Implementation Guide
ePA Medication Service
Version 1.2.0-ballot.2 - draft

## Resource Profile: EPAMedicationRequest - Detailed Descriptions

Draft as of 2025-09-02

Definitions for the epa-medication-request resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationRequest
Definition | An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Short | Ordering of medication for patient or group
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Prescription, Order
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationRequest.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Meta
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Version specific identifier
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. MedicationRequest.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Short | When the resource version last changed
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationRequest.extension:multiplePrescription
Slice Name | multiplePrescription
Definition | This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.
Short | MultiplePrescription
Control | 0..1
Type | Extension(MultiplePrescription) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
12. MedicationRequest.extension:multiplePrescription.extension:indicator
Slice Name | indicator
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. MedicationRequest.extension:multiplePrescription.extension:indicator.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. MedicationRequest.extension:multiplePrescription.extension:indicator.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `indicator`
18. MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
Definition | Indicator of whether the current prescription is part of a multiple prescription true - the current prescription is part of a multiple prescription false - the current prescription is not part of a multiple prescription Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Multiple Prescription IndicatorValue of extension
Control | 10..1 This element is affected by the following invariants: ele-1
Type | boolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. MedicationRequest.extension:multiplePrescription.extension:counter
Slice Name | counter
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. MedicationRequest.extension:multiplePrescription.extension:counter.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. MedicationRequest.extension:multiplePrescription.extension:counter.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `counter`
26. MedicationRequest.extension:multiplePrescription.extension:counter.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Ratio, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator
Definition | The value of the numerator.
Short | Numerator value
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Quantity
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
30. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
Definition | The field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4" The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | Multiple Prescription CounterNumerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 10..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..01
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 0..01
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..01 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..01
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator
Definition | The value of the denominator.
Short | Denominator value
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Quantity
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
42. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
Definition | The field serves to indicate the length of this series. Example: "4" in "2 out of 4" The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | Denominator of Multiple Prescription SeriesNumerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 10..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..01
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 0..01
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..01 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..01
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. MedicationRequest.extension:multiplePrescription.extension:period
Slice Name | period
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
54. MedicationRequest.extension:multiplePrescription.extension:period.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
56. MedicationRequest.extension:multiplePrescription.extension:period.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `period`
58. MedicationRequest.extension:multiplePrescription.extension:period.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Period, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD (`start.toString().length()=10`) -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD (`end.exists().not() or end.toString().length()=10`)
60. MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
Definition | Date from which the partial prescription of the multiple prescription can be redeemed The start of the period. The boundary is inclusive.
Short | Start Date of the Prescription Redemption PeriodStarting time with inclusive boundary
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 10..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. MedicationRequest.extension:multiplePrescription.extension:period.value[x].end
Definition | Date of the last redemption day for the partial prescription within the multiple prescription series. The issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV) The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Short | End Date of the Prescription Redemption PeriodEnd time with inclusive boundary, if not ongoing
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Control | 0..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. MedicationRequest.extension:multiplePrescription.extension:id
Slice Name | id
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
66. MedicationRequest.extension:multiplePrescription.extension:id.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
68. MedicationRequest.extension:multiplePrescription.extension:id.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `id`
70. MedicationRequest.extension:multiplePrescription.extension:id.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Identifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. MedicationRequest.extension:multiplePrescription.extension:id.value[x].use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..01
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. MedicationRequest.extension:multiplePrescription.extension:id.value[x].type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..01 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. MedicationRequest.extension:multiplePrescription.extension:id.value[x].system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | Specification as UUIDThe namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `urn:ietf:rfc:3986`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
Definition | A unique ID that is identical across all partial prescriptions of a multiple prescription. The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | Multiple Prescription IDThe value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. MedicationRequest.extension:multiplePrescription.extension:id.value[x].period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
Control | 0..01 This element is affected by the following invariants: ele-1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
82. MedicationRequest.extension:multiplePrescription.extension:id.value[x].assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..01 This element is affected by the following invariants: ele-1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
84. MedicationRequest.extension:multiplePrescription.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension`
86. MedicationRequest.extension:multiplePrescription.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..01 This element is affected by the following invariants: ele-1
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. MedicationRequest.extension:isBvg
Slice Name | isBvg
Definition | Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.
