Status: Active: Approved (STU)

Introduction

This profile sets out the expectations for the interweave medication request resource. We use this resource to represent prescriptions of medication and repeat prescription schedules. Only prescriptions which have been issued should be shared. Issued is the point at when the prescription is either printed and signed, or passed on to the Electronic Prescription Service (EPS). The exception to this rule is repeat prescriptions, which are not themselves issued, but are authorised for instances of them to be issued.

Mandatory fields

The following fields are mandatory:

• prescriptionType – This field records the type of prescription rather than having to derive this information from other fields. We use the required binding supplied by care connect, further details on how the codes should be used are outlined in the table below:

• status - Repeat prescriptions can have the statuses listed below. For all other prescription types, this should be defaulted to “complete”.

  • active – the repeat prescription is active
  • stopped – the repeat has been stopped, discontinued or cancelled.
  • complete – the repeat has ran its course

• intent – Only prescriptions which have been issued/authorised should be shared. When prescriptionType == “repeat” then intent == “plan” otherwise set to “order”. GPC use this field as part of a hierarchy implementation of prescriptions. It is felt that for the shared care record, having a linear list of prescriptions, and being able to identify which are ‘repeat prescriptions’ is enough and we do not want to create any complex linkages.

• category – We update the valueset used to populated this field, to include the additional code of “discharge”, which is present in R4. We also make this a required binding, as currently it is an example only.

• medicationReference - Care connect have removed medication.codeableConcept in favour of referencing a medication resource, meaning that we have to model the medication resource. the reference.display field should be populated with the name of the medication which will be a DM&D description.

• subject – A reference to the patient who the request is for. To aid the data consumer, the display element should contain the patient’s name.

• authoredOn – This is the date/time that the medication was authorised/prescribed.

Must Support fields

In addition, the following fields are “Must Support” - i.e. they must be populated if relevant and known:

• repeatInformation – This is a useful extension created by care connect which allows repeat information to be captured. We further extend this field to also include the date when the last repeat was issued. These fields should be populated when the prescription type is “repeat”.
• statusReason – Another useful care connect extension which should be used to record the reason why and when a medication was stopped. This should be populated when the status == “stopped”. Currently care connect do not offer any valueset for populating this field, SNOMED have a concept, Drug therapy discontinued (274512008), which appears to be a good candidate to use here. We have set this as our “preferred” valueset – and will accept other code lists which have similar representations on a case by case basis.
• identifier – We keep this fields usage inline with GPC (GP Connect) specification as follows; If the EPS identifier is present, then the identifier.value is where the EPS Id SHOULD also be added. The codeSystem for this identifier is https://fhir.nhs.uk/Id/prescription-order-item-number and use should be set to “official”. This field may also be used to provide other types of unique business identifiers.
• context - This field is renamed to Encounter in R4. Here we limit the field to only allow references to an encounter resource. For a repeat prescriptions, this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
• requester - R4 has this as one field, whereas STU3 has this split into requester.agent and requester.onBehalfOf. We remove the onBehalfOf field to aid and use the agent to provide reference to the Practitioner or Organization making the request.
• reasonCode – A preferred list of SNOMED codes are used to populate this field which represent Condition/Problem/Diagnosis.
• note - Use this field for instructions to a third party e.g. “GP to Continue” noted on a prescription given to an outpatient. dispenseRequest – Hold useful information on quantity and expected supply duration.

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Optional fields to note include:

• recorder – This field is used to capture the person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. In pharmacy systems, it is a legal requirement to capture this field, however we have left as optional, as no real-benefit was identified for use within the shared care record.

• reasonReference – Option to provide more detailed information via Observation and/or a condition resource which represent the reason for the medication request.

Discouraged or Removed fields

• definition – This field has been removed in R4 and we have done the same in our specification to keep it inline.
• basedOn and groupIdentifier – Both removed to avoid unnecessary hierarchy complexity, a simple list of prescriptions in date order will suffice.
• priority – Removed, this field is more likely to be used in a prescribing system rather than the shared care record.
• supportingInformation – Removed. This field allows reference to any type of resource which is very open and may cause confusion to the consumer. GPC also do not use this field
• substitution – Removed. This field is more pertinent to a pharmacy system.
• priorPrescription – Removed to avoid any unnecessary complexity.
• detectedIssue – Removed. Not required for the shared care record.
• eventHistory – Removed. Not required for the shared care record.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CareConnect-MedicationRequest-1

