Generated Narrative: StructureDefinition epa-medication-request Name Flags Card. Type Description & Constraints MedicationRequest 0..* MedicationRequest Ordering of medication for patient or group #xD; meta S 0..1 Meta Metadata about the resource #xD; versionId S 0..1 id Version specific identifier #xD; lastUpdated S 0..1 instant When the resource version last changed #xD; extension S 0..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:multiplePrescription S 0..1 (Complex) MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension #xD; extension S 0..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:indicator S 0..1 Extension Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 boolean Multiple Prescription Indicator #xD; extension:counter S 0..1 Extension Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 Ratio Value of extension #xD; numerator S 1..1 Quantity Numerator value #xD; value S 1..1 decimal Multiple Prescription Counter #xD; unit S 0..0 string Unit representation #xD; system S 0..0 uri System that defines coded unit form #xD; code S 0..0 code Coded form of the unit #xD; denominator S 1..1 Quantity Denominator value #xD; value S 1..1 decimal Denominator of Multiple Prescription Series #xD; unit S 0..0 string Unit representation #xD; system S 0..0 uri System that defines coded unit form #xD; code S 0..0 code Coded form of the unit #xD; extension:period S 0..1 Extension Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 Period Value of extension #xD; start S 1..1 dateTime Start Date of the Prescription Redemption Period #xD; end S 0..1 dateTime End Date of the Prescription Redemption Period #xD; extension:id S 0..1 Extension Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 Identifier Value of extension #xD; type S 0..0 CodeableConcept Description of identifier #xD; system S 0..1 uri Specification as UUID #xD; value S 0..1 string Multiple Prescription ID #xD; url S 1..1 uri identifies the meaning of the extension #xD; extension:isBvg S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 boolean BVG #xD; extension:isSer S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-ser-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 boolean SER #xD; extension:prescriberID S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/prescriber-id-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 Identifier Value of extension #xD; type S 0..0 CodeableConcept Description of identifier #xD; system S 0..1 uri The namespace for the identifier value #xD; value S 1..1 string Verschreiber-ID #xD; extension:patientID S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-id-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 Identifier Value of extension #xD; type S 0..0 CodeableConcept Description of identifier #xD; system S 0..1 uri The namespace for the identifier value #xD; value S 1..1 string Patienten-ID #xD; extension:narcotics S 0..1 (Complex) Betäubungsmittel (BtM) URL: https://gematik.de/fhir/epa-medication/StructureDefinition/narcotics-extension #xD; extension:teratogenic S 0..1 (Complex) T-Rezept URL: https://gematik.de/fhir/epa-medication/StructureDefinition/teratogenic-extension #xD; extension:renderedDosageInstruction S 0..1 (Complex) Vollständige Darstellung der Dosierungsanweisungen (generiert aus den Dosage-Elementen). URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction #xD; extension 0..0 Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 0..1 markdown Full representation of the dosage instructions #xD; extension:generatedDosageInstructionsMeta S 0..1 (Complex) Metadaten zu den generierten Dosierungsanweisungen URL: http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta #xD; Slices for extension Content/Rules for all slices #xD; extension:language 1..1 Extension Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 code Value of extension #xD; extension:algorithmVersion 1..1 Extension Extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Value of extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; Slices for identifier S 0..* Identifier External ids for this request Slice: Unordered, Open by pattern:$this #xD; identifier:RxPrescriptionProcessIdentifier S 0..1 RxPrescriptionProcessIdentifier External ids for this request Required Pattern: At least the following #xD; system 1..1 uri The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; identifier:RxOriginatorProcessIdentifier S 0..1 RxOriginatorProcessIdentifier External ids for this request Required Pattern: At least the following #xD; system 1..1 uri The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; status S 1..1 code Status of Medication Request Binding: TI Medication Request ValueSet (required) #xD; intent S 1..1 code filler-order #xD; medication[x] S 1..1 Reference(Medication) Medication to be taken #xD; reference S 0..1 string Literal reference, Relative, internal or absolute URL #xD; identifier S 0..1 Identifier Logical reference, when literal reference is not known #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; system S 0..1 uri The namespace for the identifier value #xD; value S 0..1 string The value that is unique #xD; display S 0..1 string Text alternative for the resource #xD; subject S 1..1 Reference(Patient) Who or group medication request is for #xD; identifier S 1..1 IdentifierKvid10 Logical reference, when literal reference is not known #xD; authoredOn S 1..1 dateTime Issue Date #xD; requester S 0..1 Reference(Organization | Practitioner | PractitionerRole) Who/What requested the Request #xD; reference S 0..1 string Literal reference, Relative, internal or absolute URL #xD; identifier S 0..1 Identifier Logical reference, when literal reference is not known #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; system S 0..1 uri The namespace for the identifier value #xD; value S 0..1 string The value that is unique #xD; display S 0..1 string Text alternative for the resource #xD; basedOn S 0..* Reference(eMP MedicationRequest) What request fulfills #xD; reference S 0..1 string Literal reference, Relative, internal or absolute URL #xD; identifier S 0..1 MedicationPlanIdentifier Logical reference, when literal reference is not known #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; system S 1..1 uri The namespace for the identifier value #xD; value S 1..1 string Der eindeutige Identifikationswert #xD; display S 0..1 string Text alternative for the resource #xD; note S 0..1 Annotation Information about the prescription #xD; time S 0..1 dateTime When the annotation was made #xD; text S 1..1 markdown Dispensing Note #xD; dosageInstruction S 0..* DosageDgMP Hier werden Informationen zur Dosierung angegeben. #xD; doseAndRate #xD; dose[x] S 0..1 SimpleQuantity Amount of medication per dose #xD; Slices for dose[x] Content/Rules for all slices #xD; dose[x]:doseQuantity 0..1 SimpleQuantity Menge des Medikaments pro Dosis #xD; value S 0..1 decimal Numerical value (with implicit precision) #xD; dispenseRequest S 0..1 BackboneElement Medication supply authorization #xD; quantity S 0..1 SimpleQuantity(4.0.1) Amount of medication to supply per dispense #xD; value S 1..1 decimal Number of Prescribed Packages #xD; unit S 0..1 string Unit representation #xD; system S 0..1 uri System that defines coded unit form Required Pattern: http://unitsofmeasure.org #xD; code S 0..1 code Coded form of the unit #xD; expectedSupplyDuration S 0..1 Duration Number of days supply per dispense #xD; substitution S 0..1 BackboneElement Any restrictions on medication substitution #xD; allowed[x] S 1..1 boolean Whether substitution is allowed or not #xD; Documentation for this format
Defines the medication request resource for the Medication Service in the ePA system.
gematik GmbH / Dieses Artefakt ist lizenziert unter [Apache License](./license.html), Version 2.0.
Ordering of medication for patient or group
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.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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.
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.
When the resource last changed - e.g. when the version changed.
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](http://hl7.org/fhir/R4/http.html#read) interaction.
Identifies where the resource comes from
A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) 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.
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.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
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.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
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.
Security Labels from the Healthcare Privacy and Security Classification System.
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
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.
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.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.
Source of the definition for the extension code - a logical name or a URL.
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.
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](http://hl7.org/fhir/R4/extensibility.html) for a list).
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.
If a code for the unit is present, the system SHALL also be present
PQ, IVL<PQ>, MO, CO, depending on the values
The field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4"
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).
Precision is handled implicitly in almost all cases of measurement.
PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
< | <= | >= | > - how to understand the value
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.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
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
How the Quantity should be understood and represented.
Note that FHIR strings SHALL NOT exceed 1MB in size
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
The identification of the system that provides the coded form of the unit.
see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Need to know the system that defines the coded form of the unit.
