CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
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CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v2.0.0-cibuild) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ACH Monthly Event MedicationRequest

Official URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-medicationrequest Version: 2.0.0-cibuild
Standards status: Trial-use Maturity Level: 1 Computable Name: AcuteCareHospitalMonthlyReportingMedicationRequest

This profile contains Required and Must Support data elements for reporting medication request (order) information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile inherits from the US Core 6.1.0 MedicationRequest profile and applies capabilities from the QI Core 6.0.0 MedicationRequest profile and QI Core 6.0.0 Medication Not Requested profile.

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 1.0.0:

  • New Content

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... id Σ 1..1 id Logical id of this artifact
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... statusReason S 0..1 CodeableConcept Reason for current status
    Binding: medicationRequest Status Reason Codes (extensible)
    ... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
    Slice: Unordered, Open by pattern:$this
    Binding: medicationRequest Category Codes (extensible)
    .... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
    Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... priority SΣ 0..1 code routine | urgent | asap | stat
    Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
    ... doNotPerform ?!SΣ 0..1 boolean (QI-Core) True if medication was not requested
    ... reported[x] SΣ 0..1 Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) (QI-Core)(USCDI) Reported rather than primary record
    ... Slices for medication[x] SΣC 1..1 (USCDI) Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    Constraints: not-done-extension-present
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(6.1.0))
    .... medication[x]:medicationCodeableConcept SΣ 0..1 CodeableConcept (USCDI) Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    ..... Slices for extension Content/Rules for all slices
    ...... extension:notDoneValueSet 0..1 canonical(ValueSet) (QI-Core) If not requested, Url of a value set of medications not requested
    URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
    .... medication[x]:medicationReference SΣ 0..1 Reference(ACH Monthly Event Medication) (USCDI) Medication to be taken
    ..... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who or group medication request is for
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter S 0..1 Reference(QICore Encounter) (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... authoredOn SΣ 1..1 dateTime (QI-Core)(USCDI) When request was initially authored
    ... requester SΣC 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) (QI-Core)(USCDI) Who/What requested the Request
    ... reasonCode S 0..* CodeableConcept (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
    Binding: Medication Request Reason ValueSet (extensible)
    ... reasonReference S 0..* Reference(ACH Monthly Event Condition | QICore Simple Observation) (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... instantiatesCanonical SΣ 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri SΣ 0..* uri Instantiates external protocol or definition
    ... courseOfTherapyType S 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... dosageInstruction S 0..* Dosage (QI-Core)(USCDI) How medication should be taken
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... text SΣ 0..1 string (USCDI) Free text dosage instructions e.g. SIG
    .... timing SΣ 0..1 Timing (QI-Core)(USCDI) When medication should be administered
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... event SΣ 0..* dateTime When the event occurs
    ..... repeat SΣC 0..1 Element (QI-Core) When the event is to occur
    Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
    ...... bounds[x] SΣ 0..1 (QI-Core) Length/Range of lengths, or (Start and/or end) limits
    ....... boundsDuration Duration
    ....... boundsRange Range
    ....... boundsPeriod Period
    ...... count SΣ 0..1 positiveInt Number of times to repeat
    ...... countMax SΣ 0..1 positiveInt Maximum number of times to repeat
    ...... duration SΣ 0..1 decimal How long when it happens
    ...... durationMax SΣ 0..1 decimal How long when it happens (Max)
    ...... durationUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... frequency SΣ 0..1 positiveInt (QI-Core) Event occurs frequency times per period
    ...... frequencyMax SΣ 0..1 positiveInt (QI-Core) Event occurs frequencyMax times per period
    ...... period SΣ 0..1 decimal (QI-Core) Event occurs frequency times per period
    ...... periodMax SΣ 0..1 decimal (QI-Core) Upper limit of period (3-4 hours)
    ...... periodUnit SΣ 0..1 code (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... dayOfWeek SΣ 0..* code mon | tue | wed | thu | fri | sat | sun
    Binding: DaysOfWeek (required)
    ...... timeOfDay SΣ 0..* time Time of day for action
    ...... when SΣ 0..* code Code for time period of occurrence
    Binding: EventTiming (required): Real world event relating to the schedule.
    ...... offset SΣ 0..1 unsignedInt Minutes from event (before or after)
    ..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
    Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
    .... asNeeded[x] SΣ 0..1 (QI-Core) Take "as needed" (for x)
    Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
    ..... asNeededBoolean boolean
    ..... asNeededCodeableConcept CodeableConcept
    .... site SΣ 0..1 CodeableConcept Body site to administer to
    Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
    .... route SΣ 1..1 CodeableConcept How drug should enter body
    Binding: SNOMEDCTRouteCodes (extensible)
    .... method SΣ 0..1 CodeableConcept Technique for administering medication
    Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
    .... doseAndRate SΣ 0..* Element (QI-Core)(USCDI) Amount of medication administered
    ..... type SΣ 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 (QI-Core)(USCDI) Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S
    ...... doseRange Range
    ..... rate[x] SΣ 0..1 Amount of medication per unit of time
    ...... rateRatio Ratio
    ...... rateRange Range
    ...... rateQuantity Quantity(SimpleQuantity)
    ... dispenseRequest S 0..1 BackboneElement (QI-Core)(USCDI) Medication supply authorization
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... dispenseInterval 0..1 Duration (QI-Core) Minimum period of time between dispenses
    .... numberOfRepeatsAllowed S 0..1 unsignedInt (QI-Core)(USCDI) Number of refills authorized
    .... quantity S 0..1 SimpleQuantity (QI-Core)(USCDI) Amount of medication to supply per dispense
    .... expectedSupplyDuration 0..1 Duration (QI-Core) Number of days supply per dispense