Name	Flags	Card.	Type	Description & Constraints
​ MedicationRequest		0..*	CareConnect-MedicationRequest-1	Ordering of medication for patient or group
​ id	S	0..1	id	Logical id of this artifact
​ meta
​ versionId	S	0..1	id	Version specific identifier
​ lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
​ profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
​ security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
​ Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
​ tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
​ system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
​ code	S	1..1	code	The Data Provider Id of the system supplying the data
​ display	S	1..1	string	Name of the system supplying the data
​ tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
​ system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
​ code	S	1..1	code	The ODS Code of the organisation responsible for the data
​ display	S	1..1	string	Name of the organisation supplying the data
​ implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
​ language		0..1	code	English is assumed (not currently a multi-lingual implementation)
​ text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
​ extension		1..*	Extension	Extension
​ extension:repeatInformation	S	0..1	Extension-CareConnect-MedicationRepeatInformation-1	Medication repeat information
​ extension:numberOfRepeatPrescriptionsAllowed	S	0..1	Extension	Extension
​ extension:numberOfRepeatPrescriptionsIssued	S	0..1	Extension	Extension
​ extension:authorisationExpiryDate	S	0..1	Extension	Extension
​ LastIssuedDate	S	0..1	dateTime	Last issued date for repeat medication. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1
​ extension:statusReason	S	0..1	Extension-CareConnect-MedicationStatusReason-1	To record the reason the medication (plan or order) was stopped and the date this occurred
​ extension		2..*	Extension	Extension
​ extension:statusReason	S	1..1	Extension	Extension
​ extension:statusChangeDate	S	1..1	Extension	Extension
​ extension:prescriptionType	S	1..1	Extension-CareConnect-PrescriptionType-1	To record the type of prescription
definition		0..0
basedOn		0..0
groupIdentifier		0..0
​ status	S	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
​ intent	S	1..1	code	proposal | plan | order | instance-order
​ category	S	1..1	CodeableConcept	Type of medication usage Binding: InterweaveMedicationRequestCategory (required)
​ coding
​ system		1..1	uri	Identity of the terminology system
​ code		1..1	code	Symbol in syntax defined by the system
​ display		1..1	string	Representation defined by the system
priority		0..0
​ Slices for medication[x]		1..1	Reference()	Medication to be taken Slice: Unordered, Open by type:$this
​ medication[x]:medicationReference	S	1..1	Reference(CareConnect-Medication-1)	Reference to the medicatin resource
​ subject	S	1..1	Reference(CareConnectPatient1)	Who the medication request is for.
​ reference		1..1	string	Reference to a resource (could be Contained)
​ identifier		0..1	Identifier	If relevant could include an id
​ display		1..1	string	Description of the referenced resource
​ context	S	0..1	Reference(CareConnect-Encounter-1)	For a repeat prescription this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
supportingInformation		0..0
​ authoredOn	S	1..1	dateTime	When request was initially authored
​ requester
​ agent	S	1..1	Reference(CareConnect-Practitioner-1 | CareConnect-Organization-1)	Who ordered the initial medication(s)
onBehalfOf		0..0
​ reasonCode	S	0..*	CodeableConcept	Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (preferred)
​ note	S	0..*	Annotation	Extra information about the prescription that could not be conveyed by the other attributes.
​ dosageInstruction	S	1..1	Dosage	How the medication should be taken
​ text	S	1..1	string	Complete dosage instructions as text.
​ patientInstruction	S	1..1	string	Patient or consumer oriented instructions e.g. RHS of prescription label.
​ dispenseRequest
​ validityPeriod		0..1	Period	This indicates the validity period of a prescription (stale dating the Prescription).
numberOfRepeatsAllowed		0..0
​ quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
​ extension:quantityText	S	0..1	Extension-CareConnect-MedicationQuantityText-1	To support the textual representation of a medication structured quantity.
​ expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
​ value	S	1..1	decimal	The number of days supply.
​ unit	S	1..1	string	Unit representation Fixed Value: day
​ system	S	1..1	uri	System that defines coded unit form
​ code	S	1..1	code	Coded form of the unit Fixed Value: d
substitution		0..0
priorPrescription		0..0
detectedIssue		0..0
eventHistory		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
MedicationRequest.category	required	InterweaveMedicationRequestCategory
MedicationRequest.reasonCode	preferred	Condition/Problem/Diagnosis Codes

