{
"description": "This profile represents the constraints applied to the MedicationRequest resource by the CA Core+ project to represent the minimum expectations for the MedicationRequest resource when used to promote capacity building for functionality found across Canadian FHIR implementations. It is informed by the constraints of shared across CIHI pCHDCF data sets and has also undergone analysis to assert alignment with the [Canadian Baseline MedicationRequest Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-medicationrequest.html)",
"_filename": "structuredefinition-medicationrequest-ca-core.json",
"package_name": "ca.infoway.io.core",
"date": null,
"derivation": "constraint",
"publisher": null,
"fhirVersion": "4.0.1",
"name": "MedicationRequestCACore",
"mapping": [ {
"name": "Pan-Canadian Health Data Content Framework",
"identity": "pCHDCF"
} ],
"abstract": false,
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"type": "MedicationRequest",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Medication Request (CA-Core)",
"package_version": "0.2.0-dft-ballot",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:able-to-populate"
}, {
"url": "elementId",
"valueString": "status"
}, {
"url": "elementId",
"valueString": "priority"
}, {
"url": "elementId",
"valueString": "medication[x]:medicationReference"
}, {
"url": "elementId",
"valueString": "medication[x]:medicationCodeableConcept"
}, {
"url": "elementId",
"valueString": "subject"
}, {
"url": "elementId",
"valueString": "authoredOn"
}, {
"url": "elementId",
"valueString": "requester"
}, {
"url": "elementId",
"valueString": "reasonCode"
}, {
"url": "elementId",
"valueString": "dosageInstruction"
}, {
"url": "elementId",
"valueString": "dosageInstruction.text"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat.durationUnit"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat.frequency"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat.period"
}, {
"url": "elementId",
"valueString": "dosageInstruction.route"
}, {
"url": "elementId",
"valueString": "dosageInstruction.doseAndRate"
}, {
"url": "elementId",
"valueString": "dosageInstruction.doseAndRate.dose[x]:doseRange"
}, {
"url": "elementId",
"valueString": "dosageInstruction.doseAndRate.dose[x]:doseQuantity"
}, {
"url": "elementId",
"valueString": "dispenseRequest.numberOfRepeatsAllowed"
}, {
"url": "elementId",
"valueString": "detectedIssue"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/server"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "elementId",
"valueString": "status"
}, {
"url": "elementId",
"valueString": "priority"
}, {
"url": "elementId",
"valueString": "medication[x]:medicationReference"
}, {
"url": "elementId",
"valueString": "medication[x]:medicationCodeableConcept"
}, {
"url": "elementId",
"valueString": "subject"
}, {
"url": "elementId",
"valueString": "authoredOn"
}, {
"url": "elementId",
"valueString": "requester"
}, {
"url": "elementId",
"valueString": "reasonCode"
}, {
"url": "elementId",
"valueString": "dosageInstruction"
}, {
"url": "elementId",
"valueString": "dosageInstruction.text"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat.durationUnit"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat.frequency"
}, {
"url": "elementId",
"valueString": "dosageInstruction.timing.repeat.period"
}, {
"url": "elementId",
"valueString": "dosageInstruction.route"
}, {
"url": "elementId",
"valueString": "dosageInstruction.doseAndRate"
}, {
"url": "elementId",
"valueString": "dosageInstruction.doseAndRate.dose[x]:doseRange"
}, {
"url": "elementId",
"valueString": "dosageInstruction.doseAndRate.dose[x]:doseQuantity"
}, {
"url": "elementId",
"valueString": "dispenseRequest.numberOfRepeatsAllowed"
}, {
"url": "elementId",
"valueString": "detectedIssue"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/client"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-imposeProfile",
"valueCanonical": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest"
} ],
"status": "draft",
"id": "cc0b25a6-303a-4dc1-9891-1a38a9ece027",
"kind": "resource",
"url": "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/medicationrequest-ca-core",
"version": null,
"differential": {
"element": [ {
"id": "MedicationRequest.status",
"path": "MedicationRequest.status",
"mapping": [ {
"map": "Medication Request Status",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.intent",
"path": "MedicationRequest.intent",
"comment": "This element is considered mandatory in the Base FHIR R4 Specification. \r\n\r\nBase R4 Note: It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a Patient, RelatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable."