Short | Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(IndicatorBVGExtension) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. MedicationRequest.extension:isBvg.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
92. MedicationRequest.extension:isBvg.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension`
94. MedicationRequest.extension:isBvg.value[x]
Definition | Indicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG). false - not BVG (default value) true - BVG Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | BVGValue of extension
Control | 10..1 This element is affected by the following invariants: ele-1
Type | boolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. MedicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `MedicationRequest.modifierExtension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
98. MedicationRequest.identifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationRequest.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
100. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
Slice Name | RxPrescriptionProcessIdentifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Identifier(RxPrescriptionProcessIdentifier)
Is Modifier | false
Pattern Value | `{ "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. MedicationRequest.identifier:RxOriginatorProcessIdentifier
Slice Name | RxOriginatorProcessIdentifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Identifier(RxOriginatorProcessIdentifier)
Is Modifier | false
Pattern Value | `{ "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. MedicationRequest.status
Definition | A code specifying the current state of the order. Generally, this will be active or completed state.
Short | Status of Medication Requestactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` ) A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. MedicationRequest.intent
Definition | e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here. Whether the request is a proposal, plan, or an original order.
Short | filler-orderproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` ) The kind of medication order.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. MedicationRequest.doNotPerform
Definition | If true indicates that the provider is asking for the medication request not to occur.
Short | True if request is prohibiting action
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform".
Control | 0..1
Type | boolean
Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. MedicationRequest.medication[x]
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Medication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Medication), CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. MedicationRequest.subject
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given.
Short | Who or group medication request is for
Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient, Group)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
114. MedicationRequest.subject.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1 This element is affected by the following invariants: ele-1
Type | Identifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. MedicationRequest.authoredOn
Definition | Issue Date of the Prescription The date (and perhaps time) when the prescription was initially written or authored on.
Short | Issue DateWhen request was initially authored
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. MedicationRequest.requester
Definition | The individual, organization, or device that initiated the request and has responsibility for its activation.
Short | Who/What requested the Request
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Organization, Practitioner, PractitionerRole, Patient, RelatedPerson, Device)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
120. MedicationRequest.basedOn
Definition | A plan or request that is fulfilled in whole or in part by this medication request.
Short | What request fulfills
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(eMP-Eintrag, CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
122. MedicationRequest.basedOn.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. MedicationRequest.basedOn.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(Profil für den Identifikator eines eMP-Eintrags)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. MedicationRequest.note
Definition | Extra information about the prescription that could not be conveyed by the other attributes.
Short | Information about the prescription
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Control | 0..1* This element is affected by the following invariants: ele-1
Type | Annotation
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. MedicationRequest.note.text
Definition | Instructions to the pharmacy that go beyond the dosage information The text of the annotation in markdown format.
Short | Dispensing NoteThe annotation - text content (as markdown)
Comments | Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
Control | 1..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. MedicationRequest.dosageInstruction
Definition | Hier werden Informationen zur Dosierung angegeben. Indicates how the medication is to be used by the patient.
Short | Hier werden Informationen zur Dosierung angegeben.How the medication should be taken
Comments | There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
Control | 0..*
Type | Dosage(Dosage dgMP)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. MedicationRequest.dispenseRequest
Definition | Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Short | Medication supply authorization
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. MedicationRequest.dispenseRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
136. MedicationRequest.dispenseRequest.quantity
Definition | The amount that is to be dispensed for one fill.
Short | Amount of medication to supply per dispense
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists()) sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
138. MedicationRequest.dispenseRequest.quantity.value
Definition | Number of Prescribed Packages The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | Number of Prescribed PackagesNumerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 10..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. MedicationRequest.dispenseRequest.quantity.comparator
Definition | Not allowed to be used in this context How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..01
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. MedicationRequest.dispenseRequest.quantity.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. MedicationRequest.dispenseRequest.quantity.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. MedicationRequest.dispenseRequest.quantity.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. MedicationRequest.substitution
Definition | Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Short | Any restrictions on medication substitution
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. MedicationRequest.substitution.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. MedicationRequest.substitution.allowed[x]
Definition | True if the prescriber allows a different drug to be dispensed from what was prescribed.