Name	Flags	Card.	Type	Description & Constraints
​ MedicationRequest		0..*	CareConnect-MedicationRequest-1	Ordering of medication for patient or group
​ id	SΣ	0..1	id	Logical id of this artifact
​ meta	Σ	0..1	Meta	Metadata about the resource
​ versionId	SΣ	0..1	id	Version specific identifier
​ lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
​ profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
​ security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
​ Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
​ code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
​ display	SΣ	1..1	string	Name of the system supplying the data
​ tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
​ code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
​ display	SΣ	1..1	string	Name of the organisation supplying the data
​ implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
​ language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
​ text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
​ Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
​ repeatInformation	S	0..1	(Complex)	Medication repeat information URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1
​ extension:numberOfRepeatPrescriptionsAllowed	S	0..1	Extension	Extension
​ url		1..1	uri	"numberOfRepeatPrescriptionsAllowed"
​ Slices for value[x]		1..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		1..1	unsignedInt	Number of issues authorised
​ extension:numberOfRepeatPrescriptionsIssued	S	0..1	Extension	Extension
​ url		1..1	uri	"numberOfRepeatPrescriptionsIssued"
​ Slices for value[x]		0..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		0..1	unsignedInt	Number of issues issued
​ extension:authorisationExpiryDate	S	0..1	Extension	Extension
​ url		1..1	uri	"authorisationExpiryDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	Repeat review date
​ LastIssuedDate	S	0..1	dateTime	Last issued date for repeat medication. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1"
​ statusReason	S	0..1	(Complex)	To record the reason the medication (plan or order) was stopped and the date this occurred URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1
​ Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
​ extension:statusReason	S	1..1	Extension	Extension
​ url		1..1	uri	"statusReason"
​ Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueCodeableConcept		0..1	CodeableConcept	To record the reason the medication (plan or order) was stopped
​ extension:statusChangeDate	S	1..1	Extension	Extension
​ url		1..1	uri	"statusChangeDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	To record the date this occurred
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1"
​ prescriptionType	S	1..1	CodeableConcept	To record the type of prescription URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-PrescriptionType-1 Binding: Care Connect Prescription Type (required): A ValueSet to identify the type of prescription.
​ modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
​ status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription
​ intent	?!SΣ	1..1	code	proposal | plan | order | instance-order Binding: MedicationRequestIntent (required): The kind of medication order
​ category	S	1..1	CodeableConcept	Type of medication usage Binding: InterweaveMedicationRequestCategory (required)
​ Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
​ medication[x]:medicationReference	SΣ	1..1	Reference(CareConnect-Medication-1)	Reference to the medicatin resource
​ subject	SΣ	1..1	Reference(CareConnectPatient1)	Who the medication request is for.
​ reference	ΣC	1..1	string	Reference to a resource (could be Contained)
​ identifier	Σ	0..1	Identifier	If relevant could include an id
​ display	Σ	1..1	string	Description of the referenced resource
​ context	S	0..1	Reference(CareConnect-Encounter-1)	For a repeat prescription this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
​ authoredOn	SΣ	1..1	dateTime	When request was initially authored
​ requester	ΣC	0..1	BackboneElement	Who/What requested the Request
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ agent	SΣ	1..1	Reference(CareConnect-Practitioner-1 | CareConnect-Organization-1)	Who ordered the initial medication(s)
​ reasonCode	S	0..*	CodeableConcept	Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (preferred)
​ note	S	0..*	Annotation	Extra information about the prescription that could not be conveyed by the other attributes.
​ text		1..1	string	The annotation - text content
​ dosageInstruction	S	1..1	Dosage	How the medication should be taken
​ text	SΣ	1..1	string	Complete dosage instructions as text.
​ patientInstruction	SΣ	1..1	string	Patient or consumer oriented instructions e.g. RHS of prescription label.
​ dispenseRequest		0..1	BackboneElement	Medication supply authorization
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ validityPeriod		0..1	Period	This indicates the validity period of a prescription (stale dating the Prescription).
​ quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
​ quantityText	S	0..1	string	To support the textual representation of a medication structured quantity. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1
​ expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
​ value	SΣ	1..1	decimal	The number of days supply.
​ comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
​ unit	SΣ	1..1	string	Unit representation Fixed Value: day
​ system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
​ code	SΣ	1..1	code	Coded form of the unit Binding: UnitsOfTime (required): A unit of time (units from UCUM). Fixed Value: d
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationRequest.meta.security	extensible	All Security Labels
MedicationRequest.meta.tag	example	Common Tags
MedicationRequest.meta.tag:Source	example	Common Tags
MedicationRequest.meta.tag:Provenance	example	Common Tags
MedicationRequest.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.groupIdentifier.use	required	IdentifierUse
MedicationRequest.status	required	MedicationRequestStatus
MedicationRequest.intent	required	MedicationRequestIntent
MedicationRequest.category	required	InterweaveMedicationRequestCategory
MedicationRequest.reasonCode	preferred	Condition/Problem/Diagnosis Codes
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator	required	QuantityComparator
MedicationRequest.dispenseRequest.expectedSupplyDuration.code	required	Fixed Value: d

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType, MedicationRequest.requester, MedicationRequest.dispenseRequest	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mps-1	error	MedicationRequest.requester	onBehalfOf can only be specified if agent is practitioner or device : (agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()

