Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: InterweaveMedicationRequest

Official URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-MedicationRequest Version: 0.0.1
Draft as of 2024-07-15 Computable Name: InterweaveMedicationRequest

Interweave MedicationRequest resource profile - DRAFT.

Status: DRAFT: For Review

Introduction

This profile sets out the expectations for the interweave medication request resource. We use the madication structure definition as a base to this profile.

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:

  • 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
  • courseOfTherapyType – This field records the type of prescription rather than having to derive this information from other fields. further details on how the codes should be used are outlined in the table below:

Code Description
acute A medication which the patient is only expected to consume for the duration of the current order and which is not expected to be renewed.
repeat Details of medication which are expected to be issued on a regular basis to treat an ongoing medical condition.
repeat dispensing A dispense of medication which is on a repeat prescription i.e. an instance of a repeat prescription.
delayed prescribing The supply of a prescription to a patient in advance of the possible need for it to be dispensed and taken.
  • 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 – Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). We also make this a required binding.

  • medication[x] - Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. In either case, the display field should be populated with the name of the medication which will be a DM&D description.

  • subject – A reference to the representing the person (patient) to whom the medication will be given. 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.

  • dosageInstruction - Dosage instructions for the medication that indicates how the medication is to be used by the patient. The following sub-elements are mandatory.

    • dosageInstruction.text - Complete dosage instructions as text. The content of this attribute does not include the name or description of the medication. Additional information about administration or preparation of the medication should be included as text.

    • dosageInstruction.patientInstruction - Instructions in terms that are understood by the patient or consumer.

  • substitution - Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. UK Core have mandated this field.

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 which allows repeat information to be captured. It also include the date when the last repeat was issued. These fields should be populated when the prescription type is “repeat”.

  • 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.

  • statusReason – This should be populated when the status == “stopped” / "on-hold". along with the FHIR valueSet, We also add SNOMED 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.

  • encounter - 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 - The individual or organization that initiated the request and has responsibility for its activation.

  • 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 suseful information on quantity and expected supply duration. We keep this sub-elements usage inline with GPC (GP Connect) specification

    • dispenseRequest.validityPeriod - This indicates the validity period of a prescription. It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The startDate of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an endDate is not specified then the Prescription is open-ended.

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:

  • performer - The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

  • performerType - Indicates the type of performer of the administration of the medication. If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

  • 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

  • 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.

  • instantiatesCanonical – Removed.

  • instantiatesUri – Removed.

  • basedOn and groupIdentifier – Both removed to avoid unnecessary hierarchy complexity, a simple list of prescriptions in date order will suffice.

  • insurance - Removed.Not required for the shared care record.