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
    MedicationRequest.statusReason Base extensible Medication request status reason codes 📦4.0.1 FHIR Std.
    MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
    MedicationRequest.category Base extensible Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
    MedicationRequest.medication[x] Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.medication[x]:medicationCodeableConcept Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.reasonCode Base extensible Medication Request Reason ValueSet 📦2.0.0-cibuild This IG
    MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.durationUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek Base required DaysOfWeek 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.when Base required EventTiming 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.code Base preferred TimingAbbreviation 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​route Base extensible SNOMED CT Route Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    not-done-extension-present error MedicationRequest.medication[x] qicore-notDoneValueSet extension does not exist extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not()
    tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
    tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
    tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
    tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
    tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
    tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
    tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
    tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
    tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()
    us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

    This structure is derived from USCoreMedicationRequestProfile

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
    ... id 1..1 id Logical id of this artifact
    ... meta
    .... Slices for extension Content/Rules for all slices
    ..... extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    ... status 1..1 code (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    ... category 0..* CodeableConcept (USCDI) Type of medication usage
    Binding: medicationRequest Category Codes (extensible)
    ... priority S 0..1 code routine | urgent | asap | stat
    ... doNotPerform S 0..1 boolean (QI-Core) True if medication was not requested
    ... reported[x] 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) (QI-Core)(USCDI) Reported rather than primary record
    ... Slices for medication[x] C 1..1 CodeableConcept, Reference(US Core Medication Profile(6.1.0)) (USCDI) Medication to be taken
    Slice: Unordered, Open by type:$this
    Constraints: not-done-extension-present
    .... medication[x]:medicationCodeableConcept 0..1 CodeableConcept (USCDI) Medication to be taken
    ..... Slices for extension Content/Rules for all slices
    ...... extension:notDoneValueSet 0..1 canonical(ValueSet) (QI-Core) If not requested, Url of a value set of medications not requested
    URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
    .... medication[x]:medicationReference 0..1 Reference(ACH Monthly Event Medication) (USCDI) Medication to be taken
    ..... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... subject 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who or group medication request is for
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter 0..1 Reference(QICore Encounter) (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... authoredOn 1..1 dateTime (QI-Core)(USCDI) When request was initially authored
    ... requester 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) (QI-Core)(USCDI) Who/What requested the Request
    ... reasonCode S 0..* CodeableConcept (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
    Binding: Medication Request Reason ValueSet (extensible)
    ... reasonReference S 0..* Reference(ACH Monthly Event Condition | QICore Simple Observation) (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... instantiatesCanonical S 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri S 0..* uri Instantiates external protocol or definition
    ... courseOfTherapyType S 0..1 CodeableConcept Overall pattern of medication administration
    ... dosageInstruction 0..* Dosage (QI-Core)(USCDI) How medication should be taken
    .... timing 0..1 Timing (QI-Core)(USCDI) When medication should be administered
    ..... event S 0..* dateTime When the event occurs
    ..... repeat S 0..1 Element (QI-Core) When the event is to occur
    ...... bounds[x] S 0..1 Duration, Range, Period (QI-Core) Length/Range of lengths, or (Start and/or end) limits
    ...... count S 0..1 positiveInt Number of times to repeat
    ...... countMax S 0..1 positiveInt Maximum number of times to repeat
    ...... duration S 0..1 decimal How long when it happens
    ...... durationMax S 0..1 decimal How long when it happens (Max)
    ...... durationUnit S 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
    ...... frequency S 0..1 positiveInt (QI-Core) Event occurs frequency times per period
    ...... frequencyMax S 0..1 positiveInt (QI-Core) Event occurs frequencyMax times per period
    ...... period S 0..1 decimal (QI-Core) Event occurs frequency times per period
    ...... periodMax S 0..1 decimal (QI-Core) Upper limit of period (3-4 hours)
    ...... periodUnit S 0..1 code (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
    ...... dayOfWeek S 0..* code mon | tue | wed | thu | fri | sat | sun
    ...... timeOfDay S 0..* time Time of day for action
    ...... when S 0..* code Code for time period of occurrence
    ...... offset S 0..1 unsignedInt Minutes from event (before or after)
    ..... code S 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
    .... asNeeded[x] S 0..1 boolean, CodeableConcept (QI-Core) Take "as needed" (for x)
    .... site S 0..1 CodeableConcept Body site to administer to
    .... route S 1..1 CodeableConcept How drug should enter body
    Binding: SNOMEDCTRouteCodes (extensible)
    .... method S 0..1 CodeableConcept Technique for administering medication
    .... doseAndRate 0..* Element (QI-Core)(USCDI) Amount of medication administered
    ..... type S 0..1 CodeableConcept The kind of dose or rate specified
    ..... dose[x] 0..1 Quantity, Range (QI-Core)(USCDI) Amount of medication per dose
    ..... rate[x] S 0..1 Ratio, Range, SimpleQuantity Amount of medication per unit of time
    ... dispenseRequest 0..1 BackboneElement (QI-Core)(USCDI) Medication supply authorization
    .... dispenseInterval 0..1 Duration (QI-Core) Minimum period of time between dispenses
    .... numberOfRepeatsAllowed 0..1 unsignedInt (QI-Core)(USCDI) Number of refills authorized
    .... quantity 0..1 SimpleQuantity (QI-Core)(USCDI) Amount of medication to supply per dispense
    .... expectedSupplyDuration 0..1 Duration (QI-Core) Number of days supply per dispense