Name	Flags	Card.	Type	Description & Constraints
​ MedicationRequest		0..*	CareConnect-MedicationRequest-1	Ordering of medication for patient or group
​ id	SΣ	0..1	id	Logical id of this artifact
​ meta	Σ	0..1	Meta	Metadata about the resource
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ versionId	SΣ	0..1	id	Version specific identifier
​ lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
​ profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
​ security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
​ Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
​ display	SΣ	1..1	string	Name of the system supplying the data
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
​ display	SΣ	1..1	string	Name of the organisation supplying the data
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
​ language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
​ text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
​ contained		0..*	Resource	Contained, inline Resources
​ Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
​ repeatInformation	S	0..1	(Complex)	Medication repeat information URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ extension:numberOfRepeatPrescriptionsAllowed	S	0..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"numberOfRepeatPrescriptionsAllowed"
​ Slices for value[x]		1..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		1..1	unsignedInt	Number of issues authorised
​ extension:numberOfRepeatPrescriptionsIssued	S	0..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"numberOfRepeatPrescriptionsIssued"
​ Slices for value[x]		0..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		0..1	unsignedInt	Number of issues issued
​ extension:authorisationExpiryDate	S	0..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"authorisationExpiryDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	Repeat review date
​ LastIssuedDate	S	0..1	dateTime	Last issued date for repeat medication. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1"
​ statusReason	S	0..1	(Complex)	To record the reason the medication (plan or order) was stopped and the date this occurred URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
​ extension:statusReason	S	1..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"statusReason"
​ Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueCodeableConcept		0..1	CodeableConcept	To record the reason the medication (plan or order) was stopped
​ extension:statusChangeDate	S	1..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"statusChangeDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	To record the date this occurred
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1"
​ prescriptionType	S	1..1	CodeableConcept	To record the type of prescription URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-PrescriptionType-1 Binding: Care Connect Prescription Type (required): A ValueSet to identify the type of prescription.
​ modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
​ identifier		0..*	Identifier	External ids for this request
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
​ type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
​ system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
​ value	Σ	1..1	string	The value that is unique Example General: 123456
​ period	Σ	0..1	Period	Time period when id is/was valid for use
​ assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
​ status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription
​ intent	?!SΣ	1..1	code	proposal | plan | order | instance-order Binding: MedicationRequestIntent (required): The kind of medication order
​ category	S	1..1	CodeableConcept	Type of medication usage Binding: InterweaveMedicationRequestCategory (required)
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ coding	Σ	0..*	Coding	Code defined by a terminology system
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ system	Σ	1..1	uri	Identity of the terminology system
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	Σ	1..1	code	Symbol in syntax defined by the system
​ display	Σ	1..1	string	Representation defined by the system
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ text	Σ	0..1	string	Plain text representation of the concept
​ Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
​ medication[x]:medicationReference	SΣ	1..1	Reference(CareConnect-Medication-1)	Reference to the medicatin resource
​ subject	SΣ	1..1	Reference(CareConnectPatient1)	Who the medication request is for.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ reference	ΣC	1..1	string	Reference to a resource (could be Contained)
​ identifier	Σ	0..1	Identifier	If relevant could include an id
​ display	Σ	1..1	string	Description of the referenced resource
​ context	S	0..1	Reference(CareConnect-Encounter-1)	For a repeat prescription this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
​ authoredOn	SΣ	1..1	dateTime	When request was initially authored
​ requester	ΣC	0..1	BackboneElement	Who/What requested the Request
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ agent	SΣ	1..1	Reference(CareConnect-Practitioner-1 | CareConnect-Organization-1)	Who ordered the initial medication(s)
​ recorder		0..1	Reference(CareConnect-Practitioner-1)	Person who entered the request
​ reasonCode	S	0..*	CodeableConcept	Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (preferred)
​ reasonReference		0..*	Reference(CareConnect-Condition-1 | CareConnect-Observation-1)	Condition or Observation that supports why the prescription is being written
​ note	S	0..*	Annotation	Extra information about the prescription that could not be conveyed by the other attributes.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)
authorString			string
​ time	Σ	0..1	dateTime	When the annotation was made
​ text		1..1	string	The annotation - text content
​ dosageInstruction	S	1..1	Dosage	How the medication should be taken
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ sequence	Σ	0..1	integer	The order of the dosage instructions
​ text	SΣ	1..1	string	Complete dosage instructions as text.
​ additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction - e.g. "with meals" Binding: SNOMED CT Additional Dosage Instructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
​ coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	Σ	1..1	code	Symbol in syntax defined by the system
​ display	Σ	1..1	string	Representation defined by the system
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ text	Σ	0..1	string	Plain text representation of the concept
​ patientInstruction	SΣ	1..1	string	Patient or consumer oriented instructions e.g. RHS of prescription label.
​ timing	Σ	0..1	Timing	When medication should be administered
​ asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
​ site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
​ route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMED CT Route Codes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
​ coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Medication Dosage Route (preferred): A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	Σ	1..1	code	Symbol in syntax defined by the system
​ display	Σ	1..1	string	Representation defined by the system
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ text	Σ	0..1	string	Plain text representation of the concept
​ method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.
​ dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
​ maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
​ maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
​ maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
​ rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
​ dispenseRequest		0..1	BackboneElement	Medication supply authorization
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ validityPeriod		0..1	Period	This indicates the validity period of a prescription (stale dating the Prescription).
​ quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ quantityText	S	0..1	string	To support the textual representation of a medication structured quantity. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1
​ value	Σ	0..1	decimal	Numerical value (with implicit precision)
​ unit	Σ	0..1	string	Unit representation
​ system	ΣC	0..1	uri	System that defines coded unit form
​ code	Σ	0..1	code	Coded form of the unit
​ expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ value	SΣ	1..1	decimal	The number of days supply.
​ comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
​ unit	SΣ	1..1	string	Unit representation Fixed Value: day
​ system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
​ code	SΣ	1..1	code	Coded form of the unit Binding: UnitsOfTime (required): A unit of time (units from UCUM). Fixed Value: d
​ performer		0..1	Reference(CareConnect-Organization-1)	Intended dispenser
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationRequest.meta.security	extensible	All Security Labels
MedicationRequest.meta.tag	example	Common Tags
MedicationRequest.meta.tag:Source	example	Common Tags
MedicationRequest.meta.tag:Provenance	example	Common Tags
MedicationRequest.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.identifier.use	required	IdentifierUse
MedicationRequest.identifier.type	extensible	Identifier Type Codes
MedicationRequest.groupIdentifier.use	required	IdentifierUse
MedicationRequest.groupIdentifier.type	extensible	Identifier Type Codes
MedicationRequest.status	required	MedicationRequestStatus
MedicationRequest.intent	required	MedicationRequestIntent
MedicationRequest.category	required	InterweaveMedicationRequestCategory
MedicationRequest.reasonCode	preferred	Condition/Problem/Diagnosis Codes
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMED CT Additional Dosage Instructions
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMED CT Medication As Needed Reason Codes
MedicationRequest.dosageInstruction.site	example	SNOMED CT Anatomical Structure for Administration Site Codes
MedicationRequest.dosageInstruction.route	example	SNOMED CT Route Codes
MedicationRequest.dosageInstruction.route.coding:snomedCT	preferred	Care Connect Medication Dosage Route
MedicationRequest.dosageInstruction.method	example	SNOMED CT Administration Method Codes
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator	required	QuantityComparator
MedicationRequest.dispenseRequest.expectedSupplyDuration.code	required	Fixed Value: d
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from CareConnect-MedicationRequest-1