  • 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.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from UKCoreMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest UKCoreMedicationRequest
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... 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..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... 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
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... 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
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... 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
... Slices for extension Content/Rules for all slices
.... extension:medicationRepeatInformation S 0..1 ExtensionUKCoreMedicationRepeatInformation Medication repeat information
..... Slices for extension Content/Rules for all slices
...... extension:numberOfPrescriptionsIssued 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.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
... identifier
.... assigner 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... statusReason S 0..1 CodeableConcept Reason for current status
Binding: InterweaveMedicationRequestStatusReason (preferred)
... category 1..1 CodeableConcept Provides the business context for the relevant dispensing processes.
Binding: UK Core Medication Request Category (required)
... priority 0..0
... doNotPerform 0..0
... medication[x] 1..1 CodeableConcept, Reference(Medication) Identifies the medication being requested.
Binding: UK Core Medication Code (required)
... subject 1..1 Reference(InterweavePatient) 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
... encounter S 0..1 Reference(InterweaveEncounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..0
... authoredOn 1..1 dateTime The date / time that the medication request was initially authored.
... requester 0..1 Reference(InterweavePractitioner | InterweaveOrganization | InterweavePractitionerRole) Who is requesting the medication.
... performerType 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (preferred)
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (preferred)
... instantiatesCanonical 0..0
... instantiatesUri 0..0
... basedOn 0..0
... groupIdentifier 0..0
... courseOfTherapyType S 1..1 CodeableConcept A course of therapy for a medication request
Binding: InterweaveMedicationRequestCourseOfTherapyType (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
... insurance 0..0
... note S 0..* Annotation Extra information about the prescription that could not be conveyed by the other attributes.
... dosageInstruction 1..1 Dosage Dosage instructions for the medication.
.... id 0..0
.... extension 0..0
.... text 1..1 string Complete dosage instructions as text.
.... patientInstruction S 1..1 string Patient or consumer oriented instructions e.g. RHS of prescription label.
.... site
..... id 0..0
..... extension 0..0
..... 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
.... route
..... id 0..0
..... extension 0..0
..... 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
.... method
..... id 0..0
..... extension 0..0
..... 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
... dispenseRequest
.... id 0..0
.... extension 0..0
.... initialFill
..... id 0..0
..... extension 0..0
.... validityPeriod S 1..1 Period Time period supply is authorized for
.... expectedSupplyDuration S 0..1 Duration Number of days supply per dispense
..... id 0..0
..... extension 0..0
..... value S 0..1 decimal The number of days supply.
..... unit S 1..1 string Unit representation
Fixed Value: day
..... system S 0..1 uri System that defines coded unit form
..... code S 1..1 code Coded form of the unit
Fixed Value: d
... priorPrescription 0..0
... detectedIssue 0..0
... eventHistory 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationRequest.statusReasonpreferredInterweaveMedicationRequestStatusReason
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestStatusReason
from this IG
MedicationRequest.categoryrequiredUKCoreMedicationRequestCategory
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
from this IG
MedicationRequest.medication[x]requiredUKCoreMedicationCode
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode
from this IG
MedicationRequest.performerTypepreferredProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodepreferredCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTyperequiredInterweaveMedicationRequestCourseOfTherapyType
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestCourseOfTherapyType
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* UKCoreMedicationRequest 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..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... 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: CommonTags (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: CommonTags (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://fhir.interweavedigital.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: CommonTags (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://fhir.interweavedigital.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
... 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 Content/Rules for all slices
.... medicationRepeatInformation S 0..1 (Complex) Medication repeat information
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation
..... Slices for extension Content/Rules for all slices
...... extension:numberOfPrescriptionsIssued S 0..1 Extension Extension
....... extension 0..0
....... url 1..1 uri "numberOfPrescriptionsIssued"
....... value[x] 1..1 unsignedInt The specific number of times a repeat prescription has been issued
...... extension:authorisationExpiryDate S 0..1 Extension Extension
....... extension 0..0
....... url 1..1 uri "authorisationExpiryDate"
....... value[x] 1..1 dateTime Repeat prescription review date
...... LastIssuedDate S 0..1 dateTime Last issued date for repeat medication.
URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
..... url 1..1 uri "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation"
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier Allows the resource to be referenced within / by other resources.
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code A code specifying the current state of the order.
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason S 0..1 CodeableConcept Reason for current status
Binding: InterweaveMedicationRequestStatusReason (preferred)
... intent ?!SΣ 1..1 code Whether the request is a proposal, plan, or an original order.
Binding: medicationRequest Intent (required): The kind of medication order.