CO.codeSystem, PQ.translation.codeSystem
A computer processable form of the unit in some unit representation system.
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.
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.
PQ.code, MO.currency, PQ.translation.code
Denominator of Multiple Prescription Series
The field serves to indicate the length of this series. Example: "4" in "2 out of 4"
Limitation of the date format to 10 characters YYYY-MM-DD
end.exists().not() or end.toString().length()=10
Start Date of the Prescription Redemption Period
Date from which the partial prescription of the multiple prescription can be redeemed
If the low element is missing, the meaning is that the low boundary is not known.
End Date of the Prescription Redemption Period
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 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.
If the end of the period is missing, it means that the period is ongoing
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
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.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
fhir:CodeableConcept rdfs:subClassOf dt:CD
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Identifier.system is always case sensitive.
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.
A unique ID that is identical across all partial prescriptions of a multiple prescription.
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](http://hl7.org/fhir/R4/extension-rendered-value.html). 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.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
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](http://hl7.org/fhir/R4/datatypes.html#Duration).
If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))
IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
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.
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'))
not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])
The target of a resource reference is a RIM entry point (Act, Role, or Entity)
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.
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
Kennzeichnung, ob diese Verordnung mit Bezug zum Sozialen Entschädigungsrecht nach SGB XIV (SER) erfolgt
Kennzeichnung, ob diese Verordnung mit Bezug zum Sozialen Entschädigungsrecht nach SGB XIV (SER) erfolgt false - not SER (default value) true - SER
Verschreiber-ID, welche bei der Verordnung bestimmter Präparate anzugeben ist, damit die Apotheke das Rezept beliefern darf.
Patienten-ID, welche bei der Verordnung bestimmter Arzneimittel angegeben werden kann.
Abbildung der Angaben zur Verordnung eines Betäubungsmittels im Sinne des Betäubungsmittelgesetzes (BtMG)
Abbildung der Angaben zur Verordnung eines teratogenen Arzneimittels (T-Rezept)
Vollständige Darstellung der Dosierungsanweisungen (generiert aus den Dosage-Elementen).
Ein menschenlesbarer, vollständiger Text der Dosierungsanweisungen. Der Text wird aus den strukturierten Dosage-Elementen generiert und dient der patientensicheren Darstellung der Dosierung. Er soll die maschinenlesbaren Angaben konsistent wiedergeben und in einer für Patient:innen verständlichen Form bereitstellen.
Element `MedicationRequest.renderedDosageInstruction` has a context of MedicationRequest based on following the parent source element upwards and mapping to `MedicationRequest`. Element `MedicationRequest.renderedDosageInstruction` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
Full representation of the dosage instructions
The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.
Metadaten zu den generierten Dosierungsanweisungen
Diese Extension enthält zusätzliche Metadaten zu den automatisch generierten Dosierungsanweisungen, wie z.B. Informationen zur Generierung oder zum Ursprung der Daten.
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).
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
ePrescription identifier and overall transaction identifier
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.
This is a business identifier, not a resource identifier.
CX / EI (occasionally, more often EI maps to a resource id or a URL)
II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
ORC-2-Placer Order Number / ORC-3-Filler Order Number
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
A code specifying the current state of the order. Generally, this will be active or completed state.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
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
Captures the reason for the current state of the MedicationRequest.
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.
Identifies the reasons for a given status.
.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.
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.
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
.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
The category can be used to include where the medication is expected to be consumed or other types of requests.
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.
Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG
.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
Indicates how quickly the Medication Request should be addressed with respect to other requests.
Identifies the level of importance to be assigned to actioning the request.
If true indicates that the provider is asking for the medication request not to occur.
If do not perform is not specified, the request is a positive request e.g. "do perform".
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)
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.
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.
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.
Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription
RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code
Literal reference, Relative, internal or absolute URL
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.
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.
Type the reference refers to (e.g. "Patient")
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).
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.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
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.