Short | Whether substitution is allowed or not
Comments | This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | boolean, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationRequest
2. MedicationRequest.meta
Must Support | true
4. MedicationRequest.meta.versionId
Must Support | true
6. MedicationRequest.meta.lastUpdated
Must Support | true
8. MedicationRequest.extension:multiplePrescription
Slice Name | multiplePrescription
Control | 0..1
Type | Extension(MultiplePrescription) (Complex Extension)
Must Support | true
10. MedicationRequest.extension:multiplePrescription.extension:indicator
Slice Name | indicator
12. MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
14. MedicationRequest.extension:multiplePrescription.extension:counter
Slice Name | counter
16. MedicationRequest.extension:multiplePrescription.extension:counter.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
18. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator
Must Support | true
20. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
Must Support | true
22. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator
Must Support | true
24. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
Must Support | true
26. MedicationRequest.extension:multiplePrescription.extension:period
Slice Name | period
28. MedicationRequest.extension:multiplePrescription.extension:period.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
30. MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
Must Support | true
32. MedicationRequest.extension:multiplePrescription.extension:period.value[x].end
Must Support | true
34. MedicationRequest.extension:multiplePrescription.extension:id
Slice Name | id
36. MedicationRequest.extension:multiplePrescription.extension:id.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
38. MedicationRequest.extension:multiplePrescription.extension:id.value[x].system
Must Support | true
40. MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
Must Support | true
42. MedicationRequest.extension:isBvg
Slice Name | isBvg
Control | 0..1
Type | Extension(IndicatorBVGExtension) (Extension Type: boolean)
Must Support | true
44. MedicationRequest.extension:isBvg.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
46. MedicationRequest.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Slicing | This element introduces a set of slices on `MedicationRequest.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
48. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
Slice Name | RxPrescriptionProcessIdentifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier(RxPrescriptionProcessIdentifier)
Pattern Value | `{ "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier" }`
50. MedicationRequest.identifier:RxOriginatorProcessIdentifier
Slice Name | RxOriginatorProcessIdentifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier(RxOriginatorProcessIdentifier)
Pattern Value | `{ "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier" }`
52. MedicationRequest.status
Short | Status of Medication Request
Must Support | true
54. MedicationRequest.intent
Definition | e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.
Short | filler-order
Must Support | true
56. MedicationRequest.medication[x]
Type | Reference(Medication), CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
58. MedicationRequest.subject
Type | Reference(Patient)
Must Support | true
60. MedicationRequest.subject.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
Type | Identifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
Must Support | true
62. MedicationRequest.authoredOn
Definition | Issue Date of the Prescription
Short | Issue Date
Control | 1..?
Must Support | true
64. MedicationRequest.requester
Type | Reference(Organization, Practitioner, PractitionerRole)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
66. MedicationRequest.basedOn
Type | Reference(eMP-Eintrag)
Must Support | true
68. MedicationRequest.basedOn.reference
Must Support | true
70. MedicationRequest.basedOn.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Type | Identifier(Profil für den Identifikator eines eMP-Eintrags)
Must Support | true
72. MedicationRequest.note
Control | 0..1
Must Support | true
74. MedicationRequest.note.text
Definition | Instructions to the pharmacy that go beyond the dosage information
Short | Dispensing Note
Must Support | true
76. MedicationRequest.dosageInstruction
Definition | Hier werden Informationen zur Dosierung angegeben.
Short | Hier werden Informationen zur Dosierung angegeben.
Type | Dosage(Dosage dgMP)
Must Support | true
78. MedicationRequest.dispenseRequest
Must Support | true
80. MedicationRequest.dispenseRequest.quantity
Must Support | true
82. MedicationRequest.dispenseRequest.quantity.value
Definition | Number of Prescribed Packages
Short | Number of Prescribed Packages
Control | 1..?
