CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
1.0.0 - Release 1

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Downloaded Version 1.0.0 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: 1.0.0
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 is based on the HL7 FHIR® US Core MedicationRequest Profile v3.1.1.

Usages:

- Examples for this Profile: MedicationRequest/medicationrequest-example-ach-monthly-pass1-vancomycin, MedicationRequest/medicationrequest-example-ach-monthly-pass2-dex4-tablet, MedicationRequest/medicationrequest-example-ach-monthly-pass2-heparin, MedicationRequest/medicationrequest-example-ach-monthly-pass2-insulin-lispro... Show 4 more, MedicationRequest/medicationrequest-example-ach-monthly-pass2-metformin, MedicationRequest/medicationrequest-example-ach-monthly-pass3-cipro, MedicationRequest/medicationrequest-example-ach-monthly-pass3-enoxaparin and MedicationRequest/medicationrequest-example-ach-monthly-pass3-metronidazole

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group
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
status | ?!S Σ | 1..1 | code | 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 | ?!S Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (extensible)
priority | S Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!S Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | S Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) |
reported[x]:reportedReference | S Σ | 0..1 | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | Reported rather than primary record
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
medication[x]:medicationReference | S Σ | 0..1 | Reference(US Core Medication Profile) | Medication to be taken
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | Who or group medication request is for
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
encounter | S | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile) | Who/What requested the Request
reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference | S | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
instantiatesCanonical | S Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | S Σ | 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 | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | S Σ | 0..1 |  | 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 | S Σ | 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 | Σ | 1..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (extensible)
method | S Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
type | S Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | S Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status` From the FHIR Standard
MedicationRequest.statusReason | extensible | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent` From the FHIR Standard
MedicationRequest.category | extensible | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | extensible | Medication Clinical Drug `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4` From https://vsac.nlm.nih.gov
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` From the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.route | extensible | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |

This structure is derived from USCoreMedicationRequestProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | USCoreMedicationRequestProfile | 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
statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (extensible)
category | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (extensible)
priority | S | 0..1 | code | routine | urgent | asap | stat
doNotPerform | S | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] |  | 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:$this
reported[x]:reportedReference |  | 0..1 | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | Reported rather than primary record
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for medication[x] |  | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | Medication to be taken Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationReference |  | 0..1 | Reference(US Core Medication Profile) | Medication to be taken
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
subject |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
encounter |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication
reasonReference | S | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
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 |  |  |  |
timing | S | 0..1 | Timing | When medication should be administered
asNeeded[x] | S | 0..1 | boolean, CodeableConcept | Take "as needed" (for x)
site | S | 0..1 | CodeableConcept | Body site to administer to
route |  | 1..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (extensible)
method | S | 0..1 | CodeableConcept | Technique for administering medication
doseAndRate | S | 0..* | Element | Amount of medication administered
type | S | 0..1 | CodeableConcept | The kind of dose or rate specified
dose[x] | S | 0..1 | Range, SimpleQuantity | Amount of medication per dose
rate[x] | S | 0..1 | Ratio, Range, SimpleQuantity | Amount of medication per unit of time
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.statusReason | extensible | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.category | extensible | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.medication[x] | extensible | Medication Clinical Drug `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4` From https://vsac.nlm.nih.gov
MedicationRequest.dosageInstruction.route | extensible | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` From the FHIR Standard

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group
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 Bindings | Purpose
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 | ?!S Σ | 1..1 | code | 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 | ?!S Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (extensible)
priority | S Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!S Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | S Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) |
reported[x]:reportedReference | S Σ | 0..1 | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | Reported rather than primary record
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
medication[x]:medicationReference | S Σ | 0..1 | Reference(US Core Medication Profile) | 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 | S Σ C | 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 | S Σ | 1..1 | Reference(US Core Patient Profile) | 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 | S Σ C | 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(Encounter) | 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 | S Σ C | 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 | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile) | 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 | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference | S | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
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 | S Σ C | 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 | S Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | S Σ | 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 | How the 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 | S Σ | 0..1 | string | 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 | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | S Σ | 0..1 |  | 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 | S Σ | 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 | Σ | 1..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (extensible)
method | S Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | 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 | S Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | S Σ | 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 |  | 0..1 | BackboneElement | 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 | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | 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
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` From the FHIR Standard
MedicationRequest.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` From the FHIR Standard
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status` From the FHIR Standard
MedicationRequest.statusReason | extensible | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent` From the FHIR Standard
MedicationRequest.category | extensible | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.reported[x]:reportedReference.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | extensible | Medication Clinical Drug `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4` From https://vsac.nlm.nih.gov
MedicationRequest.medication[x]:medicationReference.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.encounter.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.reasonReference.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` From the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.route | extensible | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` From the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode|3.0.0`
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason|3.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |

This structure is derived from USCoreMedicationRequestProfile

Summary

Mandatory: 2 elements(5 nested mandatory elements)
Must-Support: 22 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
- US Core Medication Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication)

Extensions

This structure refers to these extensions:

- http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.reported[x]
- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group
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
status | ?!S Σ | 1..1 | code | 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 | ?!S Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (extensible)
priority | S Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!S Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | S Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) |
reported[x]:reportedReference | S Σ | 0..1 | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | Reported rather than primary record
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
medication[x]:medicationReference | S Σ | 0..1 | Reference(US Core Medication Profile) | Medication to be taken
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | Who or group medication request is for
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
encounter | S | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile) | Who/What requested the Request
reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference | S | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
instantiatesCanonical | S Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | S Σ | 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 | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | S Σ | 0..1 |  | 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 | S Σ | 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 | Σ | 1..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (extensible)
method | S Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
type | S Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | S Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status` From the FHIR Standard
MedicationRequest.statusReason | extensible | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent` From the FHIR Standard
MedicationRequest.category | extensible | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | extensible | Medication Clinical Drug `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4` From https://vsac.nlm.nih.gov
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` From the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.route | extensible | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |

Differential View

This structure is derived from USCoreMedicationRequestProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | USCoreMedicationRequestProfile | 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
statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (extensible)
category | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (extensible)
priority | S | 0..1 | code | routine | urgent | asap | stat
doNotPerform | S | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] |  | 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:$this
reported[x]:reportedReference |  | 0..1 | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | Reported rather than primary record
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for medication[x] |  | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | Medication to be taken Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationReference |  | 0..1 | Reference(US Core Medication Profile) | Medication to be taken
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
subject |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
encounter |  |  |  |
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication
reasonReference | S | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
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 |  |  |  |
timing | S | 0..1 | Timing | When medication should be administered
asNeeded[x] | S | 0..1 | boolean, CodeableConcept | Take "as needed" (for x)
site | S | 0..1 | CodeableConcept | Body site to administer to
route |  | 1..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (extensible)
method | S | 0..1 | CodeableConcept | Technique for administering medication
doseAndRate | S | 0..* | Element | Amount of medication administered
type | S | 0..1 | CodeableConcept | The kind of dose or rate specified
dose[x] | S | 0..1 | Range, SimpleQuantity | Amount of medication per dose
rate[x] | S | 0..1 | Ratio, Range, SimpleQuantity | Amount of medication per unit of time
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.statusReason | extensible | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.category | extensible | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.medication[x] | extensible | Medication Clinical Drug `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4` From https://vsac.nlm.nih.gov
MedicationRequest.dosageInstruction.route | extensible | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` From the FHIR Standard

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group
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 Bindings | Purpose
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 | ?!S Σ | 1..1 | code | 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 | ?!S Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (extensible)
priority | S Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!S Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | S Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) |
reported[x]:reportedReference | S Σ | 0..1 | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | Reported rather than primary record
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
medication[x]:medicationReference | S Σ | 0..1 | Reference(US Core Medication Profile) | 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 | S Σ C | 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 | S Σ | 1..1 | Reference(US Core Patient Profile) | 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 | S Σ C | 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(Encounter) | 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 | S Σ C | 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 | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile) | 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 | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference | S | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
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 | S Σ C | 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 | S Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | S Σ | 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 | How the 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 | S Σ | 0..1 | string | 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 | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | S Σ | 0..1 |  | 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 | S Σ | 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 | Σ | 1..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (extensible)
method | S Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | 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 | S Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | S Σ | 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 |  | 0..1 | BackboneElement | 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 | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | 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
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` From the FHIR Standard
MedicationRequest.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` From the FHIR Standard
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status` From the FHIR Standard
MedicationRequest.statusReason | extensible | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent` From the FHIR Standard
MedicationRequest.category | extensible | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.reported[x]:reportedReference.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | extensible | Medication Clinical Drug `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4` From https://vsac.nlm.nih.gov
MedicationRequest.medication[x]:medicationReference.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.encounter.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.reasonReference.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` From the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.route | extensible | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` From the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode|3.0.0`
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason|3.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
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() |

This structure is derived from USCoreMedicationRequestProfile

Summary

Mandatory: 2 elements(5 nested mandatory elements)
Must-Support: 22 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
- US Core Medication Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication)

Extensions

This structure refers to these extensions:

- http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.reported[x]
- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Maturity: 1

Other representations of profile: CSV, Excel, Schematron