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    MedicationRequest.statusReason Base extensible Medication request status reason codes 📦4.0.1 FHIR Std.
    MedicationRequest.category Base extensible Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.reasonCode Base extensible Medication Request Reason ValueSet 📦2.0.0-cibuild This IG
    MedicationRequest.dosageInstruction.​route Base extensible SNOMED CT Route Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    not-done-extension-present error MedicationRequest.medication[x] qicore-notDoneValueSet extension does not exist extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not()
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... id Σ 1..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    .... 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:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    .... versionId Σ 0..1 id Version specific identifier
    .... lastUpdated Σ 0..1 instant When the resource version last changed
    .... source Σ 0..1 uri Identifies where the resource comes from
    .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    .... security Σ 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    .... tag Σ 0..* Coding Tags applied to this resource
    Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier External ids for this request
    ... status ?!SΣ 1..1 code (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
    ... statusReason S 0..1 CodeableConcept Reason for current status
    Binding: medicationRequest Status Reason Codes (extensible)
    ... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
    Slice: Unordered, Open by pattern:$this
    Binding: medicationRequest Category Codes (extensible)
    .... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
    Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... priority SΣ 0..1 code routine | urgent | asap | stat
    Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
    ... doNotPerform ?!SΣ 0..1 boolean (QI-Core) True if medication was not requested
    ... reported[x] SΣ 0..1 Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) (QI-Core)(USCDI) Reported rather than primary record
    ... Slices for medication[x] SΣC 1..1 (USCDI) Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    Constraints: not-done-extension-present
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(6.1.0))
    .... medication[x]:medicationCodeableConcept SΣ 0..1 CodeableConcept (USCDI) Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    ..... 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:notDoneValueSet 0..1 canonical(ValueSet) (QI-Core) If not requested, Url of a value set of medications not requested
    URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
    ..... coding Σ 0..* Coding Code defined by a terminology system
    ..... text Σ 0..1 string Plain text representation of the concept
    .... medication[x]:medicationReference SΣ 0..1 Reference(ACH Monthly Event Medication) (USCDI) Medication to be taken
    ..... 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ..... 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 Logical reference, when literal reference is not known
    ..... display Σ 0..1 string Text alternative for the resource
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who or group 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... 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 Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... encounter S 0..1 Reference(QICore Encounter) (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
    .... 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... 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 Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    ... authoredOn SΣ 1..1 dateTime (QI-Core)(USCDI) When request was initially authored
    ... requester SΣC 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) (QI-Core)(USCDI) Who/What requested the Request
    ... 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 (example): Identifies the type of individual that is desired to administer the medication.
    ... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
    ... reasonCode S 0..* CodeableConcept (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
    Binding: Medication Request Reason ValueSet (extensible)
    ... reasonReference S 0..* Reference(ACH Monthly Event Condition | QICore Simple Observation) (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
    .... 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... 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 Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... instantiatesCanonical SΣ 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri SΣ 0..* uri Instantiates external protocol or definition
    ... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
    ... groupIdentifier Σ 0..1 Identifier Composite request this is part of
    ... courseOfTherapyType S 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
    ... note 0..* Annotation Information about the prescription
    ... dosageInstruction S 0..* Dosage (QI-Core)(USCDI) How medication should be taken
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... 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 0..1 string (USCDI) Free text dosage instructions e.g. SIG
    .... 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 Σ 0..1 string Patient or consumer oriented instructions
    .... timing SΣ 0..1 Timing (QI-Core)(USCDI) When medication should be administered
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... event SΣ 0..* dateTime When the event occurs
    ..... repeat SΣC 0..1 Element (QI-Core) When the event is to occur
    Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... bounds[x] SΣ 0..1 (QI-Core) Length/Range of lengths, or (Start and/or end) limits
    ....... boundsDuration Duration
    ....... boundsRange Range
    ....... boundsPeriod Period
    ...... count SΣ 0..1 positiveInt Number of times to repeat
    ...... countMax SΣ 0..1 positiveInt Maximum number of times to repeat
    ...... duration SΣ 0..1 decimal How long when it happens
    ...... durationMax SΣ 0..1 decimal How long when it happens (Max)
    ...... durationUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... frequency SΣ 0..1 positiveInt (QI-Core) Event occurs frequency times per period
    ...... frequencyMax SΣ 0..1 positiveInt (QI-Core) Event occurs frequencyMax times per period
    ...... period SΣ 0..1 decimal (QI-Core) Event occurs frequency times per period
    ...... periodMax SΣ 0..1 decimal (QI-Core) Upper limit of period (3-4 hours)
    ...... periodUnit SΣ 0..1 code (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... dayOfWeek SΣ 0..* code mon | tue | wed | thu | fri | sat | sun
    Binding: DaysOfWeek (required)
    ...... timeOfDay SΣ 0..* time Time of day for action
    ...... when SΣ 0..* code Code for time period of occurrence
    Binding: EventTiming (required): Real world event relating to the schedule.
    ...... offset SΣ 0..1 unsignedInt Minutes from event (before or after)
    ..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
    Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
    .... asNeeded[x] SΣ 0..1 (QI-Core) Take "as needed" (for x)
    Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
    ..... asNeededBoolean boolean
    ..... asNeededCodeableConcept CodeableConcept
    .... site SΣ 0..1 CodeableConcept Body site to administer to
    Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
    .... route SΣ 1..1 CodeableConcept How drug should enter body
    Binding: SNOMEDCTRouteCodes (extensible)
    .... method SΣ 0..1 CodeableConcept Technique for administering medication
    Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
    .... doseAndRate SΣ 0..* Element (QI-Core)(USCDI) Amount of medication administered
    ..... 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 SΣ 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 (QI-Core)(USCDI) Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S
    ...... doseRange Range
    ..... rate[x] SΣ 0..1 Amount of medication per unit of time
    ...... 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 (QI-Core)(USCDI) Medication supply authorization
    .... 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
    .... initialFill 0..1 BackboneElement First fill details
    ..... 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
    ..... quantity 0..1 SimpleQuantity First fill quantity
    ..... duration 0..1 Duration First fill duration
    .... dispenseInterval 0..1 Duration (QI-Core) Minimum period of time between dispenses
    .... validityPeriod 0..1 Period Time period supply is authorized for
    .... numberOfRepeatsAllowed S 0..1 unsignedInt (QI-Core)(USCDI) Number of refills authorized
    .... quantity S 0..1 SimpleQuantity (QI-Core)(USCDI) Amount of medication to supply per dispense
    .... expectedSupplyDuration 0..1 Duration (QI-Core) Number of days supply per dispense
    .... performer 0..1 Reference(Organization) Intended dispenser
    ... substitution 0..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 (3.0.0) (example): Identifies the type of substitution allowed.
    ..... allowedBoolean boolean
    ..... allowedCodeableConcept CodeableConcept
    .... reason 0..1 CodeableConcept Why should (not) substitution be made
    Binding: SubstanceAdminSubstitutionReason (3.0.0) (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
    ... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
    ... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
    ... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    MedicationRequest.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
    MedicationRequest.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
    MedicationRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
    MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
    MedicationRequest.statusReason Base extensible Medication request status reason codes 📦4.0.1 FHIR Std.
    MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
    MedicationRequest.category Base extensible Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
    MedicationRequest.medication[x] Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.medication[x]:medicationCodeableConcept Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.medication[x]:medicationReference.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
    MedicationRequest.reasonCode Base extensible Medication Request Reason ValueSet 📦2.0.0-cibuild This IG
    MedicationRequest.reasonReference.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.durationUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek Base required DaysOfWeek 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.when Base required EventTiming 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.code Base preferred TimingAbbreviation 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​route Base extensible SNOMED CT Route Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
    MedicationRequest.substitution.​allowed[x] Base example ActSubstanceAdminSubstitutionCode 📍3.0.0 THO v6.5
    MedicationRequest.substitution.​reason Base example SubstanceAdminSubstitutionReason 📍3.0.0 THO v6.5

