Motivation

Dieses Profil wird in den Anwendungsfällen genutzt, um angefragte, verordnete oder dispensierte Arzneimittelinformationen zu übertragen.

Als Anfragender möchte ich angeben können, welche Medikation ich für einen Patienten anfragen möchte. Eine Einrichtung/ Person, die eine Verordnung anfragt nutzt dieses Profil, um strukturiert anzugeben, welche Medikation benötigt wird. Hierzu muss in ERPServiceRequestPrescriptionRequest.basedOn ein ERPServiceRequestMedicationRequest mit angegeben werden. Dieser enthält die medizinische Information, die der Verordnende benötigt, um ein entsprechendes Rezept auszustellen.

Analog kann der Verordnende angeben, welches Arzneimittel er verordnet hat, sowie ein abgebender LE welches Arzneimittel geliefert wird.

Die anzugebende Medication entspricht dabei den Medication Profilen aus dem eRezept Projekt der KBV.

Da die KBV_PR_ERP_Prescription Informationen voraussetzt, die u.U. im Moment der Anfrage nicht bekannt sind, wurde dieses Profil spezifiziert. Es lehnt sich an die Spezifikation der KBV_PR_ERP_Prescription an, ist aber offener, erlaubt also auch dass die fehlenden Informationen nicht angegeben werden müssen.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:PriorPrescriptionID	S	0..1	EPrescriptionId	Provide a previous PrescriptionID that corresponds to the requested medication. URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:requestMVO	?!S	0..1	boolean	Multiple prescription order URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
medication[x]	SΣ	1..1	Reference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)	Medication to be taken
subject	SΣ	1..1	Reference(ERP Service Request Patient)	Patient for whom a dispense is requested on behalf of the patient.
dosageInstruction	S	0..*	Dosage	How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Dosieranweisung Max Length:500
patientInstruction	SΣ	0..1	string	Gebrauchsanweisung einer Rezeptur Max Length:500
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity	S	1..1	SimpleQuantity	Number of prescribed units
value	SΣ	1..1	decimal	Number prescribed
unit	SΣ	1..1	string	Requested units of the prescription
system	ΣC	0..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	0..1	code	Code from Unit of measure
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 From the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:PriorPrescriptionID	S	0..1	EPrescriptionId	Provide a previous PrescriptionID that corresponds to the requested medication. URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
Slices for modifierExtension		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:requestMVO	S	0..1	boolean	Multiple prescription order URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex
medication[x]	S	1..1	Reference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)	Medication to be taken
subject	S	1..1	Reference(ERP Service Request Patient)	Patient for whom a dispense is requested on behalf of the patient.
dosageInstruction	S	0..*	Dosage	How the medication should be taken
text	S	0..1	string	Dosieranweisung Max Length:500
patientInstruction	S	0..1	string	Gebrauchsanweisung einer Rezeptur Max Length:500
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
quantity	S	1..1	SimpleQuantity	Number of prescribed units
value	S	1..1	decimal	Number prescribed
unit	S	1..1	string	Requested units of the prescription
system		0..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		0..1	code	Code from Unit of measure
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:PriorPrescriptionID	S	0..1	EPrescriptionId	Provide a previous PrescriptionID that corresponds to the requested medication. URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:requestMVO	?!S	0..1	boolean	Multiple prescription order URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex
identifier		0..*	Identifier	External ids for this request
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): 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.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
medication[x]	SΣ	1..1	Reference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)	Medication to be taken
subject	SΣ	1..1	Reference(ERP Service Request Patient)	Patient for whom a dispense is requested on behalf of the patient.
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Dosieranweisung Max Length:500
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	SΣ	0..1	string	Gebrauchsanweisung einer Rezeptur Max Length:500
timing	Σ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	ΣC	0..1	Ratio	Upper limit on medication per unit of time Constraints: rat-1
maxDosePerAdministration	ΣC	0..1	SimpleQuantity	Upper limit on medication per administration Constraints: qty-3, sqty-1
maxDosePerLifetime	ΣC	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient Constraints: qty-3, sqty-1
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized
quantity	S	1..1	SimpleQuantity	Number of prescribed units
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Number prescribed
unit	SΣ	1..1	string	Requested units of the prescription
system	ΣC	0..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	0..1	code	Code from Unit of measure
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 From the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason From the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 From the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category From the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 From the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role From the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code From the FHIR Standard
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy From the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason From the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes From the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes From the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type From the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
qty-3	error	MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
rat-1	error	MedicationRequest.dosageInstruction.maxDosePerPeriod	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
