseTrial"
}, {
"id": "MedicationRequest.dispenseRequest.initialFill",
"path": "MedicationRequest.dispenseRequest.initialFill",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.quantity",
"path": "MedicationRequest.dispenseRequest.initialFill.quantity",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescribedquantityunit"
},
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/dtprofile-quantity-drug",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.value",
"min": 1,
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.unit",
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.unit",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.system",
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.system",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.quantity.code",
"path": "MedicationRequest.dispenseRequest.initialFill.quantity.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.duration",
"path": "MedicationRequest.dispenseRequest.initialFill.duration",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.duration.value",
"min": 1,
"path": "MedicationRequest.dispenseRequest.initialFill.duration.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.duration.unit",
"path": "MedicationRequest.dispenseRequest.initialFill.duration.unit",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.duration.system",
"path": "MedicationRequest.dispenseRequest.initialFill.duration.system",
"fixedUri": "http://unitsofmeasure.org",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.initialFill.duration.code",
"path": "MedicationRequest.dispenseRequest.initialFill.duration.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.dispenseInterval",
"path": "MedicationRequest.dispenseRequest.dispenseInterval",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.dispenseInterval.value",
"path": "MedicationRequest.dispenseRequest.dispenseInterval.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.dispenseInterval.system",
"path": "MedicationRequest.dispenseRequest.dispenseInterval.system",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.dispenseInterval.code",
"path": "MedicationRequest.dispenseRequest.dispenseInterval.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.validityPeriod",
"path": "MedicationRequest.dispenseRequest.validityPeriod",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: End date of the prescription when set.",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.validityPeriod.start",
"path": "MedicationRequest.dispenseRequest.validityPeriod.start",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.validityPeriod.end",
"path": "MedicationRequest.dispenseRequest.validityPeriod.end",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nConformance Rule: This must be populated when the number of repeats is 1 or more. As this field only allows a positive integer, this is not populated if there are no refills allowed.",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity",
"path": "MedicationRequest.dispenseRequest.quantity",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity.value",
"path": "MedicationRequest.dispenseRequest.quantity.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity.unit",
"path": "MedicationRequest.dispenseRequest.quantity.unit",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity.system",
"path": "MedicationRequest.dispenseRequest.quantity.system",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity.code",
"path": "MedicationRequest.dispenseRequest.quantity.code",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Dosage duration value and unit.",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.unit",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.unit",
"fixedString": "days",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"min": 1,
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"fixedUri": "http://unitsofmeasure.org",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"fixedCode": "d",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.performer",
"path": "MedicationRequest.dispenseRequest.performer",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwOrganization" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: The pharmacy should be included when known.",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.performer.display",
"path": "MedicationRequest.dispenseRequest.performer.display",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution",
"path": "MedicationRequest.substitution",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported\n\nCHR: Based on the medication substitution-not-allowed flag.\n\nConformance Rule: This MUST be included when the prescriber specifies \"no substitution\" (boolean = false)",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.allowed[x]",
"path": "MedicationRequest.substitution.allowed[x]",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.reason",
"path": "MedicationRequest.substitution.reason",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.reason.coding",
"path": "MedicationRequest.substitution.reason.coding",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.reason.coding.system",
"path": "MedicationRequest.substitution.reason.coding.system",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.reason.coding.code",
"path": "MedicationRequest.substitution.reason.coding.code",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.reason.text",
"path": "MedicationRequest.substitution.reason.text",
"mustSupport": true
}, {
"id": "MedicationRequest.priorPrescription",
"path": "MedicationRequest.priorPrescription",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationRequest.detectedIssue",
"path": "MedicationRequest.detectedIssue",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🔴 Not Supported\n\nConformance Rule: Detected Issue will be used to convey managed drug interactions. If available, this must be sent.",
"mapping": [ {
"map": "http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue",
"identity": "PrescribeIT"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.detectedIssue.display",
"path": "MedicationRequest.detectedIssue.display",
"mustSupport": true
} ]
},
"contact": [ {
"name": "TELUS Health",
"telecom": [ {
"value": "https://www.telus.com/health",
"system": "url"
} ]
}, {
"name": "TELUS Health",
"telecom": [ {
"value": "https://www.telus.com/health",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}