... category S 1..1 CodeableConcept Provides the business context for the relevant dispensing processes.
Binding: UK Core Medication Request Category (required)
... medication[x] SΣ 1..1 Identifies the medication being requested.
Binding: UK Core Medication Code (required)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(InterweavePatient) 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
... encounter S 0..1 Reference(InterweaveEncounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime The date / time that the medication request was initially authored.
... requester SΣ 0..1 Reference(InterweavePractitioner | InterweaveOrganization | InterweavePractitionerRole) Who is requesting the medication.
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (preferred)
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (preferred)
... courseOfTherapyType S 1..1 CodeableConcept A course of therapy for a medication request
Binding: InterweaveMedicationRequestCourseOfTherapyType (required)
... note S 0..* Annotation Extra information about the prescription that could not be conveyed by the other attributes.
... dosageInstruction S 1..1 Dosage Dosage instructions for the medication.
.... extension 0..0
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... 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.
.... timing SΣ 0..1 Timing When the medication should be administered.
.... doseAndRate SΣ 0..* Element Dosage instructions for the requested medication.
..... dose[x] SΣ 0..1 Quantity of requested medication to be administered.
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] SΣ 0..1 Rate at which the requested medication is to be administered.
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
... dispenseRequest S 0..1 BackboneElement Specific dispensing quantity instructions.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... validityPeriod S 1..1 Period Time period supply is authorized for
.... quantity S 0..1 SimpleQuantity >Amount of medication to supply per dispense.
.... expectedSupplyDuration S 0..1 Duration Number of days supply per dispense
..... extension 0..0
..... value SΣ 0..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 0..1 uri System that defines coded unit form
..... code SΣ 1..1 code Coded form of the unit
Fixed Value: d
... substitution S 1..1 BackboneElement Any restrictions on medication substitution.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonpreferredInterweaveMedicationRequestStatusReason
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestStatusReason
from this IG
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryrequiredUKCoreMedicationRequestCategory
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
from this IG
MedicationRequest.medication[x]requiredUKCoreMedicationCode
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode
from this IG
MedicationRequest.performerTypepreferredProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodepreferredCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTyperequiredInterweaveMedicationRequestCourseOfTherapyType
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestCourseOfTherapyType
from this IG
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationRequestIf 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()
dom-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* UKCoreMedicationRequest 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
.... 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.
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... 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: CommonTags (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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... 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://fhir.interweavedigital.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
...... 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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... 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://fhir.interweavedigital.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
...... 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: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... medicationRepeatInformation S 0..1 (Complex) Medication repeat information
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... extension:numberOfPrescriptionsIssued S 0..1 Extension Extension
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "numberOfPrescriptionsIssued"
....... value[x] 1..1 unsignedInt The specific number of times a repeat prescription has been issued
...... extension:authorisationExpiryDate S 0..1 Extension Extension
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "authorisationExpiryDate"
....... value[x] 1..1 dateTime Repeat prescription review date
...... LastIssuedDate S 0..1 dateTime Last issued date for repeat medication.
URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
..... url 1..1 uri "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation"
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier Allows the resource to be referenced within / by other resources.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (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 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..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(InterweaveOrganization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code A code specifying the current state of the order.
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason S 0..1 CodeableConcept Reason for current status
Binding: InterweaveMedicationRequestStatusReason (preferred)
... intent ?!SΣ 1..1 code Whether the request is a proposal, plan, or an original order.
Binding: medicationRequest Intent (required): The kind of medication order.