sqty-1	error	MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime	The comparator is not used on a SimpleQuantity : comparator.empty()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:PriorPrescriptionID	S	0..1	EPrescriptionId	Provide a previous PrescriptionID that corresponds to the requested medication. URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:requestMVO	?!S	0..1	boolean	Multiple prescription order URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
medication[x]	SΣ	1..1	Reference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)	Medication to be taken
subject	SΣ	1..1	Reference(ERP Service Request Patient)	Patient for whom a dispense is requested on behalf of the patient.
dosageInstruction	S	0..*	Dosage	How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Dosieranweisung Max Length:500
patientInstruction	SΣ	0..1	string	Gebrauchsanweisung einer Rezeptur Max Length:500
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity	S	1..1	SimpleQuantity	Number of prescribed units
value	SΣ	1..1	decimal	Number prescribed
unit	SΣ	1..1	string	Requested units of the prescription
system	ΣC	0..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	0..1	code	Code from Unit of measure
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 From the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:PriorPrescriptionID	S	0..1	EPrescriptionId	Provide a previous PrescriptionID that corresponds to the requested medication. URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
Slices for modifierExtension		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:requestMVO	S	0..1	boolean	Multiple prescription order URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex
medication[x]	S	1..1	Reference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)	Medication to be taken
subject	S	1..1	Reference(ERP Service Request Patient)	Patient for whom a dispense is requested on behalf of the patient.
dosageInstruction	S	0..*	Dosage	How the medication should be taken
text	S	0..1	string	Dosieranweisung Max Length:500
patientInstruction	S	0..1	string	Gebrauchsanweisung einer Rezeptur Max Length:500
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
quantity	S	1..1	SimpleQuantity	Number of prescribed units
value	S	1..1	decimal	Number prescribed
unit	S	1..1	string	Requested units of the prescription
system		0..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		0..1	code	Code from Unit of measure
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:PriorPrescriptionID	S	0..1	EPrescriptionId	Provide a previous PrescriptionID that corresponds to the requested medication. URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
Slices for modifierExtension	?!	0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:requestMVO	?!S	0..1	boolean	Multiple prescription order URL: https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex
identifier		0..*	Identifier	External ids for this request
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): 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.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
medication[x]	SΣ	1..1	Reference(KBV_PR_ERP_Medication_PZN | KBV_PR_ERP_Medication_Compounding | KBV_PR_ERP_Medication_Ingredient | KBV_PR_ERP_Medication_FreeText)	Medication to be taken
subject	SΣ	1..1	Reference(ERP Service Request Patient)	Patient for whom a dispense is requested on behalf of the patient.
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Dosieranweisung Max Length:500
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	SΣ	0..1	string	Gebrauchsanweisung einer Rezeptur Max Length:500
timing	Σ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	ΣC	0..1	Ratio	Upper limit on medication per unit of time Constraints: rat-1
maxDosePerAdministration	ΣC	0..1	SimpleQuantity	Upper limit on medication per administration Constraints: qty-3, sqty-1
maxDosePerLifetime	ΣC	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient Constraints: qty-3, sqty-1
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized
quantity	S	1..1	SimpleQuantity	Number of prescribed units
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Number prescribed
unit	SΣ	1..1	string	Requested units of the prescription
system	ΣC	0..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	Σ	0..1	code	Code from Unit of measure
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 From the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason From the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 From the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category From the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 From the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role From the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code From the FHIR Standard
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy From the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason From the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes From the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes From the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type From the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
qty-3	error	MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
rat-1	error	MedicationRequest.dosageInstruction.maxDosePerPeriod	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
sqty-1	error	MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime	The comparator is not used on a SimpleQuantity : comparator.empty()

This structure is derived from MedicationRequest

Summary

Mandatory: 0 element(3 nested mandatory elements)
Must-Support: 12 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• KBV_PR_ERP_Medication_PZN (https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_PZN)
• KBV_PR_ERP_Medication_Compounding (https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Compounding)
• KBV_PR_ERP_Medication_Ingredient (https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_Ingredient)
• KBV_PR_ERP_Medication_FreeText (https://fhir.kbv.de/StructureDefinition/KBV_PR_ERP_Medication_FreeText)
• ERP Service Request Patient (https://gematik.de/fhir/erp-servicerequest/StructureDefinition/erp-service-request-patient)

Extensions

This structure refers to these extensions:

• https://gematik.de/fhir/erp-servicerequest/StructureDefinition/prescription-id-ex
• https://gematik.de/fhir/erp-servicerequest/StructureDefinition/request-mvo-ex (Modifier)