Profile Comparison between http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-medicationrequest vs http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-medicationrequest

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest	http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest|6.1.0	Values Differ
copyright
description	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 is based on the [HL7 FHIR® US Core MedicationRequest Profile v3.1.1](http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-medicationrequest.html).	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](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-medicationrequest.html) profile and applies capabilities from the QI Core 6.0.0 [MedicationRequest](https://hl7.org/fhir/us/qicore/STU6/StructureDefinition-qicore-medicationrequest.html) profile and QI Core 6.0.0 [Medication Not Requested](https://hl7.org/fhir/us/qicore/STU6/StructureDefinition-qicore-medicationnotrequested.html) profile.	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	AcuteCareHospitalMonthlyReportingMedicationRequest
publisher	CDC National Healthcare Safety Network (NHSN)
purpose
status	active
title	ACH Monthly Event MedicationRequest
type	MedicationRequest
url	http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-monthly-medicationrequest

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group	C	0..*	USCoreMedicationRequestProfile(6.1.0)	Ordering of medication for patient or group
id	Σ	1..1	id	Logical id of this artifact	SΣ	1..1	id	(NHSN-MS) Logical id of this artifact	Elements differ in definition for mustSupport: 'false' vs 'true'
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing		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		0..*	Extension	(NHSN-MS) Received Date Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System.	Σ	0..*	Coding	Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".	Σ	0..*	Coding	Tags applied to this resource Binding: ?? (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	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? 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		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		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External ids for this request		0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.	?!SΣ	1..1	code	(NHSN-MS)(QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (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: ?? (extensible)	S	0..1	CodeableConcept	(NHSN-MS) Reason for current status Binding: ?? (extensible)
intent	?!SΣ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order.	?!SΣC	1..1	code	(NHSN-MS)(USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order.
category	S	0..*	CodeableConcept	Type of medication usage Binding: ?? (extensible)	S	0..*	CodeableConcept	(NHSN-MS)(USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: ?? (extensible)
priority	SΣ	0..1	code	routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request.	SΣ	0..1	code	(NHSN-MS) routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!SΣ	0..1	boolean	True if request is prohibiting action	?!SΣ	0..1	boolean	(NHSN-MS)(QI-Core) True if medication was not requested
Slices for reported[x]	SΣ	0..1	boolean, Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)	Reported rather than primary record Slice: Unordered, Open by type:$this	SΣ	0..1	boolean S, Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(NHSN-MS)(QI-Core)(USCDI) Reported rather than primary record
Slices for medication[x]	SΣ	1..1	CodeableConcept, Reference(US Core Medication Profile)	Medication to be taken Slice: Unordered, Open by type:$this Binding: ?? (extensible)	SΣC	1..1	CodeableConcept, Reference(US Core Medication Profile(6.1.0))	(NHSN-MS)(USCDI) Medication to be taken Slice: Unordered, Closed by type:$this Binding: ?? (extensible) Constraints: not-done-extension-present
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for	SΣ	1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS)(QI-Core)(USCDI) Who or group medication request is for
id		0..1	string	Unique id for inter-element referencing		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		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	SΣC	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (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	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource	Σ	0..1	string	Text alternative for the resource
encounter	S	0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay	S	0..1	Reference(QICore Encounter) {b}	(NHSN-MS)(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
id		0..1	string	Unique id for inter-element referencing		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		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	SΣC	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (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	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource	Σ	0..1	string	Text alternative for the resource
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	1..1	dateTime	When request was initially authored	SΣ	1..1	dateTime	(NHSN-MS)(QI-Core)(USCDI) When request was initially authored
requester	SΣ	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile)	Who/What requested the Request	SΣC	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) Who/What requested the Request	Element minimum cardinalities differ: '1' vs '0'
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration		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: ?? (example): Identifies the type of individual that is desired to administer the medication.	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ?? (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode	S	0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: ?? (example): A coded concept indicating why the medication was ordered.	S	0..*	CodeableConcept	(NHSN-MS)(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: ?? (extensible)