... category S 1..1 CodeableConcept Provides the business context for the relevant dispensing processes.
Binding: UK Core Medication Request Category (required)
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ 1..1 Identifies the medication being requested.
Binding: UK Core Medication Code (required)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(InterweavePatient) Who the medication request is for.
.... id 0..1 string Unique id for inter-element referencing
.... 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)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter S 0..1 Reference(InterweaveEncounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime The date / time that the medication request was initially authored.
... requester SΣ 0..1 Reference(InterweavePractitioner | InterweaveOrganization | InterweavePractitionerRole) Who is requesting the medication.
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (preferred)
... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (preferred)
... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... courseOfTherapyType S 1..1 CodeableConcept A course of therapy for a medication request
Binding: InterweaveMedicationRequestCourseOfTherapyType (required)
.... id 0..1 string Unique id for inter-element referencing
.... 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 Unique id for inter-element referencing
..... 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
... note S 0..* Annotation Extra information about the prescription that could not be conveyed by the other attributes.
... dosageInstruction S 1..1 Dosage Dosage instructions for the medication.
.... extension 0..0
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... 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 or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction SΣ 1..1 string Patient or consumer oriented instructions e.g. RHS of prescription label.
.... timing SΣ 0..1 Timing When the medication should be administered.
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (preferred): 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: UK Core Body Site (preferred)
..... extension 0..0
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... 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
.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: UK Core Substance Or Product Administration Route (preferred)
..... extension 0..0
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... 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
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: UK Core Medication Dosage Method (preferred)
..... extension 0..0
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... 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
.... doseAndRate SΣ 0..* Element Dosage instructions for the requested medication.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣ 0..1 Quantity of requested medication to be administered.
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] SΣ 0..1 Rate at which the requested medication is to be administered.
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity 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
... dispenseRequest S 0..1 BackboneElement Specific dispensing quantity instructions.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod S 1..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity S 0..1 SimpleQuantity >Amount of medication to supply per dispense.
.... expectedSupplyDuration S 0..1 Duration Number of days supply per dispense
..... extension 0..0
..... value SΣ 0..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 0..1 uri System that defines coded unit form
..... code SΣ 1..1 code Coded form of the unit
Fixed Value: d
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution S 1..1 BackboneElement Any restrictions on medication substitution.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonpreferredInterweaveMedicationRequestStatusReason
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestStatusReason
from this IG
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryrequiredUKCoreMedicationRequestCategory
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
from this IG
MedicationRequest.medication[x]requiredUKCoreMedicationCode
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode
from this IG
MedicationRequest.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performerTypepreferredProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodepreferredCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTyperequiredInterweaveMedicationRequestCourseOfTherapyType
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestCourseOfTherapyType
from this IG
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]preferredSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.sitepreferredUKCoreBodySite
https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite
from this IG
MedicationRequest.dosageInstruction.routepreferredUKCoreSubstanceOrProductAdministrationRoute
https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute
from this IG
MedicationRequest.dosageInstruction.methodpreferredUKCoreMedicationDosageMethod
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod
from this IG
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationRequestIf 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()
dom-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from UKCoreMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest UKCoreMedicationRequest
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... 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..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... 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
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... 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
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... 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
... Slices for extension Content/Rules for all slices
.... extension:medicationRepeatInformation S 0..1 ExtensionUKCoreMedicationRepeatInformation Medication repeat information
..... Slices for extension Content/Rules for all slices
...... extension:numberOfPrescriptionsIssued 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.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
... identifier
.... assigner 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... statusReason S 0..1 CodeableConcept Reason for current status
Binding: InterweaveMedicationRequestStatusReason (preferred)
... category 1..1 CodeableConcept Provides the business context for the relevant dispensing processes.
Binding: UK Core Medication Request Category (required)
... priority 0..0
... doNotPerform 0..0
... medication[x] 1..1 CodeableConcept, Reference(Medication) Identifies the medication being requested.
Binding: UK Core Medication Code (required)
... subject 1..1 Reference(InterweavePatient) 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
... encounter S 0..1 Reference(InterweaveEncounter) Encounter created as part of encounter/admission/stay
... supportingInformation 0..0
... authoredOn 1..1 dateTime The date / time that the medication request was initially authored.
... requester 0..1 Reference(InterweavePractitioner | InterweaveOrganization | InterweavePractitionerRole) Who is requesting the medication.
... performerType 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (preferred)
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (preferred)
... instantiatesCanonical 0..0
... instantiatesUri 0..0
... basedOn 0..0
... groupIdentifier 0..0
... courseOfTherapyType S 1..1 CodeableConcept A course of therapy for a medication request
Binding: InterweaveMedicationRequestCourseOfTherapyType (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
... insurance 0..0
... note S 0..* Annotation Extra information about the prescription that could not be conveyed by the other attributes.
... dosageInstruction 1..1 Dosage Dosage instructions for the medication.
.... id 0..0
.... extension 0..0
.... text 1..1 string Complete dosage instructions as text.
.... patientInstruction S 1..1 string Patient or consumer oriented instructions e.g. RHS of prescription label.
.... site
..... id 0..0
..... extension 0..0
..... 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
.... route
..... id 0..0
..... extension 0..0
..... 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
.... method
..... id 0..0
..... extension 0..0
..... 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
... dispenseRequest
.... id 0..0
.... extension 0..0
.... initialFill
..... id 0..0
..... extension 0..0
.... validityPeriod S 1..1 Period Time period supply is authorized for
.... expectedSupplyDuration S 0..1 Duration Number of days supply per dispense
..... id 0..0
..... extension 0..0
..... value S 0..1 decimal The number of days supply.
..... unit S 1..1 string Unit representation
Fixed Value: day
..... system S 0..1 uri System that defines coded unit form
..... code S 1..1 code Coded form of the unit
Fixed Value: d
... priorPrescription 0..0
... detectedIssue 0..0
... eventHistory 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationRequest.statusReasonpreferredInterweaveMedicationRequestStatusReason
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestStatusReason
from this IG
MedicationRequest.categoryrequiredUKCoreMedicationRequestCategory
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
from this IG
MedicationRequest.medication[x]requiredUKCoreMedicationCode
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode
from this IG
MedicationRequest.performerTypepreferredProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodepreferredCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTyperequiredInterweaveMedicationRequestCourseOfTherapyType
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestCourseOfTherapyType
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* UKCoreMedicationRequest 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..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... 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: CommonTags (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: CommonTags (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://fhir.interweavedigital.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: CommonTags (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://fhir.interweavedigital.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
... 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 Content/Rules for all slices
.... medicationRepeatInformation S 0..1 (Complex) Medication repeat information
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation
..... Slices for extension Content/Rules for all slices
...... extension:numberOfPrescriptionsIssued S 0..1 Extension Extension
....... extension 0..0
....... url 1..1 uri "numberOfPrescriptionsIssued"
....... value[x] 1..1 unsignedInt The specific number of times a repeat prescription has been issued
...... extension:authorisationExpiryDate S 0..1 Extension Extension
....... extension 0..0
....... url 1..1 uri "authorisationExpiryDate"
....... value[x] 1..1 dateTime Repeat prescription review date
...... LastIssuedDate S 0..1 dateTime Last issued date for repeat medication.
URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
..... url 1..1 uri "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation"
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier Allows the resource to be referenced within / by other resources.
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code A code specifying the current state of the order.
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason S 0..1 CodeableConcept Reason for current status
Binding: InterweaveMedicationRequestStatusReason (preferred)
... intent ?!SΣ 1..1 code Whether the request is a proposal, plan, or an original order.
Binding: medicationRequest Intent (required): The kind of medication order.