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).
Plain text narrative that identifies the resource in addition to the resource reference.
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.
A link to a resource representing the person or set of individuals to whom the medication will be given.
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.
Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)
Encounter created as part of encounter/admission/stay
The Encounter during which this [x] was created or to which the creation of this record is tightly associated.
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.
.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
Information to support ordering of the medication
Include additional information (for example, patient height and weight) that supports the ordering of the medication.
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.
.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction
The individual, organization, or device that initiated the request and has responsibility for its activation.
The specified desired performer of the medication treatment (e.g. the performer of the medication administration).
Desired kind of performer of the medication administration
Indicates the type of performer of the administration of the medication.
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.
Identifies the type of individual that is desired to administer the medication.
The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
Reason or indication for ordering or not ordering the medication
The reason or the indication for ordering or not ordering the medication.
This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
A coded concept indicating why the medication was ordered.
ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication
Condition or observation that supports why the prescription is being written
Condition or observation that supports why the medication was ordered.
This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Instantiates FHIR protocol or definition
The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
see [Canonical References](http://hl7.org/fhir/R4/references.html#canonical)
Instantiates external protocol or 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.
A plan or request that is fulfilled in whole or in part by this medication request.
.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
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.
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.
.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
Overall pattern of medication administration
The description of the overall patte3rn of the administration of the medication to the patient.
This attribute should not be confused with the protocol of the medication.
Identifies the overall pattern of medication administratio.
Act.code where classCode = LIST and moodCode = EVN
Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Extra information about the prescription that could not be conveyed by the other attributes.
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).
Individual responsible for the annotation
The individual responsible for making the annotation.
Organization is used when there's no need for specific attribution as to who made the comment.
Indicates when this particular annotation was made.
Instructions to the pharmacy that go beyond the dosage information
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/
Hier werden Informationen zur Dosierung angegeben.
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.
.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
Extensions that cannot be ignored even if unrecognized
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).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Indicates the order in which the dosage instructions should be applied or interpreted.
Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.
Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'
Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker
Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.
Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.
Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.
Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.
A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
Patient or consumer oriented instructions
Instructions in terms that are understood by the patient or consumer.
Wann das Medikament verabreicht werden soll
Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.
The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
A coded specification of the anatomic site where the medication first enters the body.
A coded concept describing the site location the medicine enters into or onto the body.
Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.
A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.
A coded concept describing the technique by which the medicine is administered.
Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
The kind of dose or rate specified, for example, ordered or calculated.
Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
If the type is not populated, assume to be "ordered".
Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
The amount of therapeutic or other substance given at one administration event.
Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.
Numerical value (with implicit precision)
The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Upper limit on medication per unit of time
Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.
Upper limit on medication per administration
Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
Upper limit on medication per lifetime of the patient
Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.
The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
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.
Indicates the quantity or duration for the first dispense of the medication.
If populating this element, either the quantity or the duration must be included.
SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
The amount or quantity to provide as part of the first dispense.
The comparator is not used on a SimpleQuantity
The length of time that the first dispense is expected to last.
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())
(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org')
Minimum period of time between dispenses
The minimum period of time that must occur between dispenses of the medication.
This indicates the validity period of a prescription (stale dating the Prescription).
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.
Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
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.
If displaying "number of authorized fills", add 1 to this number.
Amount of medication to supply per dispense
The amount that is to be dispensed for one fill.
RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
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.
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.
Indicates the intended dispensing Organization specified by the prescriber.
.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
Any restrictions on medication substitution
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.
specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions
True if the prescriber allows a different drug to be dispensed from what was prescribed.
This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
RXO-9-Allow Substitutions / RXE-9-Substitution Status
Indicates the reason for the substitution, or why substitution must or must not be performed.
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.
A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
An order/prescription that is being replaced
A link to a resource representing an earlier order related order or prescription.
.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
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.
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.
A list of events of interest in the lifecycle
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.
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.).
.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]