reasonReference	S	0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written	S	0..*	Reference(ACH Monthly Event Condition | QICore Simple Observation (Substitute)) {b}	(NHSN-MS)(QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
id		0..1	string	Unique id for inter-element referencing		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		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	SΣC	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ?? (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	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource	Σ	0..1	string	Text alternative for the resource
instantiatesCanonical	SΣ	0..*	canonical()	Instantiates FHIR protocol or definition	SΣ	0..*	canonical()	(NHSN-MS) Instantiates FHIR protocol or definition
instantiatesUri	SΣ	0..*	uri	Instantiates external protocol or definition	SΣ	0..*	uri	(NHSN-MS) Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType	S	0..1	CodeableConcept	Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio.	S	0..1	CodeableConcept	(NHSN-MS) Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken	S	0..*	Dosage	(NHSN-MS)(QI-Core)(USCDI) How medication should be taken
id		0..1	string	Unique id for inter-element referencing		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		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	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG	SΣ	0..1	string	(NHSN-MS)(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: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (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	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered	SΣ	0..1	Timing	(NHSN-MS)(QI-Core)(USCDI) When medication should be administered
id						0..1	string	Unique id for inter-element referencing	Added this element
Slices for extension						0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url	Added this element
modifierExtension					?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	Added this element
event					SΣ	0..*	dateTime	(NHSN-MS) When the event occurs	Added this element
repeat					SΣC	0..1	Element	(NHSN-MS)(QI-Core) When the event is to occur	Added this element
code					SΣ	0..1	CodeableConcept	(NHSN-MS) BID | TID | QID | AM | PM | QD | QOD | + Binding: ?? (preferred): Code for a known / defined timing pattern.	Added this element
asNeeded[x]	SΣ	0..1	boolean, CodeableConcept	Take "as needed" (for x) Binding: ?? (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.	SΣ	0..1	boolean, CodeableConcept	(NHSN-MS)(QI-Core) Take "as needed" (for x) Binding: ?? (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.
site	SΣ	0..1	CodeableConcept	Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body.	SΣ	0..1	CodeableConcept	(NHSN-MS) Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	1..1	CodeableConcept	How drug should enter body Binding: ?? (extensible)	SΣ	1..1	CodeableConcept	(NHSN-MS) How drug should enter body Binding: ?? (extensible)	Elements differ in definition for mustSupport: 'false' vs 'true'
method	SΣ	0..1	CodeableConcept	Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered.	SΣ	0..1	CodeableConcept	(NHSN-MS) Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	Amount of medication administered	SΣ	0..*	Element	(NHSN-MS)(QI-Core)(USCDI) Amount of medication administered
id		0..1	string	Unique id for inter-element referencing		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		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: ?? (example): The kind of dose or rate specified.	SΣ	0..1	CodeableConcept	(NHSN-MS) The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1	Range, ??	Amount of medication per dose	SΣ	0..1	Quantity S, Range	(NHSN-MS)(QI-Core)(USCDI) Amount of medication per dose Binding: ?? (preferred) Additional Bindings Purpose ?? Max Binding
rate[x]	SΣ	0..1	Ratio, Range, ??	Amount of medication per unit of time	SΣ	0..1	Ratio, Range, ??	(NHSN-MS) Amount of medication per unit of time
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	??	Upper limit on medication per administration	Σ	0..1	??	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	??	Upper limit on medication per lifetime of the patient	Σ	0..1	??	Upper limit on medication per lifetime of the patient
dispenseRequest		0..1	BackboneElement	Medication supply authorization	S	0..1	BackboneElement	(QI-Core)(USCDI) Medication supply authorization	Elements differ in definition for mustSupport: 'false' vs 'true'
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	??	First fill quantity		0..1	??	First fill quantity
duration		0..1	Duration	First fill duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses		0..1	Duration	(QI-Core) Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized	S	0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized	Elements differ in definition for mustSupport: 'false' vs 'true'
quantity		0..1	??	Amount of medication to supply per dispense	S	0..1	??	(QI-Core)(USCDI) Amount of medication to supply per dispense	Elements differ in definition for mustSupport: 'false' vs 'true'
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense		0..1	Duration	(QI-Core) Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1	boolean, CodeableConcept	Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed.		1..1	boolean, CodeableConcept	Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed.
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.		0..1	CodeableConcept	Why should (not) substitution be made Binding: ?? (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		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format