}, {
"id": "MedicationRequest.priority",
"path": "MedicationRequest.priority",
"mapping": [ {
"map": "Medication Request Priority",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.medication[x]",
"path": "MedicationRequest.medication[x]",
"comment": "Currently, this profile allows pCHDCF medication code and name concepts to be met through either medicationReference or medicationCodeableConcept. Future expectations to support one data type over another will become clearer as pCHDCF modelling evolves and expressed the minimum set of information that needs to be demonstrable for a medicationRequest. For example, if details only expressed on the medication resource (e.g., the amount of drug in the packaged product, form details separate from the form expressed on the CCDD code) needs to be exchanged in relation to a medicationRequest then support of medicationReference may be required to meet the full breadth of expectation.",
"mapping": [ {
"map": "Medication Brand Name",
"comment": "Mapping of this concept applies to both medicationReference or medicationCodeableConcept data types",
"identity": "pCHDCF"
}, {
"map": "Medication Generic Name",
"comment": "Mapping of this concept applies to both medicationReference or medicationCodeableConcept data types",
"identity": "pCHDCF"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "MedicationRequest.medication[x]:medicationReference",
"max": "1",
"min": 0,
"path": "MedicationRequest.medication[x]",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/medication-ca-core" ]
} ],
"mapping": [ {
"map": "Medication Details*",
"comment": "*The reference that is the target of this element conveys additional details about the Medication (e.g., Brand Name, Generic Name) as indicated in the pCHDCF artefacts. Readers should review the profile to understand the pCHDCF mapping against its elements",
"identity": "pCHDCF"
} ],
"sliceName": "medicationReference"
}, {
"path": "MedicationRequest.medication[x]",
"min": 0,
"mapping": [ {
"map": "Medication Brand Name*",
"comment": "*medicationCodeableConcept may convey both coded (e.g., code, system, display) as well as text details for this concept",
"identity": "pCHDCF"
}, {
"map": "Medication Generic Name*",
"comment": "*medicationCodeableConcept may convey both coded (e.g., code, system, display) as well as text details for this concept",
"identity": "pCHDCF"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "medicationCodeableConcept",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/manufacturedproductmp"
}, {
"url": "documentation",
"valueMarkdown": "ValueSet used to convey Medication Brand Name for Manufactured Products"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/non-proprietarytherapeuticproductntp"
}, {
"url": "documentation",
"valueMarkdown": "ValueSet used to convey Medication Generic Name for Non-Proprietary Therapeutic Products"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/devicenon-proprietarytherapeuticproductdevicentp"
}, {
"url": "documentation",
"valueMarkdown": "ValueSet used to convey Medication Generic Name for Device Non-Proprietary Therapeutic Products"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductcode"
}, {
"url": "documentation",
"valueMarkdown": "per pCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
} ]
} ]
},
"max": "1",
"id": "MedicationRequest.medication[x]:medicationCodeableConcept",
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet."
}, {
"id": "MedicationRequest.subject",
"path": "MedicationRequest.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/patient-ca-core", "http://hl7.org/fhir/StructureDefinition/Group" ]
} ]
}, {
"id": "MedicationRequest.authoredOn",
"path": "MedicationRequest.authoredOn",
"mapping": [ {
"map": "Medication Request Date",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.requester",
"path": "MedicationRequest.requester",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/practitioner-ca-core", "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/practitionerRole-ca-core", "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/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Device" ]
} ],
"mapping": [ {
"map": "Medication Prescriber*",
"comment": "*The reference that is the target of this element conveys additional details about the Medication Prescriber (e.g. first name, last name, ID) as indicated in the pCHDCF artefacts",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.reasonCode",
"path": "MedicationRequest.reasonCode",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/PHCVScode"
},
"mapping": [ {
"map": "Medication Reason",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction",
"path": "MedicationRequest.dosageInstruction"
}, {
"id": "MedicationRequest.dosageInstruction.text",
"path": "MedicationRequest.dosageInstruction.text",
"comment": "Reviewers are encouraged to provide feedback on the impact of expecting systems demonstrate they support the text element without further expectations to demonstrate they can populate or receive the sequence element (which can be used when dosage instructions have more than one line that should be treated sequentially)",
"mapping": [ {
"map": "Medication Administration Instruction",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction.timing",
"path": "MedicationRequest.dosageInstruction.timing",
"mapping": [ {
"map": "Medication Administration Instruction Time",