Name	Flags	Card.	Type	Description & Constraints
​ MedicationRequest		0..*	CareConnect-MedicationRequest-1	Ordering of medication for patient or group
​ id	S	0..1	id	Logical id of this artifact
​ meta
​ versionId	S	0..1	id	Version specific identifier
​ lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
​ profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
​ security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
​ Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
​ tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
​ system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
​ code	S	1..1	code	The Data Provider Id of the system supplying the data
​ display	S	1..1	string	Name of the system supplying the data
​ tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
​ system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
​ code	S	1..1	code	The ODS Code of the organisation responsible for the data
​ display	S	1..1	string	Name of the organisation supplying the data
​ implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
​ language		0..1	code	English is assumed (not currently a multi-lingual implementation)
​ text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
​ extension		1..*	Extension	Extension
​ extension:repeatInformation	S	0..1	Extension-CareConnect-MedicationRepeatInformation-1	Medication repeat information
​ extension:numberOfRepeatPrescriptionsAllowed	S	0..1	Extension	Extension
​ extension:numberOfRepeatPrescriptionsIssued	S	0..1	Extension	Extension
​ extension:authorisationExpiryDate	S	0..1	Extension	Extension
​ LastIssuedDate	S	0..1	dateTime	Last issued date for repeat medication. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1
​ extension:statusReason	S	0..1	Extension-CareConnect-MedicationStatusReason-1	To record the reason the medication (plan or order) was stopped and the date this occurred
​ extension		2..*	Extension	Extension
​ extension:statusReason	S	1..1	Extension	Extension
​ extension:statusChangeDate	S	1..1	Extension	Extension
​ extension:prescriptionType	S	1..1	Extension-CareConnect-PrescriptionType-1	To record the type of prescription
definition		0..0
basedOn		0..0
groupIdentifier		0..0
​ status	S	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
​ intent	S	1..1	code	proposal | plan | order | instance-order
​ category	S	1..1	CodeableConcept	Type of medication usage Binding: InterweaveMedicationRequestCategory (required)
​ coding
​ system		1..1	uri	Identity of the terminology system
​ code		1..1	code	Symbol in syntax defined by the system
​ display		1..1	string	Representation defined by the system
priority		0..0
​ Slices for medication[x]		1..1	Reference()	Medication to be taken Slice: Unordered, Open by type:$this
​ medication[x]:medicationReference	S	1..1	Reference(CareConnect-Medication-1)	Reference to the medicatin resource
​ subject	S	1..1	Reference(CareConnectPatient1)	Who the medication request is for.
​ reference		1..1	string	Reference to a resource (could be Contained)
​ identifier		0..1	Identifier	If relevant could include an id
​ display		1..1	string	Description of the referenced resource
​ context	S	0..1	Reference(CareConnect-Encounter-1)	For a repeat prescription this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
supportingInformation		0..0
​ authoredOn	S	1..1	dateTime	When request was initially authored
​ requester
​ agent	S	1..1	Reference(CareConnect-Practitioner-1 | CareConnect-Organization-1)	Who ordered the initial medication(s)
onBehalfOf		0..0
​ reasonCode	S	0..*	CodeableConcept	Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (preferred)
​ note	S	0..*	Annotation	Extra information about the prescription that could not be conveyed by the other attributes.
​ dosageInstruction	S	1..1	Dosage	How the medication should be taken
​ text	S	1..1	string	Complete dosage instructions as text.
​ patientInstruction	S	1..1	string	Patient or consumer oriented instructions e.g. RHS of prescription label.
​ dispenseRequest
​ validityPeriod		0..1	Period	This indicates the validity period of a prescription (stale dating the Prescription).
numberOfRepeatsAllowed		0..0
​ quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
​ extension:quantityText	S	0..1	Extension-CareConnect-MedicationQuantityText-1	To support the textual representation of a medication structured quantity.
​ expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
​ value	S	1..1	decimal	The number of days supply.
​ unit	S	1..1	string	Unit representation Fixed Value: day
​ system	S	1..1	uri	System that defines coded unit form
​ code	S	1..1	code	Coded form of the unit Fixed Value: d
substitution		0..0
priorPrescription		0..0
detectedIssue		0..0
eventHistory		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
MedicationRequest.category	required	InterweaveMedicationRequestCategory
MedicationRequest.reasonCode	preferred	Condition/Problem/Diagnosis Codes