... category S 1..1 CodeableConcept Provides the business context for the relevant dispensing processes.
Binding: UK Core Medication Request Category (required)
... medication[x] SΣ 1..1 Identifies the medication being requested.
Binding: UK Core Medication Code (required)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(InterweavePatient) 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
... encounter S 0..1 Reference(InterweaveEncounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime The date / time that the medication request was initially authored.
... requester SΣ 0..1 Reference(InterweavePractitioner | InterweaveOrganization | InterweavePractitionerRole) Who is requesting the medication.
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (preferred)
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (preferred)
... courseOfTherapyType S 1..1 CodeableConcept A course of therapy for a medication request
Binding: InterweaveMedicationRequestCourseOfTherapyType (required)
... note S 0..* Annotation Extra information about the prescription that could not be conveyed by the other attributes.
... dosageInstruction S 1..1 Dosage Dosage instructions for the medication.
.... extension 0..0
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... 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.
.... timing SΣ 0..1 Timing When the medication should be administered.
.... doseAndRate SΣ 0..* Element Dosage instructions for the requested medication.
..... dose[x] SΣ 0..1 Quantity of requested medication to be administered.
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] SΣ 0..1 Rate at which the requested medication is to be administered.
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
... dispenseRequest S 0..1 BackboneElement Specific dispensing quantity instructions.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... validityPeriod S 1..1 Period Time period supply is authorized for
.... quantity S 0..1 SimpleQuantity >Amount of medication to supply per dispense.
.... expectedSupplyDuration S 0..1 Duration Number of days supply per dispense
..... extension 0..0
..... value SΣ 0..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 0..1 uri System that defines coded unit form
..... code SΣ 1..1 code Coded form of the unit
Fixed Value: d
... substitution S 1..1 BackboneElement Any restrictions on medication substitution.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonpreferredInterweaveMedicationRequestStatusReason
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestStatusReason
from this IG
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryrequiredUKCoreMedicationRequestCategory
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
from this IG
MedicationRequest.medication[x]requiredUKCoreMedicationCode
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode
from this IG
MedicationRequest.performerTypepreferredProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodepreferredCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTyperequiredInterweaveMedicationRequestCourseOfTherapyType
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestCourseOfTherapyType
from this IG
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationRequestIf 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()
dom-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* UKCoreMedicationRequest 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
.... 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.
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... 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: CommonTags (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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... 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://fhir.interweavedigital.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
...... 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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... 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://fhir.interweavedigital.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
...... 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: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... medicationRepeatInformation S 0..1 (Complex) Medication repeat information
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... extension:numberOfPrescriptionsIssued S 0..1 Extension Extension
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "numberOfPrescriptionsIssued"
....... value[x] 1..1 unsignedInt The specific number of times a repeat prescription has been issued
...... extension:authorisationExpiryDate S 0..1 Extension Extension
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "authorisationExpiryDate"
....... value[x] 1..1 dateTime Repeat prescription review date
...... LastIssuedDate S 0..1 dateTime Last issued date for repeat medication.
URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
..... url 1..1 uri "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation"
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 0..* Identifier Allows the resource to be referenced within / by other resources.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (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 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..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(InterweaveOrganization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code A code specifying the current state of the order.
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason S 0..1 CodeableConcept Reason for current status
Binding: InterweaveMedicationRequestStatusReason (preferred)
... intent ?!SΣ 1..1 code Whether the request is a proposal, plan, or an original order.
Binding: medicationRequest Intent (required): The kind of medication order.