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    not-done-extension-present error MedicationRequest.medication[x] qicore-notDoneValueSet extension does not exist extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not()
    tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
    tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
    tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
    tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
    tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
    tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
    tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
    tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
    tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()
    us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... id Σ 1..1 id Logical id of this artifact
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... statusReason S 0..1 CodeableConcept Reason for current status
    Binding: medicationRequest Status Reason Codes (extensible)
    ... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
    Slice: Unordered, Open by pattern:$this
    Binding: medicationRequest Category Codes (extensible)
    .... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
    Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... priority SΣ 0..1 code routine | urgent | asap | stat
    Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
    ... doNotPerform ?!SΣ 0..1 boolean (QI-Core) True if medication was not requested
    ... reported[x] SΣ 0..1 Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) (QI-Core)(USCDI) Reported rather than primary record
    ... Slices for medication[x] SΣC 1..1 (USCDI) Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    Constraints: not-done-extension-present
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(6.1.0))
    .... medication[x]:medicationCodeableConcept SΣ 0..1 CodeableConcept (USCDI) Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    ..... Slices for extension Content/Rules for all slices
    ...... extension:notDoneValueSet 0..1 canonical(ValueSet) (QI-Core) If not requested, Url of a value set of medications not requested
    URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
    .... medication[x]:medicationReference SΣ 0..1 Reference(ACH Monthly Event Medication) (USCDI) Medication to be taken
    ..... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who or group medication request is for
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter S 0..1 Reference(QICore Encounter) (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... authoredOn SΣ 1..1 dateTime (QI-Core)(USCDI) When request was initially authored
    ... requester SΣC 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) (QI-Core)(USCDI) Who/What requested the Request
    ... reasonCode S 0..* CodeableConcept (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
    Binding: Medication Request Reason ValueSet (extensible)
    ... reasonReference S 0..* Reference(ACH Monthly Event Condition | QICore Simple Observation) (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
    .... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ... instantiatesCanonical SΣ 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri SΣ 0..* uri Instantiates external protocol or definition
    ... courseOfTherapyType S 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... dosageInstruction S 0..* Dosage (QI-Core)(USCDI) How medication should be taken
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... text SΣ 0..1 string (USCDI) Free text dosage instructions e.g. SIG
    .... timing SΣ 0..1 Timing (QI-Core)(USCDI) When medication should be administered
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... event SΣ 0..* dateTime When the event occurs
    ..... repeat SΣC 0..1 Element (QI-Core) When the event is to occur
    Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
    ...... bounds[x] SΣ 0..1 (QI-Core) Length/Range of lengths, or (Start and/or end) limits
    ....... boundsDuration Duration
    ....... boundsRange Range
    ....... boundsPeriod Period
    ...... count SΣ 0..1 positiveInt Number of times to repeat
    ...... countMax SΣ 0..1 positiveInt Maximum number of times to repeat
    ...... duration SΣ 0..1 decimal How long when it happens
    ...... durationMax SΣ 0..1 decimal How long when it happens (Max)
    ...... durationUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... frequency SΣ 0..1 positiveInt (QI-Core) Event occurs frequency times per period
    ...... frequencyMax SΣ 0..1 positiveInt (QI-Core) Event occurs frequencyMax times per period
    ...... period SΣ 0..1 decimal (QI-Core) Event occurs frequency times per period
    ...... periodMax SΣ 0..1 decimal (QI-Core) Upper limit of period (3-4 hours)
    ...... periodUnit SΣ 0..1 code (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... dayOfWeek SΣ 0..* code mon | tue | wed | thu | fri | sat | sun
    Binding: DaysOfWeek (required)
    ...... timeOfDay SΣ 0..* time Time of day for action
    ...... when SΣ 0..* code Code for time period of occurrence
    Binding: EventTiming (required): Real world event relating to the schedule.
    ...... offset SΣ 0..1 unsignedInt Minutes from event (before or after)
    ..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
    Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
    .... asNeeded[x] SΣ 0..1 (QI-Core) Take "as needed" (for x)
    Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
    ..... asNeededBoolean boolean
    ..... asNeededCodeableConcept CodeableConcept
    .... site SΣ 0..1 CodeableConcept Body site to administer to
    Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
    .... route SΣ 1..1 CodeableConcept How drug should enter body
    Binding: SNOMEDCTRouteCodes (extensible)
    .... method SΣ 0..1 CodeableConcept Technique for administering medication
    Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
    .... doseAndRate SΣ 0..* Element (QI-Core)(USCDI) Amount of medication administered
    ..... type SΣ 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 (QI-Core)(USCDI) Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S
    ...... doseRange Range
    ..... rate[x] SΣ 0..1 Amount of medication per unit of time
    ...... rateRatio Ratio
    ...... rateRange Range
    ...... rateQuantity Quantity(SimpleQuantity)
    ... dispenseRequest S 0..1 BackboneElement (QI-Core)(USCDI) Medication supply authorization
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... dispenseInterval 0..1 Duration (QI-Core) Minimum period of time between dispenses
    .... numberOfRepeatsAllowed S 0..1 unsignedInt (QI-Core)(USCDI) Number of refills authorized
    .... quantity S 0..1 SimpleQuantity (QI-Core)(USCDI) Amount of medication to supply per dispense
    .... expectedSupplyDuration 0..1 Duration (QI-Core) Number of days supply per dispense

