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MedicationRequest Profile

Canonical../StructureDefinition/nexus-emr-core-medicationrequest
Statusdraft · 1.26.0
BaseMedicationRequest (constraint)
SourceFSH · JSON

Defines the Nexus EMR FHIR profile for MedicationRequest resources, based on CA-Core constraints, for aggregating prescription data from multiple EMRs.

Elements / Snapshot

The full effective definition: base MedicationRequest with this profile's constraints applied.

Element Flags Card. Type Description & Constraints
MedicationRequest 0..* Nexus EMR Medication Request Core
Invariants: dom-2, dom-3, dom-4, dom-5, dom-6, nexus-note-extension-not-where-native
id 0..1 http://hl7.org/fhirpath/System.String Logical id of this artifact i
meta 0..1 Meta Metadata about the resource
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
versionId 0..1 id Version specific identifier i
Invariants: ele-1
lastUpdated 0..1 instant When the resource version last changed i
Invariants: ele-1
source S 0..1 uri Identifies EMR instance & pipeline version the resource came from i
Invariants: ele-1
profile 0..* canonical Profiles this resource claims to conform to i
Invariants: ele-1
security 0..* Coding Security Labels applied to this resource i
Binding: security-labels (extensible)
Invariants: ele-1
tag 0..* Coding Tags applied to this resource i
Binding: common-tags (example)
Invariants: ele-1
implicitRules ?! 0..1 uri A set of rules under which this content was created i
Invariants: ele-1
language 0..1 code Language of the resource content i
Binding: languages (preferred)
Invariants: ele-1
text S 0..1 Narrative Narrative i
Invariants: ele-1
contained 0..* Resource Contained, inline Resources i
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
extension:medicationStrength S 0..1 Extension(Medication Strength Extension) Medication strength information i
Invariants: ele-1, ext-1
modifierExtension ?! 0..* Extension Extensions that cannot be ignored i
Invariants: ele-1, ext-1
identifier S 0..* Identifier Business identifier(s) for medicationrequest i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
use ?! 0..1 code usual | official | temp | secondary | old (If known) i
Binding: identifier-use (required)
Invariants: ele-1
type 0..1 CodeableConcept Description of identifier i
Binding: identifier-type (extensible)
Invariants: ele-1
system 1..1 uri The namespace for the identifier value i
Invariants: ele-1
value 1..1 string The value that is unique i
Invariants: ele-1
period 0..1 Period Time period when id is/was valid for use
Invariants: ele-1
assigner 0..1 Reference(Organization) Organization that issued id (may be just text) i
Invariants: ele-1
status S ?! 1..1 code Where the prescription is in its lifecycle i
Binding: medicationrequest-status (required)
Invariants: ele-1
statusReason 0..1 CodeableConcept Reason for current status i
Binding: medicationrequest-status-reason (example)
Invariants: ele-1
intent S ?! 1..1 code proposal | plan | order | instance-order i
Fixed: order
Binding: medicationrequest-intent (required)
Invariants: ele-1
category 0..* CodeableConcept Type of medication usage i
Binding: medicationrequest-category (example)
Invariants: ele-1
priority 0..1 code routine | urgent | asap | stat
Binding: request-priority (required)
Invariants: ele-1
doNotPerform ?! 0..1 boolean True if request is prohibiting action i
Invariants: ele-1
reported[x] 0..1 boolean, Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) Reported rather than primary record
Invariants: ele-1
medication[x] S 1..1 CodeableConcept Medication, with raw code support i
Binding: medication-codes (example)
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
coding 0..* Coding Code defined by a terminology system i
Slicing: value:system (open)
Invariants: ele-1
coding:din S 0..* Coding The Health Canada Drug Identification Number for the marketed product i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
system 1..1 uri Identity of the terminology system i
Fixed: http://hl7.org/fhir/NamingSystem/ca-hc-din