... category S 1..1 CodeableConcept Provides the business context for the relevant dispensing processes.
Binding: UK Core Medication Request Category (required)
... reported[x] Σ 0..1 Reported rather than primary record
.... reportedBoolean boolean
.... reportedReference Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ 1..1 Identifies the medication being requested.
Binding: UK Core Medication Code (required)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(Medication)
... subject SΣ 1..1 Reference(InterweavePatient) Who the medication request is for.
.... id 0..1 string Unique id for inter-element referencing
.... 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)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter S 0..1 Reference(InterweaveEncounter) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime The date / time that the medication request was initially authored.
... requester SΣ 0..1 Reference(InterweavePractitioner | InterweaveOrganization | InterweavePractitionerRole) Who is requesting the medication.
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (preferred)
... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (preferred)
... reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written
... courseOfTherapyType S 1..1 CodeableConcept A course of therapy for a medication request
Binding: InterweaveMedicationRequestCourseOfTherapyType (required)
.... id 0..1 string Unique id for inter-element referencing
.... 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 Unique id for inter-element referencing
..... 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
... note S 0..* Annotation Extra information about the prescription that could not be conveyed by the other attributes.
... dosageInstruction S 1..1 Dosage Dosage instructions for the medication.
.... extension 0..0
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... 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 or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction SΣ 1..1 string Patient or consumer oriented instructions e.g. RHS of prescription label.
.... timing SΣ 0..1 Timing When the medication should be administered.
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (preferred): 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: UK Core Body Site (preferred)
..... extension 0..0
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... 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
.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: UK Core Substance Or Product Administration Route (preferred)
..... extension 0..0
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... 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
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: UK Core Medication Dosage Method (preferred)
..... extension 0..0
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... 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
.... doseAndRate SΣ 0..* Element Dosage instructions for the requested medication.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣ 0..1 Quantity of requested medication to be administered.
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] SΣ 0..1 Rate at which the requested medication is to be administered.
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity 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
... dispenseRequest S 0..1 BackboneElement Specific dispensing quantity instructions.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod S 1..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity S 0..1 SimpleQuantity >Amount of medication to supply per dispense.
.... expectedSupplyDuration S 0..1 Duration Number of days supply per dispense
..... extension 0..0
..... value SΣ 0..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 0..1 uri System that defines coded unit form
..... code SΣ 1..1 code Coded form of the unit
Fixed Value: d
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution S 1..1 BackboneElement Any restrictions on medication substitution.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
MedicationRequest.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
from the FHIR Standard
MedicationRequest.statusReasonpreferredInterweaveMedicationRequestStatusReason
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestStatusReason
from this IG
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
from the FHIR Standard
MedicationRequest.categoryrequiredUKCoreMedicationRequestCategory
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
from this IG
MedicationRequest.medication[x]requiredUKCoreMedicationCode
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode
from this IG
MedicationRequest.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationRequest.performerTypepreferredProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodepreferredCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationRequest.courseOfTherapyTyperequiredInterweaveMedicationRequestCourseOfTherapyType
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-MedicationRequestCourseOfTherapyType
from this IG
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]preferredSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.sitepreferredUKCoreBodySite
https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite
from this IG
MedicationRequest.dosageInstruction.routepreferredUKCoreSubstanceOrProductAdministrationRoute
https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute
from this IG
MedicationRequest.dosageInstruction.methodpreferredUKCoreMedicationDosageMethod
https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod
from this IG
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.dispenseRequest.expectedSupplyDuration.comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationRequestIf 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()
dom-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Differences between Interweave STU3 and R4 profiles