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
    MedicationRequest.statusReason Base extensible Medication request status reason codes 📦4.0.1 FHIR Std.
    MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
    MedicationRequest.category Base extensible Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
    MedicationRequest.medication[x] Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.medication[x]:medicationCodeableConcept Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.reasonCode Base extensible Medication Request Reason ValueSet 📦2.0.0-cibuild This IG
    MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.durationUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek Base required DaysOfWeek 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.when Base required EventTiming 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.code Base preferred TimingAbbreviation 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​route Base extensible SNOMED CT Route Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    not-done-extension-present error MedicationRequest.medication[x] qicore-notDoneValueSet extension does not exist extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not()
    tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
    tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
    tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
    tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
    tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
    tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
    tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
    tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
    tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()
    us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

    Differential View

    This structure is derived from USCoreMedicationRequestProfile

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
    ... id 1..1 id Logical id of this artifact
    ... meta
    .... Slices for extension Content/Rules for all slices
    ..... extension:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    ... status 1..1 code (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    ... category 0..* CodeableConcept (USCDI) Type of medication usage
    Binding: medicationRequest Category Codes (extensible)
    ... priority S 0..1 code routine | urgent | asap | stat
    ... doNotPerform S 0..1 boolean (QI-Core) True if medication was not requested
    ... reported[x] 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) (QI-Core)(USCDI) Reported rather than primary record
    ... Slices for medication[x] C 1..1 CodeableConcept, Reference(US Core Medication Profile(6.1.0)) (USCDI) Medication to be taken
    Slice: Unordered, Open by type:$this
    Constraints: not-done-extension-present
    .... medication[x]:medicationCodeableConcept 0..1 CodeableConcept (USCDI) Medication to be taken
    ..... Slices for extension Content/Rules for all slices
    ...... extension:notDoneValueSet 0..1 canonical(ValueSet) (QI-Core) If not requested, Url of a value set of medications not requested
    URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
    .... medication[x]:medicationReference 0..1 Reference(ACH Monthly Event Medication) (USCDI) Medication to be taken
    ..... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... subject 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who or group medication request is for
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... encounter 0..1 Reference(QICore Encounter) (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... authoredOn 1..1 dateTime (QI-Core)(USCDI) When request was initially authored
    ... requester 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) (QI-Core)(USCDI) Who/What requested the Request
    ... reasonCode S 0..* CodeableConcept (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
    Binding: Medication Request Reason ValueSet (extensible)
    ... reasonReference S 0..* Reference(ACH Monthly Event Condition | QICore Simple Observation) (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
    .... reference S 1..1 string Literal reference, Relative, internal or absolute URL
    ... instantiatesCanonical S 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri S 0..* uri Instantiates external protocol or definition
    ... courseOfTherapyType S 0..1 CodeableConcept Overall pattern of medication administration
    ... dosageInstruction 0..* Dosage (QI-Core)(USCDI) How medication should be taken
    .... timing 0..1 Timing (QI-Core)(USCDI) When medication should be administered
    ..... event S 0..* dateTime When the event occurs
    ..... repeat S 0..1 Element (QI-Core) When the event is to occur
    ...... bounds[x] S 0..1 Duration, Range, Period (QI-Core) Length/Range of lengths, or (Start and/or end) limits
    ...... count S 0..1 positiveInt Number of times to repeat
    ...... countMax S 0..1 positiveInt Maximum number of times to repeat
    ...... duration S 0..1 decimal How long when it happens
    ...... durationMax S 0..1 decimal How long when it happens (Max)
    ...... durationUnit S 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
    ...... frequency S 0..1 positiveInt (QI-Core) Event occurs frequency times per period
    ...... frequencyMax S 0..1 positiveInt (QI-Core) Event occurs frequencyMax times per period
    ...... period S 0..1 decimal (QI-Core) Event occurs frequency times per period
    ...... periodMax S 0..1 decimal (QI-Core) Upper limit of period (3-4 hours)
    ...... periodUnit S 0..1 code (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
    ...... dayOfWeek S 0..* code mon | tue | wed | thu | fri | sat | sun
    ...... timeOfDay S 0..* time Time of day for action
    ...... when S 0..* code Code for time period of occurrence
    ...... offset S 0..1 unsignedInt Minutes from event (before or after)
    ..... code S 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
    .... asNeeded[x] S 0..1 boolean, CodeableConcept (QI-Core) Take "as needed" (for x)
    .... site S 0..1 CodeableConcept Body site to administer to
    .... route S 1..1 CodeableConcept How drug should enter body
    Binding: SNOMEDCTRouteCodes (extensible)
    .... method S 0..1 CodeableConcept Technique for administering medication
    .... doseAndRate 0..* Element (QI-Core)(USCDI) Amount of medication administered
    ..... type S 0..1 CodeableConcept The kind of dose or rate specified
    ..... dose[x] 0..1 Quantity, Range (QI-Core)(USCDI) Amount of medication per dose
    ..... rate[x] S 0..1 Ratio, Range, SimpleQuantity Amount of medication per unit of time
    ... dispenseRequest 0..1 BackboneElement (QI-Core)(USCDI) Medication supply authorization
    .... dispenseInterval 0..1 Duration (QI-Core) Minimum period of time between dispenses
    .... numberOfRepeatsAllowed 0..1 unsignedInt (QI-Core)(USCDI) Number of refills authorized
    .... quantity 0..1 SimpleQuantity (QI-Core)(USCDI) Amount of medication to supply per dispense
    .... expectedSupplyDuration 0..1 Duration (QI-Core) Number of days supply per dispense

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    MedicationRequest.statusReason Base extensible Medication request status reason codes 📦4.0.1 FHIR Std.
    MedicationRequest.category Base extensible Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.reasonCode Base extensible Medication Request Reason ValueSet 📦2.0.0-cibuild This IG
    MedicationRequest.dosageInstruction.​route Base extensible SNOMED CT Route Codes 📦4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    not-done-extension-present error MedicationRequest.medication[x] qicore-notDoneValueSet extension does not exist extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not()

