{
"description": "This profile constrains the MedicationRequest resource to convey a subset of prescription information required in the consumer real-time pharmacy benefit check (RTPBC) process. The content specifies the prescribed product and quantity, and references the prescribing practitioner and the patient's preferred pharmacy. \\n\\nThis profile differs from the US Core MedicationRequest in that it doesn't set the encounter or dosageInstruction elements as Must Support, because clients in the exchange will typically be mobile consumer applications that do not posess this information, and because that information is not pertinent to this use case.",
"_filename": "StructureDefinition-rtpbc-medicationrequest.json",
"package_name": "hl7.fhir.us.carin-rtpbc",
"date": "2020-05-23T00:00:00-05:00",
"derivation": "constraint",
"publisher": "HL7 International - Pharmacy",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166",
"display": "United States of America"
} ]
} ],
"name": "RtpbcMedicationRequest",
"mapping": [ {
"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,
"type": "MedicationRequest",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "RTPBC Medication Request",
"package_version": "1.0.0",
"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": 0,
"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": "string"
} ]
} ],
"max": "1",
"id": "MedicationRequest.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"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"
} ],
"max": "1",
"id": "MedicationRequest.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"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",
"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"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
} ],
"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"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "MedicationRequest.text",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"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"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"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": "May be used to represent additional information that is not part of the basic definition of the resource. 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.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": "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"
} ],
"max": "*",
"id": "MedicationRequest.identifier",
"comment": "This is a business identifier, not a resource identifier.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.identifier"
},
"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.status",
"fixedCode": "draft",
"min": 1,
"definition": "Status of the request for dispensing",
"isModifier": true,
"short": "Request Status",
"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",
"label": "Request Status",
"id": "MedicationRequest.status",
"comment": "Always equals 'draft'",
"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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationrequest-status-reason",
"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": "This is generally only used for \"exception\" statuses such as \"suspended\" or \"cancelled\". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.",
"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": "proposal",
"min": 1,
"definition": "Intent of the request for dispensing",
"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": "Always equals 'proposal'",
"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": "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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationrequest-category",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestCategory"
} ],
"description": "A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment."
},
"max": "*",
"id": "MedicationRequest.category",
"comment": "The category can be used to include where the medication is expected to be consumed or other types of requests.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.category"
},
"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.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": 1,
"definition": "Indicates whether the prescription information has been reported by the patient or other party (.reported = true) or is the original prescription record (.reported = false).",
"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]",
"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": "A product identifier for the prescribed medication. Either an NDC11 or an RxNorm code for a prescribable product (representing drug name, strength and dose form)",
"isModifier": false,
"short": "Prescribed Product",
"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"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-prescribable-product-code",
"description": "RTPBC prescribable product codes (NDC11 and RxNorm)"
},
"max": "1",
"label": "Prescribed Product",
"id": "MedicationRequest.medication[x]",
"comment": "The NDC11 is an 11-digit normalized format consisting of a 5-digit labeler segment, 4-digit product segment, and 2-digit package segment, with no dashes",
"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": "The patient for whom this medication is being requested",
"isModifier": false,
"short": "Patient",
"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": [ "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient" ]
} ],
"mustSupport": true,
"max": "1",
"label": "Patient",
"id": "MedicationRequest.subject",
"comment": "The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationRequest.subject"
},
"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": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
} ],
"max": "1",
"id": "MedicationRequest.encounter",
"comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.\" If there is a need to link to episodes of care they will be handled with an extension.",
"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": "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": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
} ],
"max": "*",
"id": "MedicationRequest.supportingInformation",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.supportingInformation"
},
"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.authoredOn",
"min": 1,
"definition": "The actual or approximate date on which the prescription was written.",
"isModifier": false,
"short": "When request was initially authored",
"mapping": [ {
"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",
"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": 1,
"definition": "The prescriber of the medication being requested",
"isModifier": false,
"short": "Prescriber",
"mapping": [ {
"map": "Request.requester",
"identity": "workflow"
}, {
"map": "FiveWs.author",
"identity": "w5"
}, {
"map": ".participation[typeCode=AUT].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner" ]
} ],
"mustSupport": true,
"max": "1",
"label": "Prescriber",
"id": "MedicationRequest.requester",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.requester"
},
"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", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/CareTeam" ]
} ],
"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",
"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", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
} ],
"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": "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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/condition-code",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestReason"
} ],
"description": "A coded concept indicating why the medication was ordered."
