Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

11.1 Resource MedicationRequest - Content

Pharmacy icon Work GroupMaturity Level: 4 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner

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.

11.1.1 Scope and Usage

This resource covers all type of orders for medications for a patient. This includes inpatient medication orders as well as community orders (whether filled by the prescriber or by a pharmacy). It also includes orders for over-the-counter medications (e.g. Aspirin), total parenteral nutrition and diet/ vitamin supplements. It may be used to support the order of medication-related devices e.g., prefilled syringes such as patient-controlled analgesia (PCA) syringes, or syringes used to administer other types of medications. e.g., insulin, narcotics.

This resource would not be used when ordering a device(s) that may have a medication coating e.g. heparin coated stints, or similar types of devices. These types of devices would be ordered using the Device Request or the SupplyRequest resources.

It is not intended for use in prescribing particular diets, or for ordering non-medication-related items (eyeglasses, supplies, etc.). In addition, the MedicationRequest may be used to report orders/request from external systems that have been reported for informational purposes and are not authoritative and are not expected to be acted upon (e.g. dispensed or administered).

The MedicationRequest resource is a "request" resource from a FHIR workflow perspective - see Workflow Request.

The MedicationRequest resource allows requesting only a single medication. If a workflow requires requesting multiple items simultaneously, this is done using multiple instances of this resource. These instances can be linked in different ways, depending on the needs of the workflow. For guidance, refer to the Request pattern

11.1.2 Boundaries and Relationships

The MedicationRequest resource is used to request or order medication for a subject. It may also be used to report a medication request or order from one organization or source to another. When requesting supplies or devices when there is a patient focus or instructions regarding their use, SupplyRequest or DeviceRequest should be used instead. When reporting on the usage of a medication by a patient, the MedicationStatement resource should be used.

The Medication domain includes a number of related resources

MedicationRequest An order for both supply of the medication and the instructions for administration of the medicine to a patient.
MedicationDispense Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription or order or request).
MedicationAdministration When a patient actually consumes a medicine, or it is otherwise administered to them
MedicationStatement This is a record of medication being taken by a patient, or that the medication has been given to a patient where the record is the result of a report from the patient, or another clinician. A medication statement is not a part of the prescribe->dispense->administer sequence but is a report that such a sequence (or at least a part of it) did take place resulting in a belief that the patient has received a particular medication.

11.1.3 References to this Resource

11.1.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest TUDomainResourceOrdering of medication for patient or group

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierExternal ids for this request

... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)A plan or request that is fulfilled in whole or in part by this medication request

... priorPrescription 0..1Reference(MedicationRequest)Reference to an order/prescription that is being replaced by this MedicationRequest
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... status ?!Σ1..1codeactive | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
Binding: medicationrequest Status (Required)
... statusReason 0..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (Example)
... statusChanged 0..1dateTimeWhen the status was changed
... intent ?!Σ1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (Required)
... category 0..*CodeableConceptGrouping or category of medication request
Binding: medicationRequest Administration Location Codes (Example)

... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (Required)
... doNotPerform ?!Σ0..1booleanTrue if patient is to stop taking or not to start taking the medication
... medication Σ1..1CodeableReference(Medication)Medication to be taken
Binding: SNOMED CT Medication Codes (Example)
... subject Σ1..1Reference(Patient | Group)Individual or group for whom the medication has been requested
... informationSource 0..*Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)The person or organization who provided the information about this request, if the source is someone other than the requestor

... encounter 0..1Reference(Encounter)Encounter created as part of encounter/admission/stay
... supportingInformation 0..*Reference(Any)Information to support fulfilling of the medication

... authoredOn Σ0..1dateTimeWhen request was initially authored
... requester Σ0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)Who/What requested the Request
... reported Σ0..1booleanReported rather than primary record
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: Medication Intended Performer Role (Extensible)
... performer 0..*Reference(Practitioner | PractitionerRole | Organization | Patient | DeviceDefinition | RelatedPerson | CareTeam | HealthcareService)Intended performer of administration

... device 0..*CodeableReference(DeviceDefinition)Intended type of device for the administration

... recorder 0..1Reference(Practitioner | PractitionerRole)Person who entered the request
... reason 0..*CodeableReference(Condition | Observation)Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/Diagnosis Codes (Example)

... courseOfTherapyType 0..1CodeableConceptOverall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (Extensible)
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage

... note 0..*AnnotationInformation about the prescription

... renderedDosageInstruction 0..1markdownFull representation of the dosage instructions
... effectiveDosePeriod 0..1PeriodPeriod over which the medication is to be taken
... dosageInstruction 0..*DosageSpecific instructions for how the medication should be taken