Must Support | true
84. MedicationRequest.dispenseRequest.quantity.unit
Must Support | true
86. MedicationRequest.dispenseRequest.quantity.system
Must Support | true
Pattern Value | `http://unitsofmeasure.org`
88. MedicationRequest.dispenseRequest.quantity.code
Must Support | true
90. MedicationRequest.substitution
Must Support | true
92. MedicationRequest.substitution.allowed[x]
Type | boolean, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationRequest
Definition | An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Short | Ordering of medication for patient or group
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Prescription, Order
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. MedicationRequest.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. MedicationRequest.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. MedicationRequest.meta.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
8. MedicationRequest.meta.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.meta.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. MedicationRequest.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Version specific identifier
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. MedicationRequest.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Short | When the resource version last changed
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. MedicationRequest.meta.source
Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Short | Identifies where the resource comes from
Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. MedicationRequest.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. MedicationRequest.meta.security
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Short | Security Labels applied to this resource
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. MedicationRequest.meta.tag
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Short | Tags applied to this resource
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | For example codes, see CommonTags (example to `http://hl7.org/fhir/ValueSet/common-tags` ) Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. MedicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. MedicationRequest.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. MedicationRequest.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. MedicationRequest.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
30. MedicationRequest.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. MedicationRequest.extension:multiplePrescription
Slice Name | multiplePrescription
Definition | This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.
Short | MultiplePrescription
Control | 0..1
Type | Extension(MultiplePrescription) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
34. MedicationRequest.extension:multiplePrescription.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
36. MedicationRequest.extension:multiplePrescription.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
38. MedicationRequest.extension:multiplePrescription.extension:indicator
Slice Name | indicator
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
40. MedicationRequest.extension:multiplePrescription.extension:indicator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
42. MedicationRequest.extension:multiplePrescription.extension:indicator.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
44. MedicationRequest.extension:multiplePrescription.extension:indicator.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `indicator`
46. MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
Definition | Indicator of whether the current prescription is part of a multiple prescription true - the current prescription is part of a multiple prescription false - the current prescription is not part of a multiple prescription
Short | Multiple Prescription Indicator
Control | 1..1 This element is affected by the following invariants: ele-1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. MedicationRequest.extension:multiplePrescription.extension:counter
Slice Name | counter
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
50. MedicationRequest.extension:multiplePrescription.extension:counter.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
52. MedicationRequest.extension:multiplePrescription.extension:counter.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
54. MedicationRequest.extension:multiplePrescription.extension:counter.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `counter`
56. MedicationRequest.extension:multiplePrescription.extension:counter.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Ratio
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
60. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
62. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator
Definition | The value of the numerator.
Short | Numerator value
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Quantity
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
64. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
66. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.value[x].numerator.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
68. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
Definition | The field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4"
Short | Multiple Prescription Counter
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..0
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 0..0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..0 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..0
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator
Definition | The value of the denominator.
Short | Denominator value
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Quantity
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
80. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
82. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.value[x].denominator.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
84. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
Definition | The field serves to indicate the length of this series. Example: "4" in "2 out of 4"
Short | Denominator of Multiple Prescription Series
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..0
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 0..0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..0 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..0
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. MedicationRequest.extension:multiplePrescription.extension:period
Slice Name | period
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
96. MedicationRequest.extension:multiplePrescription.extension:period.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
98. MedicationRequest.extension:multiplePrescription.extension:period.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
100. MedicationRequest.extension:multiplePrescription.extension:period.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `period`
102. MedicationRequest.extension:multiplePrescription.extension:period.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD (`start.toString().length()=10`) -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD (`end.exists().not() or end.toString().length()=10`)
104. MedicationRequest.extension:multiplePrescription.extension:period.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
106. MedicationRequest.extension:multiplePrescription.extension:period.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
108. MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
Definition | Date from which the partial prescription of the multiple prescription can be redeemed
Short | Start Date of the Prescription Redemption Period
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 1..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. MedicationRequest.extension:multiplePrescription.extension:period.value[x].end
Definition | Date of the last redemption day for the partial prescription within the multiple prescription series. The issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)
Short | End Date of the Prescription Redemption Period
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Control | 0..1 This element is affected by the following invariants: per-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. MedicationRequest.extension:multiplePrescription.extension:id
Slice Name | id
Definition | An Extension
Short | Extension
Control | 0..1
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. MedicationRequest.extension:multiplePrescription.extension:id.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
116. MedicationRequest.extension:multiplePrescription.extension:id.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
118. MedicationRequest.extension:multiplePrescription.extension:id.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `id`
120. MedicationRequest.extension:multiplePrescription.extension:id.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Identifier
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. MedicationRequest.extension:multiplePrescription.extension:id.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
124. MedicationRequest.extension:multiplePrescription.extension:id.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
126. MedicationRequest.extension:multiplePrescription.extension:id.value[x].use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..0
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. MedicationRequest.extension:multiplePrescription.extension:id.value[x].type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..0 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. MedicationRequest.extension:multiplePrescription.extension:id.value[x].system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | Specification as UUID
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `urn:ietf:rfc:3986`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
Definition | A unique ID that is identical across all partial prescriptions of a multiple prescription.