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
​ MedicationRequest		0..*	CareConnect-MedicationRequest-1	Ordering of medication for patient or group
​ id	SΣ	0..1	id	Logical id of this artifact
​ meta	Σ	0..1	Meta	Metadata about the resource
​ versionId	SΣ	0..1	id	Version specific identifier
​ lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
​ profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
​ security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
​ Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
​ code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
​ display	SΣ	1..1	string	Name of the system supplying the data
​ tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
​ code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
​ display	SΣ	1..1	string	Name of the organisation supplying the data
​ implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
​ language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
​ text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
​ Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
​ repeatInformation	S	0..1	(Complex)	Medication repeat information URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1
​ extension:numberOfRepeatPrescriptionsAllowed	S	0..1	Extension	Extension
​ url		1..1	uri	"numberOfRepeatPrescriptionsAllowed"
​ Slices for value[x]		1..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		1..1	unsignedInt	Number of issues authorised
​ extension:numberOfRepeatPrescriptionsIssued	S	0..1	Extension	Extension
​ url		1..1	uri	"numberOfRepeatPrescriptionsIssued"
​ Slices for value[x]		0..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		0..1	unsignedInt	Number of issues issued
​ extension:authorisationExpiryDate	S	0..1	Extension	Extension
​ url		1..1	uri	"authorisationExpiryDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	Repeat review date
​ LastIssuedDate	S	0..1	dateTime	Last issued date for repeat medication. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1"
​ statusReason	S	0..1	(Complex)	To record the reason the medication (plan or order) was stopped and the date this occurred URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1
​ Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
​ extension:statusReason	S	1..1	Extension	Extension
​ url		1..1	uri	"statusReason"
​ Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueCodeableConcept		0..1	CodeableConcept	To record the reason the medication (plan or order) was stopped
​ extension:statusChangeDate	S	1..1	Extension	Extension
​ url		1..1	uri	"statusChangeDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	To record the date this occurred
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1"
​ prescriptionType	S	1..1	CodeableConcept	To record the type of prescription URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-PrescriptionType-1 Binding: Care Connect Prescription Type (required): A ValueSet to identify the type of prescription.
​ modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
​ status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription
​ intent	?!SΣ	1..1	code	proposal | plan | order | instance-order Binding: MedicationRequestIntent (required): The kind of medication order
​ category	S	1..1	CodeableConcept	Type of medication usage Binding: InterweaveMedicationRequestCategory (required)
​ Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
​ medication[x]:medicationReference	SΣ	1..1	Reference(CareConnect-Medication-1)	Reference to the medicatin resource
​ subject	SΣ	1..1	Reference(CareConnectPatient1)	Who the medication request is for.
​ reference	ΣC	1..1	string	Reference to a resource (could be Contained)
​ identifier	Σ	0..1	Identifier	If relevant could include an id
​ display	Σ	1..1	string	Description of the referenced resource
​ context	S	0..1	Reference(CareConnect-Encounter-1)	For a repeat prescription this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
​ authoredOn	SΣ	1..1	dateTime	When request was initially authored
​ requester	ΣC	0..1	BackboneElement	Who/What requested the Request
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ agent	SΣ	1..1	Reference(CareConnect-Practitioner-1 | CareConnect-Organization-1)	Who ordered the initial medication(s)
​ reasonCode	S	0..*	CodeableConcept	Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (preferred)
​ note	S	0..*	Annotation	Extra information about the prescription that could not be conveyed by the other attributes.
​ text		1..1	string	The annotation - text content
​ dosageInstruction	S	1..1	Dosage	How the medication should be taken
​ text	SΣ	1..1	string	Complete dosage instructions as text.
​ patientInstruction	SΣ	1..1	string	Patient or consumer oriented instructions e.g. RHS of prescription label.
​ dispenseRequest		0..1	BackboneElement	Medication supply authorization
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ validityPeriod		0..1	Period	This indicates the validity period of a prescription (stale dating the Prescription).
​ quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
​ quantityText	S	0..1	string	To support the textual representation of a medication structured quantity. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1
​ expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
​ value	SΣ	1..1	decimal	The number of days supply.
​ comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
​ unit	SΣ	1..1	string	Unit representation Fixed Value: day
​ system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
​ code	SΣ	1..1	code	Coded form of the unit Binding: UnitsOfTime (required): A unit of time (units from UCUM). Fixed Value: d
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationRequest.meta.security	extensible	All Security Labels
MedicationRequest.meta.tag	example	Common Tags
MedicationRequest.meta.tag:Source	example	Common Tags
MedicationRequest.meta.tag:Provenance	example	Common Tags
MedicationRequest.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.groupIdentifier.use	required	IdentifierUse
MedicationRequest.status	required	MedicationRequestStatus
MedicationRequest.intent	required	MedicationRequestIntent
MedicationRequest.category	required	InterweaveMedicationRequestCategory
MedicationRequest.reasonCode	preferred	Condition/Problem/Diagnosis Codes
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator	required	QuantityComparator
MedicationRequest.dispenseRequest.expectedSupplyDuration.code	required	Fixed Value: d