... dispenseRequest 0..1BackboneElementMedication supply authorization
.... initialFill 0..1BackboneElementFirst fill details
..... quantity 0..1SimpleQuantityFirst fill quantity
..... duration 0..1DurationFirst fill duration
.... dispenseInterval 0..1DurationMinimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed 0..1unsignedIntNumber of refills authorized
.... quantity 0..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... dispenser 0..1Reference(Organization)Intended performer of dispense
.... dispenserInstruction 0..*AnnotationAdditional information for the dispenser

.... doseAdministrationAid 0..1CodeableConceptType of adherence packaging to use for the dispense
Binding: Medication Dose Aids (Example)
... substitution 0..1BackboneElementAny restrictions on medication substitution
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode icon (Preferred)
..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason icon (Example)
... eventHistory TU0..*Reference(Provenance)A list of events of interest in the lifecycle


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<MedicationRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External ids for this request --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) A plan or request that is fulfilled in whole or in part by this medication request --></basedOn>
 <priorPrescription><!-- 0..1 Reference(MedicationRequest) Reference to an order/prescription that is being replaced by this MedicationRequest --></priorPrescription>
 <groupIdentifier><!-- 0..1 Identifier Composite request this is part of --></groupIdentifier>
 <status value="[code]"/><!-- 1..1 active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <statusChanged value="[dateTime]"/><!-- 0..1 When the status was changed -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option -->
 <category><!-- 0..* CodeableConcept Grouping or category of medication request --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if patient is to stop taking or not to start taking the medication -->
 <medication><!-- 1..1 CodeableReference(Medication) Medication to be taken --></medication>
 <subject><!-- 1..1 Reference(Group|Patient) Individual or group for whom the medication has been requested --></subject>
 <informationSource><!-- 0..* Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) The person or organization who provided the information about this request, if the source is someone other than the requestor --></informationSource>
 <encounter><!-- 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Information to support fulfilling of the medication --></supportingInformation>
 <authoredOn value="[dateTime]"/><!-- 0..1 When request was initially authored -->
 <requester><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who/What requested the Request --></requester>
 <reported value="[boolean]"/><!-- 0..1 Reported rather than primary record -->
 <performerType><!-- 0..1 CodeableConcept Desired kind of performer of the medication administration --></performerType>
 <performer><!-- 0..* Reference(CareTeam|DeviceDefinition|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Intended performer of administration --></performer>
 <device><!-- 0..* CodeableReference(DeviceDefinition) Intended type of device for the administration --></device>
 <recorder><!-- 0..1 Reference(Practitioner|PractitionerRole) Person who entered the request --></recorder>
 <reason><!-- 0..* CodeableReference(Condition|Observation) Reason or indication for ordering or not ordering the medication --></reason>
 <courseOfTherapyType><!-- 0..1 CodeableConcept Overall pattern of medication administration --></courseOfTherapyType>
 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <note><!-- 0..* Annotation Information about the prescription --></note>
 <renderedDosageInstruction value="[markdown]"/><!-- 0..1 Full representation of the dosage instructions -->
 <effectiveDosePeriod><!-- 0..1 Period Period over which the medication is to be taken --></effectiveDosePeriod>
 <dosageInstruction><!-- 0..* Dosage Specific instructions for how the medication should be taken --></dosageInstruction>
 <dispenseRequest>  <!-- 0..1 Medication supply authorization -->
  <initialFill>  <!-- 0..1 First fill details -->
   <quantity><!-- 0..1 Quantity(SimpleQuantity) First fill quantity --></quantity>
   <duration><!-- 0..1 Duration First fill duration --></duration>
  </initialFill>
  <dispenseInterval><!-- 0..1 Duration Minimum period of time between dispenses --></dispenseInterval>
  <validityPeriod><!-- 0..1 Period Time period supply is authorized for --></validityPeriod>
  <numberOfRepeatsAllowed value="[unsignedInt]"/><!-- 0..1 Number of refills authorized -->
  <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of medication to supply per dispense --></quantity>
  <expectedSupplyDuration><!-- 0..1 Duration Number of days supply per dispense --></expectedSupplyDuration>
  <dispenser><!-- 0..1 Reference(Organization) Intended performer of dispense --></dispenser>
  <dispenserInstruction><!-- 0..* Annotation Additional information for the dispenser --></dispenserInstruction>
  <doseAdministrationAid><!-- 0..1 CodeableConcept Type of adherence packaging to use for the dispense --></doseAdministrationAid>
 </dispenseRequest>
 <substitution>  <!-- 0..1 Any restrictions on medication substitution -->
  <allowed[x]><!-- 1..1 boolean|CodeableConcept Whether substitution is allowed or not icon --></allowed[x]>
  <reason><!-- 0..1 CodeableConcept Why should (not) substitution be made icon --></reason>
 </substitution>
 <eventHistory><!-- 0..* Reference(Provenance) A list of events of interest in the lifecycle --></eventHistory>
</MedicationRequest>