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
    Constraints: us-core-21
    ... id Σ 1..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    .... 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:link-received-date-extension 0..1 dateTime Received Date
    URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
    .... versionId Σ 0..1 id Version specific identifier
    .... lastUpdated Σ 0..1 instant When the resource version last changed
    .... source Σ 0..1 uri Identifies where the resource comes from
    .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
    .... security Σ 0..* Coding Security Labels applied to this resource
    Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
    .... tag Σ 0..* Coding Tags applied to this resource
    Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier External ids for this request
    ... status ?!SΣ 1..1 code (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
    ... statusReason S 0..1 CodeableConcept Reason for current status
    Binding: medicationRequest Status Reason Codes (extensible)
    ... intent ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Binding: medicationRequest Intent (required): The kind of medication order.
    ... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
    Slice: Unordered, Open by pattern:$this
    Binding: medicationRequest Category Codes (extensible)
    .... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
    Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
    ... priority SΣ 0..1 code routine | urgent | asap | stat
    Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
    ... doNotPerform ?!SΣ 0..1 boolean (QI-Core) True if medication was not requested
    ... reported[x] SΣ 0..1 Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) (QI-Core)(USCDI) Reported rather than primary record
    ... Slices for medication[x] SΣC 1..1 (USCDI) Medication to be taken
    Slice: Unordered, Closed by type:$this
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    Constraints: not-done-extension-present
    .... medicationCodeableConcept CodeableConcept
    .... medicationReference Reference(US Core Medication Profile(6.1.0))
    .... medication[x]:medicationCodeableConcept SΣ 0..1 CodeableConcept (USCDI) Medication to be taken
    Binding: MedicationClinicalDrug (20240606) . (extensible)
    ..... 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:notDoneValueSet 0..1 canonical(ValueSet) (QI-Core) If not requested, Url of a value set of medications not requested
    URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
    ..... coding Σ 0..* Coding Code defined by a terminology system
    ..... text Σ 0..1 string Plain text representation of the concept
    .... medication[x]:medicationReference SΣ 0..1 Reference(ACH Monthly Event Medication) (USCDI) Medication to be taken
    ..... 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    ..... 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 Logical reference, when literal reference is not known
    ..... display Σ 0..1 string Text alternative for the resource
    ... subject SΣ 1..1 Reference(Cross-Measure Patient Profile) (QI-Core)(USCDI) Who or group 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... 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 Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... encounter S 0..1 Reference(QICore Encounter) (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
    .... 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... 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 Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
    ... authoredOn SΣ 1..1 dateTime (QI-Core)(USCDI) When request was initially authored
    ... requester SΣC 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) (QI-Core)(USCDI) Who/What requested the Request
    ... 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 (example): Identifies the type of individual that is desired to administer the medication.
    ... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
    ... reasonCode S 0..* CodeableConcept (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
    Binding: Medication Request Reason ValueSet (extensible)
    ... reasonReference S 0..* Reference(ACH Monthly Event Condition | QICore Simple Observation) (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
    .... 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 SΣC 1..1 string Literal reference, Relative, internal or absolute URL
    .... 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 Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... instantiatesCanonical SΣ 0..* canonical() Instantiates FHIR protocol or definition
    ... instantiatesUri SΣ 0..* uri Instantiates external protocol or definition
    ... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
    ... groupIdentifier Σ 0..1 Identifier Composite request this is part of
    ... courseOfTherapyType S 0..1 CodeableConcept Overall pattern of medication administration
    Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
    ... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
    ... note 0..* Annotation Information about the prescription
    ... dosageInstruction S 0..* Dosage (QI-Core)(USCDI) How medication should be taken
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    .... 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 0..1 string (USCDI) Free text dosage instructions e.g. SIG
    .... 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 Σ 0..1 string Patient or consumer oriented instructions
    .... timing SΣ 0..1 Timing (QI-Core)(USCDI) When medication should be administered
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... event SΣ 0..* dateTime When the event occurs
    ..... repeat SΣC 0..1 Element (QI-Core) When the event is to occur
    Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... bounds[x] SΣ 0..1 (QI-Core) Length/Range of lengths, or (Start and/or end) limits
    ....... boundsDuration Duration
    ....... boundsRange Range