Invariants: ele-1
version 0..1 string Version of the system - if relevant i
Invariants: ele-1
code 1..1 code Symbol in syntax defined by the system
Invariants: ele-1
display 0..1 string Representation defined by the system
Invariants: ele-1
userSelected 0..1 boolean If this coding was chosen directly by the user i
Invariants: ele-1
coding:ccdd S 0..* Coding CCDD — what the drug IS (preferred ingredient-level code) i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
system 1..1 uri Identity of the terminology system i
Fixed: http://terminology.hl7.org/CodeSystem/hc-CCDD
Invariants: ele-1
version 0..1 string Version of the system - if relevant i
Invariants: ele-1
code 1..1 code Symbol in syntax defined by the system
Invariants: ele-1
display 0..1 string Representation defined by the system
Invariants: ele-1
userSelected 0..1 boolean If this coding was chosen directly by the user i
Invariants: ele-1
coding:atc S 0..* Coding ATC classification — coarser ingredient-level grouping i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
system 1..1 uri Identity of the terminology system i
Fixed: http://www.whocc.no/atc
Invariants: ele-1
version 0..1 string Version of the system - if relevant i
Invariants: ele-1
code 1..1 code Symbol in syntax defined by the system
Invariants: ele-1
display 0..1 string Representation defined by the system
Invariants: ele-1
userSelected 0..1 boolean If this coding was chosen directly by the user i
Invariants: ele-1
coding:aign S 0..* Coding The active-ingredient group identifying the drug's ingredient and strength i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
system 1..1 uri Identity of the terminology system i
Fixed: http://terminology.hl7.org/CodeSystem/v3-hc-aign
Invariants: ele-1
version 0..1 string Version of the system - if relevant i
Invariants: ele-1
code 1..1 code Symbol in syntax defined by the system
Invariants: ele-1
display 0..1 string Representation defined by the system
Invariants: ele-1
userSelected 0..1 boolean If this coding was chosen directly by the user i
Invariants: ele-1
text S 1..1 string The medication as written, in human-readable form i
Invariants: ele-1
subject S 1..1 Reference(Patient Profile) Who the medication is for i
Invariants: ele-1
encounter S 0..1 Reference(Encounter Profile) Encounter during which prescription was written i
Invariants: ele-1
supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
Invariants: ele-1
authoredOn S 1..1 dateTime When prescription was written i
Invariants: ele-1
requester S 0..1 Reference(PractitionerRole Profile | Practitioner Profile) Who prescribed the medication
Invariants: ele-1
performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
Invariants: ele-1
performerType 0..1 CodeableConcept Desired kind of performer of the medication administration i
Binding: performer-role (example)
Invariants: ele-1
recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
Invariants: ele-1
reasonCode 0..* CodeableConcept Reason or indication for ordering or not ordering the medication i
Binding: condition-code (example)
Invariants: ele-1
reasonReference 0..* Reference(Condition | Observation) Condition or observation that supports why the prescription is being written i
Invariants: ele-1
instantiatesCanonical 0..* canonical Instantiates FHIR protocol or definition
Invariants: ele-1
instantiatesUri 0..* uri Instantiates external protocol or definition
Invariants: ele-1
basedOn 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
Invariants: ele-1
groupIdentifier 0..1 Identifier Composite request this is part of
Invariants: ele-1
courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration i
Binding: medicationrequest-course-of-therapy (example)
Invariants: ele-1
insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
Invariants: ele-1
note 0..* Annotation Information about the prescription
Invariants: ele-1
dosageInstruction S 0..* Dosage How medication should be taken i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
modifierExtension ?! 0..* Extension Extensions that cannot be ignored even if unrecognized i
