{
  "description": "This profile represents the constraints applied to the MedicationRequest resource by the CA Core+ project to represent the minimum expectations for the MedicationRequest resource when used to promote capacity building for functionality found across Canadian FHIR implementations. It is informed by the constraints of shared across CIHI pCHDCF data sets and has also undergone analysis to assert alignment with the [Canadian Baseline MedicationRequest Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-medicationrequest.html)",
  "_filename": "structuredefinition-medicationrequest-ca-core.json",
  "package_name": "ca.infoway.io.core",
  "date": null,
  "derivation": "constraint",
  "publisher": null,
  "fhirVersion": "4.0.1",
  "name": "MedicationRequestCACore",
  "mapping": [ {
    "name": "Pan-Canadian Health Data Content Framework",
    "identity": "pCHDCF"
  } ],
  "abstract": false,
  "copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
  "type": "MedicationRequest",
  "experimental": "false",
  "resourceType": "StructureDefinition",
  "title": "Medication Request (CA-Core)",
  "package_version": "0.2.0-dft",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-imposeProfile",
    "valueCanonical": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest"
  } ],
  "status": "draft",
  "id": "7286216e-9b88-45db-b37e-974f3f5d74d2",
  "kind": "resource",
  "url": "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/medicationrequest-ca-core",
  "version": null,
  "differential": {
    "element": [ {
      "id": "MedicationRequest.status",
      "path": "MedicationRequest.status",
      "mapping": [ {
        "map": "Medication Request Status Code",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.statusReason",
      "path": "MedicationRequest.statusReason",
      "mapping": [ {
        "map": "Medication Request Status Reason",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.intent",
      "path": "MedicationRequest.intent",
      "comment": "This element is considered mandatory in the Base FHIR R4 Specification. \r\n\r\nBase R4 Note: It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a Patient, RelatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
      "mapping": [ {
        "map": "Medication Request Intent",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.medication[x]",
      "path": "MedicationRequest.medication[x]",
      "comment": "Currently, this profile allows pCHDCF medication code and name concepts to be met through either medicationReference or medicationCodeableConcept. Future expectations to support one data type over another will become clearer as pCHDCF modelling evolves and expressed the minimum set of information that needs to be demonstrable for a medicationRequest. For example, if details only expressed on the medication resource (e.g., the amount of drug in the packaged product, form details separate from the form expressed on the CCDD code) needs to be exchanged in relation to a medicationRequest then support of medicationReference may be required to meet the full breadth of expectation.",
      "mapping": [ {
        "map": "Medication Code or Description",
        "comment": "Mapping of this concept applies to both medicationReference or medicationCodeableConcept data types",
        "identity": "pCHDCF"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "MedicationRequest.medication[x]:medicationReference",
      "max": "1",
      "min": 0,
      "path": "MedicationRequest.medication[x]",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/medication-ca-core" ]
      } ],
      "mapping": [ {
        "map": "Medication Details*",
        "comment": "*The reference that is the target of this element conveys additional details about the Medication (e.g., Brand Name, Generic Name) as indicated in the pCHDCF artefacts. Readers should review the profile to understand the pCHDCF mapping against its elements",
        "identity": "pCHDCF"
      } ],
      "sliceName": "medicationReference"
    }, {
      "path": "MedicationRequest.medication[x]",
      "min": 0,
      "mapping": [ {
        "map": "Medication Code or Description",
        "comment": "Mapping of this concept applies to both medicationReference or medicationCodeableConcept data types",
        "identity": "pCHDCF"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "sliceName": "medicationCodeableConcept",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct",
        "extension": [ {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/manufacturedproductmp"
          }, {
            "url": "documentation",
            "valueMarkdown": "ValueSet used to convey Medication Brand Name for Manufactured Products"
          } ]
        }, {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/non-proprietarytherapeuticproductntp"
          }, {
            "url": "documentation",
            "valueMarkdown": "ValueSet used to convey Medication Generic Name for Non-Proprietary Therapeutic Products"
          } ]
        }, {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/devicenon-proprietarytherapeuticproductdevicentp"
          }, {
            "url": "documentation",
            "valueMarkdown": "ValueSet used to convey Medication Generic Name for Device Non-Proprietary Therapeutic Products"
          } ]
        }, {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductcode"
          }, {
            "url": "documentation",
            "valueMarkdown": "per pCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
          } ]
        } ]
      },
      "max": "1",
      "id": "MedicationRequest.medication[x]:medicationCodeableConcept",
      "comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet."