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType, MedicationRequest.requester, MedicationRequest.dispenseRequest	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mps-1	error	MedicationRequest.requester	onBehalfOf can only be specified if agent is practitioner or device : (agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
​ MedicationRequest		0..*	CareConnect-MedicationRequest-1	Ordering of medication for patient or group
​ id	SΣ	0..1	id	Logical id of this artifact
​ meta	Σ	0..1	Meta	Metadata about the resource
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ versionId	SΣ	0..1	id	Version specific identifier
​ lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
​ profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
​ security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
​ Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
​ display	SΣ	1..1	string	Name of the system supplying the data
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
​ display	SΣ	1..1	string	Name of the organisation supplying the data
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
​ language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
​ text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
​ contained		0..*	Resource	Contained, inline Resources
​ Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
​ repeatInformation	S	0..1	(Complex)	Medication repeat information URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ extension:numberOfRepeatPrescriptionsAllowed	S	0..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"numberOfRepeatPrescriptionsAllowed"
​ Slices for value[x]		1..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		1..1	unsignedInt	Number of issues authorised
​ extension:numberOfRepeatPrescriptionsIssued	S	0..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"numberOfRepeatPrescriptionsIssued"
​ Slices for value[x]		0..1	unsignedInt	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueUnsignedInt		0..1	unsignedInt	Number of issues issued
​ extension:authorisationExpiryDate	S	0..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"authorisationExpiryDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	Repeat review date
​ LastIssuedDate	S	0..1	dateTime	Last issued date for repeat medication. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1"
​ statusReason	S	0..1	(Complex)	To record the reason the medication (plan or order) was stopped and the date this occurred URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
​ extension:statusReason	S	1..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"statusReason"
​ Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueCodeableConcept		0..1	CodeableConcept	To record the reason the medication (plan or order) was stopped
​ extension:statusChangeDate	S	1..1	Extension	Extension
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ url		1..1	uri	"statusChangeDate"
​ Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
​ value[x]:valueDateTime		0..1	dateTime	To record the date this occurred
​ url		1..1	uri	"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationStatusReason-1"
​ prescriptionType	S	1..1	CodeableConcept	To record the type of prescription URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-PrescriptionType-1 Binding: Care Connect Prescription Type (required): A ValueSet to identify the type of prescription.
​ modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
​ identifier		0..*	Identifier	External ids for this request
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
​ type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
​ system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
​ value	Σ	1..1	string	The value that is unique Example General: 123456
​ period	Σ	0..1	Period	Time period when id is/was valid for use
​ assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
​ status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription
​ intent	?!SΣ	1..1	code	proposal | plan | order | instance-order Binding: MedicationRequestIntent (required): The kind of medication order
​ category	S	1..1	CodeableConcept	Type of medication usage Binding: InterweaveMedicationRequestCategory (required)
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ coding	Σ	0..*	Coding	Code defined by a terminology system
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ system	Σ	1..1	uri	Identity of the terminology system
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	Σ	1..1	code	Symbol in syntax defined by the system
​ display	Σ	1..1	string	Representation defined by the system
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ text	Σ	0..1	string	Plain text representation of the concept
​ Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
​ medication[x]:medicationReference	SΣ	1..1	Reference(CareConnect-Medication-1)	Reference to the medicatin resource
​ subject	SΣ	1..1	Reference(CareConnectPatient1)	Who the medication request is for.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ reference	ΣC	1..1	string	Reference to a resource (could be Contained)
​ identifier	Σ	0..1	Identifier	If relevant could include an id
​ display	Σ	1..1	string	Description of the referenced resource
​ context	S	0..1	Reference(CareConnect-Encounter-1)	For a repeat prescription this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.
​ authoredOn	SΣ	1..1	dateTime	When request was initially authored
​ requester	ΣC	0..1	BackboneElement	Who/What requested the Request
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ agent	SΣ	1..1	Reference(CareConnect-Practitioner-1 | CareConnect-Organization-1)	Who ordered the initial medication(s)
​ recorder		0..1	Reference(CareConnect-Practitioner-1)	Person who entered the request
​ reasonCode	S	0..*	CodeableConcept	Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (preferred)
​ reasonReference		0..*	Reference(CareConnect-Condition-1 | CareConnect-Observation-1)	Condition or Observation that supports why the prescription is being written
​ note	S	0..*	Annotation	Extra information about the prescription that could not be conveyed by the other attributes.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)
authorString			string
​ time	Σ	0..1	dateTime	When the annotation was made
​ text		1..1	string	The annotation - text content