Short | Multiple Prescription ID
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. MedicationRequest.extension:multiplePrescription.extension:id.value[x].period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
Control | 0..0 This element is affected by the following invariants: ele-1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) per-1: If present, start SHALL have a lower value than end (`start.hasValue().not() or end.hasValue().not() or (start <= end)`)
136. MedicationRequest.extension:multiplePrescription.extension:id.value[x].assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..0 This element is affected by the following invariants: ele-1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
138. MedicationRequest.extension:multiplePrescription.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension`
140. MedicationRequest.extension:multiplePrescription.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..0 This element is affected by the following invariants: ele-1
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
142. MedicationRequest.extension:isBvg
Slice Name | isBvg
Definition | Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.
Short | Extension
Control | 0..1
Type | Extension(IndicatorBVGExtension) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
144. MedicationRequest.extension:isBvg.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
146. MedicationRequest.extension:isBvg.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
148. MedicationRequest.extension:isBvg.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension`
150. MedicationRequest.extension:isBvg.value[x]
Definition | Indicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG). false - not BVG (default value) true - BVG
Short | BVG
Control | 1..1 This element is affected by the following invariants: ele-1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. MedicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.modifierExtension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
154. MedicationRequest.identifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `MedicationRequest.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
156. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
Slice Name | RxPrescriptionProcessIdentifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(RxPrescriptionProcessIdentifier)
Is Modifier | false
Pattern Value | `{ "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. MedicationRequest.identifier:RxOriginatorProcessIdentifier
Slice Name | RxOriginatorProcessIdentifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(RxOriginatorProcessIdentifier)
Is Modifier | false
Pattern Value | `{ "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. MedicationRequest.status
Definition | A code specifying the current state of the order. Generally, this will be active or completed state.
Short | Status of Medication Request
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from medicationrequest Status (required to `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` ) A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. MedicationRequest.statusReason
Definition | Captures the reason for the current state of the MedicationRequest.
Short | Reason for current status
Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see medicationRequest Status Reason Codes (example to `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` ) Identifies the reasons for a given status.
Type | CodeableConcept
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. MedicationRequest.intent
Definition | e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.
Short | filler-order
Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from medicationRequest Intent (required to `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` ) The kind of medication order.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. MedicationRequest.category
Definition | Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Short | Type of medication usage
Comments | The category can be used to include where the medication is expected to be consumed or other types of requests.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | For example codes, see medicationRequest Category Codes (example to `http://hl7.org/fhir/ValueSet/medicationrequest-category` ) A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
Type | CodeableConcept
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. MedicationRequest.priority
Definition | Indicates how quickly the Medication Request should be addressed with respect to other requests.
Short | routine | urgent | asap | stat
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority (required to `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` ) Identifies the level of importance to be assigned to actioning the request.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
170. MedicationRequest.doNotPerform
Definition | If true indicates that the provider is asking for the medication request not to occur.
Short | True if request is prohibiting action
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform".
Control | 0..1
Type | boolean
Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
172. MedicationRequest.reported[x]
Definition | Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Short | Reported rather than primary record
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Choice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. MedicationRequest.medication[x]
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Medication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
176. MedicationRequest.subject
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given.
Short | Who or group medication request is for
Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
178. MedicationRequest.subject.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
180. MedicationRequest.subject.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.subject.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
182. MedicationRequest.subject.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. MedicationRequest.subject.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. MedicationRequest.subject.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Identifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. MedicationRequest.subject.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. MedicationRequest.encounter
Definition | The Encounter during which this [x] was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of encounter/admission/stay
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Encounter)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
192. MedicationRequest.supportingInformation
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Information to support ordering of the medication
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Resource)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
194. MedicationRequest.authoredOn
Definition | Issue Date of the Prescription
Short | Issue Date
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. MedicationRequest.requester
Definition | The individual, organization, or device that initiated the request and has responsibility for its activation.