"comment": "The current definition for this concept implies a separation of generic instructions from the instructions of when the medication should be administered. While dosageInstruction.timing provides these details, the current mapping is to a backbone element where individual structured components are expressed together to provide meaning (e.g., frequency + period + bounds instead of a instruction text string for timing). Implementers are encouraged to provide feedback on whether these separated timing instructions are more commonly captured as structured fields or in string form in child fields (e.g., dosageInstruction.additionalInstruction, dosageInstruction.code.text), to help inform future mapping and obligations.",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat",
"path": "MedicationRequest.dosageInstruction.timing.repeat"
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"path": "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"mapping": [ {
"map": "Medication Period of Use",
"comment": "The current definition for this concept is loose and may continue to change as the pCHDCF is refined. The supply of TimeUnitofMeasure UCUM as expected terminology for this concept in the pCHDCF influenced the selection of this mapping target over others.",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"path": "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"mapping": [ {
"map": "Medication Frequency",
"comment": "The current definition for this concept implies that the frequency is understood within a given time period. To fully provide meaning to frequency under this definition, the MedicationRequest.dosageInstruction.timing.repeat.period element must also be used.",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction.timing.repeat.period",
"path": "MedicationRequest.dosageInstruction.timing.repeat.period",
"mapping": [ {
"map": "Medication Frequency*",
"comment": "*The current definition for this concept implies that the frequency is understood within a given time period. To fully provide meaning to frequency under this definition, the MedicationRequest.dosageInstruction.timing.repeat.period element must also be used.",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction.route",
"path": "MedicationRequest.dosageInstruction.route",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
}, {
"url": "documentation",
"valueMarkdown": "per pCHDCF: The alternate value set can be used when expressing a SNOMED CT CA code for route. Note this valueSet's status as an additionalBinding is expected to change as pCHDCF refines its recommended terminology"
} ]
} ],
"description": "Route of administration for the prescription from the PrescribeIT value set"
},
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionRouteOfAdministration valueSet which uses a HL7 v2/v3 codes that are heavily implemented in production but are not the current SNOMED CT CA codes expressed in other pan-Canadian specifications. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the SCTCA valueSet.",
"mapping": [ {
"map": "Medication Route of Administration",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit",
"description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set"
},
"mapping": [ {
"map": "Medication Dose",
"comment": "Mapping of this concept applies to both the doseRange and doseQuantity data types",
"identity": "pCHDCF"
}, {
"map": "Medication Prescribed Dose",
"comment": "Mapping of this concept applies to both the doseRange and doseQuantity data types",
"identity": "pCHDCF"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange",
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"type": [ {
"code": "Range"
} ],
"mapping": [ {
"map": "Medication Dose*",
"comment": "*Mapping of this concept applies to both the doseRange and doseQuantity data types",
"identity": "pCHDCF"
}, {
"map": "Medication Prescribed Dose*",
"comment": "*Mapping of this concept applies to both the doseRange and doseQuantity data types",
"identity": "pCHDCF"
} ],
"sliceName": "doseRange"
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low",
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x].low",
"type": [ {
"code": "Quantity",
"profile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/drug-quantity-ca-core" ]
} ]
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high",
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x].high",
"type": [ {
"code": "Quantity",
"profile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/drug-quantity-ca-core" ]
} ]
}, {
"id": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity",
"path": "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"type": [ {
"code": "Quantity",
"profile": [ "http://fhir.infoway-inforoute.ca/ca-core/StructureDefinition/drug-quantity-ca-core" ]
} ],
"mapping": [ {
"map": "Medication Dose*",
"comment": "*Mapping of this concept applies to both the doseRange and doseQuantity data types",
"identity": "pCHDCF"
}, {
"map": "Medication Prescribed Dose*",
"comment": "*Mapping of this concept applies to both the doseRange and doseQuantity data types",
"identity": "pCHDCF"
} ],
"sliceName": "doseQuantity"
}, {
"id": "MedicationRequest.dispenseRequest",
"path": "MedicationRequest.dispenseRequest"
}, {
"id": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"mapping": [ {
"map": "Medication Refills",
"identity": "pCHDCF"
} ]
}, {
"id": "MedicationRequest.detectedIssue",
"path": "MedicationRequest.detectedIssue",
"mapping": [ {
"map": "Medication Incident",
"identity": "pCHDCF"
} ]
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}