},
"max": "*",
"label": "Diagnosis",
"id": "MedicationRequest.reasonCode",
"comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.reasonCode"
},
"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.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", "http://hl7.org/fhir/StructureDefinition/Observation" ]
} ],
"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": [ "http://hl7.org/fhir/StructureDefinition/CarePlan", "http://hl7.org/fhir/StructureDefinition/MedicationRequest", "http://hl7.org/fhir/StructureDefinition/ServiceRequest", "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" ]
} ],
"max": "*",
"id": "MedicationRequest.basedOn",
"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 patte3rn of the administration of the medication to the patient.",
"isModifier": false,
"short": "Overall pattern of medication administration",
"mapping": [ {
"map": "Act.code where classCode = LIST and moodCode = EVN",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationRequestCourseOfTherapy"
} ],
"description": "Identifies the overall pattern of medication administratio."
},
"max": "1",
"id": "MedicationRequest.courseOfTherapyType",
"comment": "This attribute should not be confused with the protocol of the medication.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.courseOfTherapyType"
},
"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.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", "http://hl7.org/fhir/StructureDefinition/ClaimResponse" ]
} ],
"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"
} ],
"max": "*",
"id": "MedicationRequest.note",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.note"
},
"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",
"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": "There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, \"Ondansetron 8mg orally or IV twice a day as needed for nausea\" or \"Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting\". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.dosageInstruction"
},
"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",
"min": 1,
"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",
"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": "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.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.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": "SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill",
"comment": "If populating this element, either the quantity or the duration must be included.",
"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": "Supply.quantity[moodCode=RQO]",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.quantity",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.initialFill.quantity"
},
"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",
"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"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.initialFill.duration",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.initialFill.duration"
},
"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",
"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": "Supply.effectivetime[moodCode=RQO]",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.dispenseInterval",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.dispenseInterval"
},
"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",
"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"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.validityPeriod",
"comment": "It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.validityPeriod"
},
"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.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"
} ],
"max": "1",
"id": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"comment": "If displaying \"number of authorized fills\", add 1 to this number.",
"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": 1,
"definition": "The amount that is to be dispensed for one fill.",
"isModifier": false,
"short": "Prescribed Quantity",
"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" ]
} ],
"mustSupport": true,
"max": "1",
"label": "Prescribed Quantity",
"id": "MedicationRequest.dispenseRequest.quantity",
"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": 1,
"definition": "The prescribed quantity in terms of the applicable billing unit of measure",
"isModifier": false,
"short": "Quantity in Billing Units",
"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",
"label": "Quantity in Billing Units",
"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": 1,
"definition": "Pharmacy metric billing unit: GM (gram), ML (milliliter) or EA (each)",
"isModifier": false,
"short": "Billing unit of measure",
"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
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-billing-unit",
"description": "Billing quantity unity of measure"
},
"max": "1",
"label": "Billing unit of measure",
"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"
} ],
"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"
} ],
"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": "Days Supply",
"mapping": [ {
"map": "Message/Body/NewRx/MedicationPrescribed/Substitutions",
"identity": "script10.6"
}, {
"map": "expectedUseTime",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
} ],
"mustSupport": true,
"max": "1",
"label": "Days Supply",
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"comment": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
"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 number of days the requested dispense quantity is intended to last",
"isModifier": false,
"short": "Days Supply Value",
"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",
"label": "Days Supply Value",
"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"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"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": 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"
} ],
"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",
"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"
} ],
"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": 1,
"definition": "Proposed dispensing pharmacy.",
"isModifier": false,
"short": "Pharmacy",
"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": [ "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization" ]
} ],
"mustSupport": true,
"max": "1",
"label": "Pharmacy",
"id": "MedicationRequest.dispenseRequest.performer",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.dispenseRequest.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.substitution",
"min": 1,
"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": "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",