Short | Who/What requested the Request
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Organization, Practitioner, PractitionerRole)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
198. MedicationRequest.performer
Definition | The specified desired performer of the medication treatment (e.g. the performer of the medication administration).
Short | Intended performer of administration
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
200. MedicationRequest.performerType
Definition | Indicates the type of performer of the administration of the medication.
Short | Desired kind of performer of the medication administration
Comments | If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see ProcedurePerformerRoleCodes (example to `http://hl7.org/fhir/ValueSet/performer-role` ) Identifies the type of individual that is desired to administer the medication.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
202. MedicationRequest.recorder
Definition | The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Short | Person who entered the request
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Practitioner, PractitionerRole)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
204. MedicationRequest.reasonCode
Definition | The reason or the indication for ordering or not ordering the medication.
Short | Reason or indication for ordering or not ordering the medication
Comments | This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | For example codes, see Condition/Problem/DiagnosisCodes (example to `http://hl7.org/fhir/ValueSet/condition-code` ) A coded concept indicating why the medication was ordered.
Type | CodeableConcept
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
206. MedicationRequest.reasonReference
Definition | Condition or observation that supports why the medication was ordered.
Short | Condition or observation that supports why the prescription is being written
Comments | This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Condition, Observation)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
208. MedicationRequest.instantiatesCanonical
Definition | The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
Short | Instantiates FHIR protocol or definition
Comments | see Canonical References
Control | 0..*
Type | canonical
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. MedicationRequest.instantiatesUri
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.
Short | Instantiates external protocol or definition
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..*
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
212. MedicationRequest.basedOn
Definition | A plan or request that is fulfilled in whole or in part by this medication request.
Short | What request fulfills
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(eMP-Eintrag)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
214. MedicationRequest.basedOn.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
216. MedicationRequest.basedOn.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.basedOn.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
218. MedicationRequest.basedOn.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. MedicationRequest.basedOn.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. MedicationRequest.basedOn.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(Profil für den Identifikator eines eMP-Eintrags)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. MedicationRequest.basedOn.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. MedicationRequest.groupIdentifier
Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
Short | Composite request this is part of
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. MedicationRequest.courseOfTherapyType
Definition | The description of the overall patte3rn of the administration of the medication to the patient.
Short | Overall pattern of medication administration
Comments | This attribute should not be confused with the protocol of the medication.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see medicationRequest Course of Therapy Codes (example to `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` ) Identifies the overall pattern of medication administratio.
Type | CodeableConcept
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. MedicationRequest.insurance
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Short | Associated insurance coverage
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Coverage, ClaimResponse)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
232. MedicationRequest.note
Definition | Extra information about the prescription that could not be conveyed by the other attributes.
Short | Information about the prescription
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Annotation
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. MedicationRequest.note.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
236. MedicationRequest.note.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.note.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
238. MedicationRequest.note.author[x]
Definition | The individual responsible for making the annotation.
Short | Individual responsible for the annotation
Comments | Organization is used when there's no need for specific attribution as to who made the comment.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Choice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. MedicationRequest.note.time
Definition | Indicates when this particular annotation was made.
Short | When the annotation was made
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. MedicationRequest.note.text
Definition | Instructions to the pharmacy that go beyond the dosage information
Short | Dispensing Note
Comments | Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
Control | 1..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
244. MedicationRequest.dosageInstruction
Definition | Hier werden Informationen zur Dosierung angegeben.
Short | Hier werden Informationen zur Dosierung angegeben.
Comments | There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
Control | 0..*
Type | Dosage(Dosage dgMP)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
246. MedicationRequest.dispenseRequest
Definition | Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Short | Medication supply authorization
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
248. MedicationRequest.dispenseRequest.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
250. MedicationRequest.dispenseRequest.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.dispenseRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
252. MedicationRequest.dispenseRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
254. MedicationRequest.dispenseRequest.initialFill
Definition | Indicates the quantity or duration for the first dispense of the medication.