Invariants: ele-1, ext-1
sequence 0..1 integer The order of the dosage instructions
Invariants: ele-1
text S 1..1 string Free text dosage instructions (sig)
Invariants: ele-1
additionalInstruction 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" i
Binding: additional-instruction-codes (example)
Invariants: ele-1
patientInstruction 0..1 string Patient or consumer oriented instructions
Invariants: ele-1
timing S 0..1 Timing When medication should be taken i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
modifierExtension ?! 0..* Extension Extensions that cannot be ignored even if unrecognized i
Invariants: ele-1, ext-1
event 0..* dateTime When the event occurs
Invariants: ele-1
repeat 0..1 Element When the event is to occur
Invariants: ele-1, tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
bounds[x] 0..1 Duration, Range, Period Length/Range of lengths, or (Start and/or end) limits
Slicing: type:$this (open)
Invariants: ele-1
bounds[x]:boundsPeriod 0..1 Period Length/Range of lengths, or (Start and/or end) limits
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
start 0..1 dateTime Starting time with inclusive boundary i
Invariants: ele-1
end 0..1 dateTime End time with inclusive boundary, if not ongoing i
Invariants: ele-1
bounds[x]:boundsDuration 0..1 Duration Length/Range of lengths, or (Start and/or end) limits
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
value 0..1 decimal Numerical value (with implicit precision) i
Invariants: ele-1
comparator ?! 0..1 code < | <= | >= | > - how to understand the value
Binding: quantity-comparator (required)
Invariants: ele-1
unit 0..1 string Unit representation
Invariants: ele-1
system 0..1 uri System that defines coded unit form
Invariants: ele-1
code 0..1 code Coded form of the unit i
Invariants: ele-1
count 0..1 positiveInt Number of times to repeat i
Invariants: ele-1
countMax 0..1 positiveInt Maximum number of times to repeat
Invariants: ele-1
duration 0..1 decimal How long when it happens i
Invariants: ele-1
durationMax 0..1 decimal How long when it happens (Max) i
Invariants: ele-1
durationUnit 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: units-of-time (required)
Invariants: ele-1
frequency 0..1 positiveInt Event occurs frequency times per period
Invariants: ele-1
frequencyMax 0..1 positiveInt Event occurs up to frequencyMax times per period
Invariants: ele-1
period 0..1 decimal Event occurs frequency times per period
Invariants: ele-1
periodMax 0..1 decimal Upper limit of period (3-4 hours)
Invariants: ele-1
periodUnit 0..1 code s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: units-of-time (required)
Invariants: ele-1
dayOfWeek 0..* code mon | tue | wed | thu | fri | sat | sun i
Binding: days-of-week (required)
Invariants: ele-1
timeOfDay 0..* time Time of day for action i
Invariants: ele-1
when 0..* code Code for time period of occurrence i
Binding: event-timing (required)
Invariants: ele-1
offset 0..1 unsignedInt Minutes from event (before or after)
Invariants: ele-1
code 0..1 CodeableConcept BID | TID | QID | AM | PM | QD | QOD | + i
Binding: timing-abbreviation (preferred)
Invariants: ele-1
asNeeded[x] 0..1 boolean, CodeableConcept Take "as needed" (for x) i
Binding: medication-as-needed-reason (example)
Invariants: ele-1
site 0..1 CodeableConcept Body site to administer to i
Binding: approach-site-codes (example)
Invariants: ele-1
route S 0..1 CodeableConcept Route of administration with raw code support
Binding: route-codes (preferred)
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
coding 0..* Coding Code defined by a terminology system i
Invariants: ele-1
text S 1..1 string Human-readable route description (required) i
Invariants: ele-1
method 0..1 CodeableConcept Technique for administering medication i
Binding: administration-method-codes (example)
Invariants: ele-1
doseAndRate 0..* Element Amount of medication administered
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
type 0..1 CodeableConcept The kind of dose or rate specified
Binding: dose-rate-type (example)