"label": "Substitution",
"id": "MedicationRequest.substitution",
"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": "Whether or not the pharmacy may dispense a substitutable generic product instead of a requested branded product",
"isModifier": false,
"short": "Substitution Allowed",
"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"
} ],
"mustSupport": true,
"max": "1",
"label": "Substitution Allowed",
"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"
} ],
"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",
"base": {
"max": "1",
"min": 0,
"path": "MedicationRequest.substitution.reason"
},
"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.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": [ "http://hl7.org/fhir/StructureDefinition/MedicationRequest" ]
} ],
"max": "1",
"id": "MedicationRequest.priorPrescription",
"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": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DetectedIssue" ]
} ],
"alias": [ "Contraindication", "Drug Utilization Review (DUR)", "Alert" ],
"max": "*",
"id": "MedicationRequest.detectedIssue",
"comment": "This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationRequest.detectedIssue"
},
"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.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" ]
} ],
"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
} ]
},
"status": "active",
"id": "a590f02f-1ab1-4b51-abe3-7eb9a1ad3443",
"kind": "resource",
"url": "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest",
"version": "1.0.0",
"differential": {
"element": [ {
"id": "MedicationRequest",
"path": "MedicationRequest"
}, {
"path": "MedicationRequest.status",
"fixedCode": "draft",
"min": 1,
"definition": "Status of the request for dispensing",
"short": "Request Status",
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"max": "1",
"label": "Request Status",
"id": "MedicationRequest.status",
"comment": "Always equals 'draft'"
}, {
"id": "MedicationRequest.intent",
"max": "1",
"min": 1,
"path": "MedicationRequest.intent",
"comment": "Always equals 'proposal'",
"fixedCode": "proposal",
"definition": "Intent of the request for dispensing",
"mustSupport": true
}, {
"id": "MedicationRequest.reported[x]",
"min": 1,
"path": "MedicationRequest.reported[x]",
"type": [ {
"code": "boolean"
} ],
"definition": "Indicates whether the prescription information has been reported by the patient or other party (.reported = true) or is the original prescription record (.reported = false).",
"mustSupport": true
}, {
"path": "MedicationRequest.medication[x]",
"min": 1,
"definition": "A product identifier for the prescribed medication. Either an NDC11 or an RxNorm code for a prescribable product (representing drug name, strength and dose form)",
"short": "Prescribed Product",
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-prescribable-product-code",
"description": "RTPBC prescribable product codes (NDC11 and RxNorm)"
},
"max": "1",
"label": "Prescribed Product",
"id": "MedicationRequest.medication[x]",
"comment": "The NDC11 is an 11-digit normalized format consisting of a 5-digit labeler segment, 4-digit product segment, and 2-digit package segment, with no dashes"
}, {
"path": "MedicationRequest.subject",
"min": 1,
"definition": "The patient for whom this medication is being requested",
"short": "Patient",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient" ]
} ],
"mustSupport": true,
"max": "1",
"label": "Patient",
"id": "MedicationRequest.subject"
}, {
"id": "MedicationRequest.authoredOn",
"max": "1",
"min": 1,
"path": "MedicationRequest.authoredOn",
"definition": "The actual or approximate date on which the prescription was written.",
"mustSupport": true
}, {
"path": "MedicationRequest.requester",
"min": 1,
"definition": "The prescriber of the medication being requested",
"short": "Prescriber",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner" ]
} ],
"mustSupport": true,
"max": "1",
"label": "Prescriber",
"id": "MedicationRequest.requester"
}, {
"id": "MedicationRequest.reasonCode",
"path": "MedicationRequest.reasonCode",
"label": "Diagnosis"
}, {
"id": "MedicationRequest.dosageInstruction",
"path": "MedicationRequest.dosageInstruction",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest",
"min": 1,
"path": "MedicationRequest.dispenseRequest",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity",
"max": "1",
"min": 1,
"path": "MedicationRequest.dispenseRequest.quantity",
"label": "Prescribed Quantity",
"short": "Prescribed Quantity",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity.value",
"min": 1,
"path": "MedicationRequest.dispenseRequest.quantity.value",
"label": "Quantity in Billing Units",
"short": "Quantity in Billing Units",
"definition": "The prescribed quantity in terms of the applicable billing unit of measure",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.quantity.unit",
"min": 1,
"path": "MedicationRequest.dispenseRequest.quantity.unit",
"label": "Billing unit of measure",
"short": "Billing unit of measure",
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-billing-unit",
"description": "Billing quantity unity of measure"
},
"definition": "Pharmacy metric billing unit: GM (gram), ML (milliliter) or EA (each)",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"label": "Days Supply",
"short": "Days Supply",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"path": "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"label": "Days Supply Value",
"short": "Days Supply Value",
"definition": "The number of days the requested dispense quantity is intended to last",
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.performer",
"min": 1,
"path": "MedicationRequest.dispenseRequest.performer",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization" ]
} ],
"label": "Pharmacy",
"short": "Pharmacy",
"definition": "Proposed dispensing pharmacy.",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution",
"min": 1,
"path": "MedicationRequest.substitution",
"label": "Substitution",
"short": "Substitution",
"mustSupport": true
}, {
"id": "MedicationRequest.substitution.allowed[x]",
"path": "MedicationRequest.substitution.allowed[x]",
"type": [ {
"code": "boolean"
} ],
"label": "Substitution Allowed",
"short": "Substitution Allowed",
"definition": "Whether or not the pharmacy may dispense a substitutable generic product instead of a requested branded product",
"mustSupport": true
} ]
},
"contact": [ {
"name": "HL7 International - Pharmacy",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/medication",
"system": "url"
} ]
}, {
"name": "Frank McKinney",
"telecom": [ {
"value": "frank.mckinney@pocp.com",
"system": "email"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}