Short | First fill details
Comments | If populating this element, either the quantity or the duration must be included.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. MedicationRequest.dispenseRequest.initialFill.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
258. MedicationRequest.dispenseRequest.initialFill.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.dispenseRequest.initialFill.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
260. MedicationRequest.dispenseRequest.initialFill.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
262. MedicationRequest.dispenseRequest.initialFill.quantity
Definition | The amount or quantity to provide as part of the first dispense.
Short | First fill quantity
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`) sqty-1: The comparator is not used on a SimpleQuantity (`comparator.empty()`)
264. MedicationRequest.dispenseRequest.initialFill.duration
Definition | The length of time that the first dispense is expected to last.
Short | First fill duration
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1
Type | Duration
Is Modifier | false
Invariants | drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (`code.exists() implies ((system = %ucum) and value.exists())`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
266. MedicationRequest.dispenseRequest.dispenseInterval
Definition | The minimum period of time that must occur between dispenses of the medication.
Short | Minimum period of time between dispenses
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1
Type | Duration
Is Modifier | false
Invariants | drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (`code.exists() implies ((system = %ucum) and value.exists())`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
268. MedicationRequest.dispenseRequest.validityPeriod
Definition | This indicates the validity period of a prescription (stale dating the Prescription).
Short | Time period supply is authorized for
Comments | It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Period
Is Modifier | false
Requirements | Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) per-1: If present, start SHALL have a lower value than end (`start.hasValue().not() or end.hasValue().not() or (start <= end)`)
270. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
Definition | An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
Short | Number of refills authorized
Comments | If displaying "number of authorized fills", add 1 to this number.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
272. MedicationRequest.dispenseRequest.quantity
Definition | The amount that is to be dispensed for one fill.
Short | Amount of medication to supply per dispense
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`) sqty-1: The comparator is not used on a SimpleQuantity (`comparator.empty()`)
274. MedicationRequest.dispenseRequest.quantity.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
276. MedicationRequest.dispenseRequest.quantity.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.dispenseRequest.quantity.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
278. MedicationRequest.dispenseRequest.quantity.value
Definition | Number of Prescribed Packages
Short | Number of Prescribed Packages
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. MedicationRequest.dispenseRequest.quantity.comparator
Definition | Not allowed to be used in this context
Short | < | <= | >= | > - how to understand the value
Control | 0..0
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. MedicationRequest.dispenseRequest.quantity.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. MedicationRequest.dispenseRequest.quantity.system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 0..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
286. MedicationRequest.dispenseRequest.quantity.code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
288. MedicationRequest.dispenseRequest.expectedSupplyDuration
Definition | Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
Short | Number of days supply per dispense
Comments | In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.
Control | 0..1
Type | Duration
Is Modifier | false
Invariants | drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (`code.exists() implies ((system = %ucum) and value.exists())`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qty-3: If a code for the unit is present, the system SHALL also be present (`code.empty() or system.exists()`)
290. MedicationRequest.dispenseRequest.performer
Definition | Indicates the intended dispensing Organization specified by the prescriber.
Short | Intended dispenser
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Organization)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
292. MedicationRequest.substitution
Definition | Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Short | Any restrictions on medication substitution
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
294. MedicationRequest.substitution.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
296. MedicationRequest.substitution.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.substitution.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
298. MedicationRequest.substitution.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
300. MedicationRequest.substitution.allowed[x]
Definition | True if the prescriber allows a different drug to be dispensed from what was prescribed.
Short | Whether substitution is allowed or not
Comments | This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. MedicationRequest.substitution.reason
Definition | Indicates the reason for the substitution, or why substitution must or must not be performed.
Short | Why should (not) substitution be made
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see SubstanceAdminSubstitutionReason (example to `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason` ) A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
Type | CodeableConcept
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. MedicationRequest.priorPrescription
Definition | A link to a resource representing an earlier order related order or prescription.
Short | An order/prescription that is being replaced
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(MedicationRequest)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
306. MedicationRequest.detectedIssue
Definition | Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
Short | Clinical Issue with action
Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(DetectedIssue)
Is Modifier | false
Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
308. MedicationRequest.eventHistory
Definition | Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
Short | A list of events of interest in the lifecycle
Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Provenance)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)