    ....... boundsPeriod Period
    ...... count SΣ 0..1 positiveInt Number of times to repeat
    ...... countMax SΣ 0..1 positiveInt Maximum number of times to repeat
    ...... duration SΣ 0..1 decimal How long when it happens
    ...... durationMax SΣ 0..1 decimal How long when it happens (Max)
    ...... durationUnit SΣ 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... frequency SΣ 0..1 positiveInt (QI-Core) Event occurs frequency times per period
    ...... frequencyMax SΣ 0..1 positiveInt (QI-Core) Event occurs frequencyMax times per period
    ...... period SΣ 0..1 decimal (QI-Core) Event occurs frequency times per period
    ...... periodMax SΣ 0..1 decimal (QI-Core) Upper limit of period (3-4 hours)
    ...... periodUnit SΣ 0..1 code (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
    Binding: UnitsOfTime (required): A unit of time (units from UCUM).
    ...... dayOfWeek SΣ 0..* code mon | tue | wed | thu | fri | sat | sun
    Binding: DaysOfWeek (required)
    ...... timeOfDay SΣ 0..* time Time of day for action
    ...... when SΣ 0..* code Code for time period of occurrence
    Binding: EventTiming (required): Real world event relating to the schedule.
    ...... offset SΣ 0..1 unsignedInt Minutes from event (before or after)
    ..... code SΣ 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | +
    Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
    .... asNeeded[x] SΣ 0..1 (QI-Core) Take "as needed" (for x)
    Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
    ..... asNeededBoolean boolean
    ..... asNeededCodeableConcept CodeableConcept
    .... site SΣ 0..1 CodeableConcept Body site to administer to
    Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
    .... route SΣ 1..1 CodeableConcept How drug should enter body
    Binding: SNOMEDCTRouteCodes (extensible)
    .... method SΣ 0..1 CodeableConcept Technique for administering medication
    Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
    .... doseAndRate SΣ 0..* Element (QI-Core)(USCDI) Amount of medication administered
    ..... 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 SΣ 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 (QI-Core)(USCDI) Amount of medication per dose
    Binding: Common UCUM units (preferred)
    Additional BindingsPurpose
    UCUMCodes Max Binding
    ...... doseQuantity Quantity S
    ...... doseRange Range
    ..... rate[x] SΣ 0..1 Amount of medication per unit of time
    ...... 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 (QI-Core)(USCDI) Medication supply authorization
    .... 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
    .... initialFill 0..1 BackboneElement First fill details
    ..... 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
    ..... quantity 0..1 SimpleQuantity First fill quantity
    ..... duration 0..1 Duration First fill duration
    .... dispenseInterval 0..1 Duration (QI-Core) Minimum period of time between dispenses
    .... validityPeriod 0..1 Period Time period supply is authorized for
    .... numberOfRepeatsAllowed S 0..1 unsignedInt (QI-Core)(USCDI) Number of refills authorized
    .... quantity S 0..1 SimpleQuantity (QI-Core)(USCDI) Amount of medication to supply per dispense
    .... expectedSupplyDuration 0..1 Duration (QI-Core) Number of days supply per dispense
    .... performer 0..1 Reference(Organization) Intended dispenser
    ... substitution 0..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 (3.0.0) (example): Identifies the type of substitution allowed.
    ..... allowedBoolean boolean
    ..... allowedCodeableConcept CodeableConcept
    .... reason 0..1 CodeableConcept Why should (not) substitution be made
    Binding: SubstanceAdminSubstitutionReason (3.0.0) (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
    ... priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
    ... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
    ... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    MedicationRequest.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
    MedicationRequest.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
    MedicationRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
    MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
    MedicationRequest.statusReason Base extensible Medication request status reason codes 📦4.0.1 FHIR Std.
    MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
    MedicationRequest.category Base extensible Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
    MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
    MedicationRequest.medication[x] Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.medication[x]:medicationCodeableConcept Base extensible Medication Clinical Drug . 📍20240606 VSAC v0.22
    MedicationRequest.medication[x]:medicationReference.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.subject.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.encounter.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
    MedicationRequest.reasonCode Base extensible Medication Request Reason ValueSet 📦2.0.0-cibuild This IG
    MedicationRequest.reasonReference.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
    MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.durationUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.periodUnit Base required UnitsOfTime 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek Base required DaysOfWeek 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.repeat.when Base required EventTiming 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​timing.code Base preferred TimingAbbreviation 📍4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​route Base extensible SNOMED CT Route Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
    MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
    MedicationRequest.substitution.​allowed[x] Base example ActSubstanceAdminSubstitutionCode 📍3.0.0 THO v6.5
    MedicationRequest.substitution.​reason Base example SubstanceAdminSubstitutionReason 📍3.0.0 THO v6.5

