{
"description": "This profile defines a set of constraints to the FHIR MedicationRequest resource for use in Ontario Patient Summaries (PS-ON). It refines constraints applied to the MedicationRequest resource by the PS-CA project to represent a record of a medication request in the patient summary. It is informed by the constraints of the most recent direction of the IPS-UV (September Connectathon Build) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-medicationstatement.html) to allow for cross-border and cross-jurisdiction sharing of Medication Summary information.",
"_filename": "MedicationRequestPSON.json",
"package_name": "ca.on.patient-summary",
"date": "2021-10-29T21:56:28-05:00",
"derivation": "constraint",
"publisher": "Ontario Health",
"fhirVersion": "4.0.1",
"name": "MedicationRequestPSON",
"mapping": [ {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern",
"identity": "workflow"
}, {
"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": null,
"resourceType": "StructureDefinition",
"title": "Medication Request (PS-ON)",
"package_version": "0.0.1-alpha",
"status": "draft",
"id": "b6b4feb3-e187-4c75-b69f-8157c99620fd",
"kind": "resource",
"url": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-medicationrequest",
"version": "0.0.1",
"differential": {
"element": [ {
"id": "MedicationRequest",
"path": "MedicationRequest",
"comment": "Jurisdictions mapping prescription data into FHIR profiles for the patient summary should support the MedicationRequest resource. Use of the MedicationStatement profile should be reserved for communicating a statement about the patient's usage of the medication that is ultimately provided by a patient, significant other, or a clinican."
}, {
"id": "MedicationRequest.id",
"path": "MedicationRequest.id",
"definition": "Logical id of this artifact"
}, {
"id": "MedicationRequest.meta",
"min": 1,
"path": "MedicationRequest.meta",
"mustSupport": true
}, {
"id": "MedicationRequest.meta.profile",
"min": 1,
"path": "MedicationRequest.meta.profile",
"mustSupport": true
}, {
"id": "MedicationRequest.status",
"path": "MedicationRequest.status",
"comment": "In the scope of the IPS the entered-in-error concept is not allowed.",
"mustSupport": true
}, {
"id": "MedicationRequest.medication[x]",
"path": "MedicationRequest.medication[x]",
"binding": {
"strength": "example",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"
},
"slicing": {
"rules": "closed",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code. To improve global interoperability is strongly encouraged that the reference to a medication resource is used, limiting the usage of the medicationCodeableConcept only to the cases in which no other information than a simple code is available.",
"mustSupport": true
}, {
"id": "MedicationRequest.medication[x]:medicationReference",
"max": "1",
"min": 0,
"path": "MedicationRequest.medication[x]",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-medication" ]
} ],
"sliceName": "medicationReference",
"mustSupport": true
}, {
"id": "MedicationRequest.medication[x]:medicationCodeableConcept",
"max": "1",
"min": 0,
"path": "MedicationRequest.medication[x]",
"short": "Code for the medication being administered",
"sliceName": "medicationCodeableConcept",
"definition": "Code for the medication being administered.",
"mustSupport": true
}, {
"id": "MedicationRequest.subject",
"path": "MedicationRequest.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient" ]
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.subject.reference",
"min": 1,
"path": "MedicationRequest.subject.reference",
"mustSupport": true
}, {
"id": "MedicationRequest.authoredOn",
"path": "MedicationRequest.authoredOn",
"comment": "This is a MS element in the CA Baseline that will likely make its way into the IPS-UV when/if they decide to profile MedicationRequest (likely at transition to R5). Included as preliminary analysis shows most participating systems could support this, further feedback and discussion is required on whether systems should be able to demonstrate this element for conformance",
"mustSupport": true
}, {
"id": "MedicationRequest.requester",
"path": "MedicationRequest.requester",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole" ]
} ]
}, {
"id": "MedicationRequest.dosageInstruction",
"path": "MedicationRequest.dosageInstruction",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.text",
"path": "MedicationRequest.dosageInstruction.text",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.timing",
"path": "MedicationRequest.dosageInstruction.timing",
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route",
"max": "1",
"min": 0,
"path": "MedicationRequest.dosageInstruction.route",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration",
"description": "EDQM Standards Terms"
},
"slicing": {
"rules": "open",
"description": "Discriminated by value set",
"discriminator": [ {
"path": "$this",
"type": "pattern"
} ]
},
"mustSupport": true
}, {
"id": "MedicationRequest.dosageInstruction.route:routeSCTCA",
"max": "1",
"path": "MedicationRequest.dosageInstruction.route",
"short": "Optional slice for representing SNOMED CT Canadian edition routes of administration",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/SNOMEDCT-CA-RouteOfAdmin"
},
"sliceName": "routeSCTCA",
"definition": "SNOMED CT Canadian edition routes of administration"
}, {
"id": "MedicationRequest.dispenseRequest.validityPeriod",
"min": 1,
"path": "MedicationRequest.dispenseRequest.validityPeriod",
"comment": "Some systems may need to infer the validity period using details for the start/end of the prescription. When sharing information about a prescription (particularly if it's the only medication summary information known for the person), knowing the peroid of time it is applicable to is critical - Further feedback is required on whether systems should be able to demonstrate they can support this element or the dataAbsentReason extension is required.",
"constraint": [ {
"key": "ps-ca-medreq-1",
"human": "Either MedicationRequest.dispenseRequest.validityPeriod SHALL be present or a Data Absent Reason Extension SHALL be present.",
"xpath": "(/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:validity)) or (not(/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:validityPeriod))",
"severity": "error",
"expression": "(validityPeriod.exists() xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()"
} ],
"mustSupport": true
}, {
"id": "MedicationRequest.dispenseRequest.validityPeriod.extension",
"max": "1",
"path": "MedicationRequest.dispenseRequest.validityPeriod.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
} ],
"short": "validityPeriod absence reason",
"definition": "Provides a reason why the validityPeriod is missing.",
"mustSupport": true
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}