Element name Change details
extension:medicationRepeatInformation
  • Renamed form repeatInformation to medicationRepeatInformation
extension:medicationRepeatInformation.url
  • Changed fixed value from https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationRepeatInformation-1 to https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation
extension:repeatInformation.extension:numberOfRepeatPrescriptionsAllowed
  • Deleted
extension:medicationRepeatInformation.extension:numberOfPrescriptionsIssued
  • Renamed from extension:repeatInformation.extension:numberOfRepeatPrescriptionsIssued to extension:medicationRepeatInformation.extension:numberOfPrescriptionsIssued
extension:medicationRepeatInformation.extension:numberOfPrescriptionsIssued.url
  • Changed fixed value from 'numberOfRepeatPrescriptionsIssued' to 'numberOfPrescriptionsIssued'
extension:medicationRepeatInformation.extension:LastIssuedDate.url
  • Changed fixed value from https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate-1 to https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicationLastIssuedDate
extension:statusReason
  • Deleted (added as normal element)
extension:prescriptionType
  • Deleted (added as normal element)
status
  • Changed valueSet from http://hl7.org/fhir/ValueSet/medication-request-status to http://hl7.org/fhir/ValueSet/medicationrequest-status
  • Change of codeSystem from http://hl7.org/fhir/medication-request-status to http://hl7.org/fhir/CodeSystem/medicationrequest-status
statusReason
  • Added Element
intent
  • Changed valueSet from http://hl7.org/fhir/ValueSet/medication-request-intent to http://hl7.org/fhir/ValueSet/medicationrequest-intent
  • Change of codeSystem from http://hl7.org/fhir/medication-request-intent to http://hl7.org/fhir/CodeSystem/medicationrequest-intent
category
  • Changed valueSet from https://fhir.yhcr.nhs.uk/ValueSet/Interweave-MedicationRequestCategory-1 to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCategory
  • Change of codeSystem from https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-MedicationRequestCategory-1 to http://terminology.hl7.org/CodeSystem/medicationrequest-category
  • Change of codeSystem from http://hl7.org/fhir/medication-request-category to http://terminology.hl7.org/CodeSystem/medicationrequest-category
  • Codes from codeSystem https://fhir.hl7.org.uk/CodeSystem/UKCore-MedicationRequestCategory added
reported[x]
  • Added Element
medication[x]
  • Choice of dataType CodeableConcept added
encounter
  • Renamed from context to encounter
requester
  • Type changed from BackboneElement to Reference(Practitioner | PractitionerRole | Organization)
performer
  • Added Element
performerType
  • Added Element
recorder
  • Type Reference: Added Target Type PractitionerRole
courseOfTherapyType
  • Added Element
dosageInstruction.site
  • Changed valueSet from http://hl7.org/fhir/ValueSet/approach-site-codes to https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite
dosageInstruction.route
  • Changed valueSet from https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-MedicationDosageRoute-1 to https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute
dosageInstruction.method
  • Changed valueSet from http://hl7.org/fhir/ValueSet/administration-method-codes to https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod
dispenseRequest.initialFill
  • Added Element
dispenseRequest.dispenseInterval
  • Added Element
dispenseRequest.numberOfRepeatsAllowed
  • Added Element
substitution
  • Added Element

Graphical relationship diagram

Graphical relationship diagram of Medication Request resource