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error MedicationRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
    not-done-extension-present error MedicationRequest.medication[x] qicore-notDoneValueSet extension does not exist extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not()
    tim-1 error MedicationRequest.dosageInstruction.timing.repeat if there's a duration, there needs to be duration units duration.empty() or durationUnit.exists()
    tim-2 error MedicationRequest.dosageInstruction.timing.repeat if there's a period, there needs to be period units period.empty() or periodUnit.exists()
    tim-4 error MedicationRequest.dosageInstruction.timing.repeat duration SHALL be a non-negative value duration.exists() implies duration >= 0
    tim-5 error MedicationRequest.dosageInstruction.timing.repeat period SHALL be a non-negative value period.exists() implies period >= 0
    tim-6 error MedicationRequest.dosageInstruction.timing.repeat If there's a periodMax, there must be a period periodMax.empty() or period.exists()
    tim-7 error MedicationRequest.dosageInstruction.timing.repeat If there's a durationMax, there must be a duration durationMax.empty() or duration.exists()
    tim-8 error MedicationRequest.dosageInstruction.timing.repeat If there's a countMax, there must be a count countMax.empty() or count.exists()
    tim-9 error MedicationRequest.dosageInstruction.timing.repeat If there's an offset, there must be a when (and not C, CM, CD, CV) offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
    tim-10 error MedicationRequest.dosageInstruction.timing.repeat If there's a timeOfDay, there cannot be a when, or vice versa timeOfDay.empty() or when.empty()
    us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

     

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