    }, {
      "id": "MedicationRequest.subject",
      "path": "MedicationRequest.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/patient-ca-core", "http://hl7.org/fhir/StructureDefinition/Group" ]
      } ]
    }, {
      "id": "MedicationRequest.supportingInformation",
      "path": "MedicationRequest.supportingInformation",
      "mapping": [ {
        "map": "Medication Supporting Information",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.authoredOn",
      "path": "MedicationRequest.authoredOn",
      "mapping": [ {
        "map": "Medication Request Authored On Date",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.reasonCode",
      "path": "MedicationRequest.reasonCode",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/PHCVScode"
      },
      "mapping": [ {
        "map": "Medication Reason",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.note",
      "path": "MedicationRequest.note",
      "mapping": [ {
        "map": "Medication Notes",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction",
      "path": "MedicationRequest.dosageInstruction"
    }, {
      "id": "MedicationRequest.dosageInstruction.text",
      "path": "MedicationRequest.dosageInstruction.text",
      "comment": "Reviewers are encouraged to provide feedback on the impact of expecting systems demonstrate they support the text element without further expectations to demonstrate they can populate or receive the sequence element (which can be used when dosage instructions have more than one line that should be treated sequentially)",
      "mapping": [ {
        "map": "Medication Dosage Instructions",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.timing",
      "path": "MedicationRequest.dosageInstruction.timing"
    }, {
      "id": "MedicationRequest.dosageInstruction.timing.code",
      "path": "MedicationRequest.dosageInstruction.timing.code",
      "mapping": [ {
        "map": "Medication Timing",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.asNeededBoolean",
      "path": "MedicationRequest.dosageInstruction.asNeededBoolean",
      "mapping": [ {
        "map": "Medication Dosage As Needed Flag",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.route",
      "path": "MedicationRequest.dosageInstruction.route",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration",
        "description": "SCTCA Route of Administration"
      },
      "comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionRouteOfAdministration valueSet which uses a HL7 v2/v3 codes that are heavily implemented in production but are not the current SNOMED CT CA codes expressed in other pan-Canadian specifications. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the SCTCA valueSet.",
      "mapping": [ {
        "map": "Medication Route of Administration",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.doseAndRate.type",
      "path": "MedicationRequest.dosageInstruction.doseAndRate.type",
      "mapping": [ {
        "map": "Prescribed Medication Dose Type",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
      "path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit",
        "description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set"
      },
      "mapping": [ {
        "map": "Medication Dose Value",
        "comment": "Mapping of this concept applies to both the doseRange and doseQuantity data types",
        "identity": "pCHDCF"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange",
      "path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
      "type": [ {
        "code": "Range"
      } ],
      "mapping": [ {
        "map": "Medication Dose Value*",
        "comment": "*Mapping of this concept applies to both the doseRange and doseQuantity data types",
        "identity": "pCHDCF"
      } ],
      "sliceName": "doseRange"
    }, {
      "id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low",
      "path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x].low",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/drug-quantity-ca-core" ]
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high",
      "path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x].high",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/drug-quantity-ca-core" ]
      } ]
    }, {
      "id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity",
      "path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/drug-quantity-ca-core" ]
      } ],
      "mapping": [ {
        "map": "Medication Dose Value*",
        "comment": "*Mapping of this concept applies to both the doseRange and doseQuantity data types",
        "identity": "pCHDCF"
      } ],
      "sliceName": "doseQuantity"
    }, {
      "id": "MedicationRequest.dispenseRequest",
      "path": "MedicationRequest.dispenseRequest"
    }, {
      "id": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
      "path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
      "mapping": [ {
        "map": "Medication Repeats",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
      "path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
      "mapping": [ {
        "map": "Medication Duration Value",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
      "path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
      "mapping": [ {
        "map": "Medication Duration Units of Time",
        "comment": "To fully provide meaning to unit of time under this definition, the system and code sub-elements must be used together",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
      "path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
      "mapping": [ {
        "map": "Medication Duration Units of Time",
        "comment": "To fully provide meaning to unit of time under this definition, the system and code sub-elements must be used together",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.substitution.allowedBoolean",
      "path": "MedicationRequest.substitution.allowedBoolean",
      "mapping": [ {
        "map": "Prescribed Brand No Substitution Flag",
        "identity": "pCHDCF"
      } ]
    }, {
      "id": "MedicationRequest.detectedIssue",
      "path": "MedicationRequest.detectedIssue",
      "mapping": [ {
        "map": "Medication Incident",
        "identity": "pCHDCF"
      } ]
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}