Invariants: ele-1
dose[x] 0..1 Range, Quantity(SimpleQuantity) Amount of medication per dose i
Slicing: type:$this (open)
Invariants: ele-1
dose[x]:doseQuantity 0..1 Quantity(SimpleQuantity) Patient-administered dose quantity (e.g., 2 tablets) i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
value 1..1 decimal Numerical value (with implicit precision) i
Invariants: ele-1
comparator ?! 0..0 code < | <= | >= | > - how to understand the value
Binding: quantity-comparator (required)
Invariants: ele-1
unit 1..1 string Unit representation
Invariants: ele-1
system 0..1 uri System that defines coded unit form
Invariants: ele-1
code 0..1 code Coded form of the unit i
Binding: ucum-units (required)
Invariants: ele-1
dose[x]:doseRange 0..1 Range Patient-administered dose range (e.g., 2-5 tablets) i
Invariants: ele-1
rate[x] 0..1 Ratio, Range, Quantity(SimpleQuantity) Amount of medication per unit of time i
Invariants: ele-1
maxDosePerPeriod 0..1 Ratio Upper limit on medication per unit of time i
Invariants: ele-1
maxDosePerAdministration 0..1 Quantity(SimpleQuantity) Upper limit on medication per administration i
Invariants: ele-1
maxDosePerLifetime 0..1 Quantity(SimpleQuantity) Upper limit on medication per lifetime of the patient
Invariants: ele-1
dispenseRequest S 0..1 BackboneElement Pharmacy dispensing instructions
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Invariants: ele-1, ext-1
modifierExtension ?! 0..* Extension Extensions that cannot be ignored even if unrecognized i
Invariants: ele-1, ext-1
initialFill 0..1 BackboneElement First fill details i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Invariants: ele-1, ext-1
modifierExtension ?! 0..* Extension Extensions that cannot be ignored even if unrecognized i
Invariants: ele-1, ext-1
quantity 0..1 Quantity(SimpleQuantity) First fill quantity
Invariants: ele-1
duration 0..1 Duration First fill duration
Invariants: ele-1
dispenseInterval 0..1 Duration Minimum period of time between dispenses
Invariants: ele-1
validityPeriod 0..1 Period Time period supply is authorized for i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
start 0..1 dateTime Starting time with inclusive boundary i
Invariants: ele-1
end 0..1 dateTime End time with inclusive boundary, if not ongoing i
Invariants: ele-1
numberOfRepeatsAllowed S 0..1 unsignedInt Number of refills authorized i
Invariants: ele-1
quantity S 0..1 Quantity(SimpleQuantity) Amount to dispense
Invariants: ele-1
expectedSupplyDuration 0..1 Duration Number of days supply per dispense i
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Slicing: value:url (open)
Invariants: ele-1, ext-1
value 1..1 decimal Numerical value (with implicit precision) i
Invariants: ele-1
comparator ?! 0..1 code < | <= | >= | > - how to understand the value
Binding: quantity-comparator (required)
Invariants: ele-1
unit 1..1 string Unit representation
Invariants: ele-1
system 1..1 uri System that defines coded unit form
Fixed: http://unitsofmeasure.org
Invariants: ele-1
code 1..1 code Coded form of the unit i
Invariants: ele-1
performer 0..1 Reference(Organization) Intended dispenser
Invariants: ele-1
substitution 0..1 BackboneElement Any restrictions on medication substitution
Invariants: ele-1
id 0..1 http://hl7.org/fhirpath/System.String Unique id for inter-element referencing
extension 0..* Extension Additional content defined by implementations i
Invariants: ele-1, ext-1
modifierExtension ?! 0..* Extension Extensions that cannot be ignored even if unrecognized i
Invariants: ele-1, ext-1
allowed[x] 1..1 boolean, CodeableConcept Whether substitution is allowed or not i
Binding: v3-ActSubstanceAdminSubstitutionCode (example)
Invariants: ele-1
reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: v3-SubstanceAdminSubstitutionReason (example)
Invariants: ele-1
priorPrescription 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
Invariants: ele-1
detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action i
Invariants: ele-1
eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle i
Invariants: ele-1