​ dosageInstruction	S	1..1	Dosage	How the medication should be taken
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ sequence	Σ	0..1	integer	The order of the dosage instructions
​ text	SΣ	1..1	string	Complete dosage instructions as text.
​ additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction - e.g. "with meals" Binding: SNOMED CT Additional Dosage Instructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
​ coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	Σ	1..1	code	Symbol in syntax defined by the system
​ display	Σ	1..1	string	Representation defined by the system
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ text	Σ	0..1	string	Plain text representation of the concept
​ patientInstruction	SΣ	1..1	string	Patient or consumer oriented instructions e.g. RHS of prescription label.
​ timing	Σ	0..1	Timing	When medication should be administered
​ asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
​ site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
​ route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMED CT Route Codes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
​ coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system Binding: Care Connect Medication Dosage Route (preferred): A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
​ system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
​ version	Σ	0..1	string	Version of the system - if relevant
​ code	Σ	1..1	code	Symbol in syntax defined by the system
​ display	Σ	1..1	string	Representation defined by the system
​ userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
​ text	Σ	0..1	string	Plain text representation of the concept
​ method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.
​ dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
​ maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
​ maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
​ maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
​ rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
​ dispenseRequest		0..1	BackboneElement	Medication supply authorization
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations
​ modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
​ validityPeriod		0..1	Period	This indicates the validity period of a prescription (stale dating the Prescription).
​ quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
​ id		0..1	string	xml:id (or equivalent in JSON)
​ Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
​ quantityText	S	0..1	string	To support the textual representation of a medication structured quantity. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1
​ value	Σ	0..1	decimal	Numerical value (with implicit precision)
​ unit	Σ	0..1	string	Unit representation
​ system	ΣC	0..1	uri	System that defines coded unit form
​ code	Σ	0..1	code	Coded form of the unit
​ expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
​ id		0..1	string	xml:id (or equivalent in JSON)
​ extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
​ value	SΣ	1..1	decimal	The number of days supply.
​ comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
​ unit	SΣ	1..1	string	Unit representation Fixed Value: day
​ system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
​ code	SΣ	1..1	code	Coded form of the unit Binding: UnitsOfTime (required): A unit of time (units from UCUM). Fixed Value: d
​ performer		0..1	Reference(CareConnect-Organization-1)	Intended dispenser
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationRequest.meta.security	extensible	All Security Labels
MedicationRequest.meta.tag	example	Common Tags
MedicationRequest.meta.tag:Source	example	Common Tags
MedicationRequest.meta.tag:Provenance	example	Common Tags
MedicationRequest.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.identifier.use	required	IdentifierUse
MedicationRequest.identifier.type	extensible	Identifier Type Codes
MedicationRequest.groupIdentifier.use	required	IdentifierUse
MedicationRequest.groupIdentifier.type	extensible	Identifier Type Codes
MedicationRequest.status	required	MedicationRequestStatus
MedicationRequest.intent	required	MedicationRequestIntent
MedicationRequest.category	required	InterweaveMedicationRequestCategory
MedicationRequest.reasonCode	preferred	Condition/Problem/Diagnosis Codes
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMED CT Additional Dosage Instructions
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMED CT Medication As Needed Reason Codes
MedicationRequest.dosageInstruction.site	example	SNOMED CT Anatomical Structure for Administration Site Codes
MedicationRequest.dosageInstruction.route	example	SNOMED CT Route Codes
MedicationRequest.dosageInstruction.route.coding:snomedCT	preferred	Care Connect Medication Dosage Route
MedicationRequest.dosageInstruction.method	example	SNOMED CT Administration Method Codes
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparator	required	QuantityComparator
MedicationRequest.dispenseRequest.expectedSupplyDuration.code	required	Fixed Value: d
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	MedicationRequest.extension:repeatInformation, MedicationRequest.extension:statusReason, MedicationRequest.extension:prescriptionType	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CareConnect-MedicationRequest-1

Summary

Mandatory: 11 elements (11 nested mandatory elements)
Must-Support: 39 elements
Fixed Value: 4 elements
Prohibited: 11 elements

Structures

This structure refers to these other structures:

• CareConnect-Medication-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Medication-1)
• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
• CareConnect-Encounter-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)
• CareConnect-Practitioner-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1)
• CareConnect-Organization-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1)

Extensions

This structure refers to these extensions:

• https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1

Slices

This structure defines the following Slices:

• The element MedicationRequest.meta.tag is sliced based on the value of value:system
• The element MedicationRequest.medication[x] is sliced based on the value of type:$this