JSON Template

{doco
  "resourceType" : "MedicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External ids for this request
  "basedOn" : [{ Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) }], // A plan or request that is fulfilled in whole or in part by this medication request
  "priorPrescription" : { Reference(MedicationRequest) }, // Reference to an order/prescription that is being replaced by this MedicationRequest
  "groupIdentifier" : { Identifier }, // Composite request this is part of
  "status" : "<code>", // R!  active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
  "statusReason" : { CodeableConcept }, // Reason for current status
  "statusChanged" : "<dateTime>", // When the status was changed
  "intent" : "<code>", // R!  proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  "category" : [{ CodeableConcept }], // Grouping or category of medication request
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if patient is to stop taking or not to start taking the medication
  "medication" : { CodeableReference(Medication) }, // R!  Medication to be taken
  "subject" : { Reference(Group|Patient) }, // R!  Individual or group for whom the medication has been requested
  "informationSource" : [{ Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }], // The person or organization who provided the information about this request, if the source is someone other than the requestor
  "encounter" : { Reference(Encounter) }, // Encounter created as part of encounter/admission/stay
  "supportingInformation" : [{ Reference(Any) }], // Information to support fulfilling of the medication
  "authoredOn" : "<dateTime>", // When request was initially authored
  "requester" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who/What requested the Request
  "reported" : <boolean>, // Reported rather than primary record
  "performerType" : { CodeableConcept }, // Desired kind of performer of the medication administration
  "performer" : [{ Reference(CareTeam|DeviceDefinition|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Intended performer of administration
  "device" : [{ CodeableReference(DeviceDefinition) }], // Intended type of device for the administration
  "recorder" : { Reference(Practitioner|PractitionerRole) }, // Person who entered the request
  "reason" : [{ CodeableReference(Condition|Observation) }], // Reason or indication for ordering or not ordering the medication
  "courseOfTherapyType" : { CodeableConcept }, // Overall pattern of medication administration
  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "note" : [{ Annotation }], // Information about the prescription
  "renderedDosageInstruction" : "<markdown>", // Full representation of the dosage instructions
  "effectiveDosePeriod" : { Period }, // Period over which the medication is to be taken
  "dosageInstruction" : [{ Dosage }], // Specific instructions for how the medication should be taken
  "dispenseRequest" : { // Medication supply authorization
    "initialFill" : { // First fill details
      "quantity" : { Quantity(SimpleQuantity) }, // First fill quantity
      "duration" : { Duration } // First fill duration
    },
    "dispenseInterval" : { Duration }, // Minimum period of time between dispenses
    "validityPeriod" : { Period }, // Time period supply is authorized for
    "numberOfRepeatsAllowed" : "<unsignedInt>", // Number of refills authorized
    "quantity" : { Quantity(SimpleQuantity) }, // Amount of medication to supply per dispense
    "expectedSupplyDuration" : { Duration }, // Number of days supply per dispense
    "dispenser" : { Reference(Organization) }, // Intended performer of dispense
    "dispenserInstruction" : [{ Annotation }], // Additional information for the dispenser
    "doseAdministrationAid" : { CodeableConcept } // Type of adherence packaging to use for the dispense
  },
  "substitution" : { // Any restrictions on medication substitution
    // allowed[x]: Whether substitution is allowed or not. One of these 2:
    "allowedBoolean" : <boolean>,
    "allowedCodeableConcept" : { CodeableConcept },
    "reason" : { CodeableConcept } // Why should (not) substitution be made icon
  },
  "eventHistory" : [{ Reference(Provenance) }] // A list of events of interest in the lifecycle
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External ids for this request
  fhir:basedOn  ( [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* A plan or request that is fulfilled in whole or in part by this medication request
  fhir:priorPrescription [ Reference(MedicationRequest) ] ; # 0..1 Reference to an order/prescription that is being replaced by this MedicationRequest
  fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite request this is part of
  fhir:status [ code ] ; # 1..1 active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
  fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status
  fhir:statusChanged [ dateTime ] ; # 0..1 When the status was changed
  fhir:intent [ code ] ; # 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Grouping or category of medication request
  fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat
  fhir:doNotPerform [ boolean ] ; # 0..1 True if patient is to stop taking or not to start taking the medication
  fhir:medication [ CodeableReference(Medication) ] ; # 1..1 Medication to be taken
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Individual or group for whom the medication has been requested
  fhir:informationSource  ( [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* The person or organization who provided the information about this request, if the source is someone other than the requestor
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter created as part of encounter/admission/stay
  fhir:supportingInformation  ( [ Reference(Any) ] ... ) ; # 0..* Information to support fulfilling of the medication
  fhir:authoredOn [ dateTime ] ; # 0..1 When request was initially authored
  fhir:requester [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who/What requested the Request
  fhir:reported [ boolean ] ; # 0..1 Reported rather than primary record
  fhir:performerType [ CodeableConcept ] ; # 0..1 Desired kind of performer of the medication administration
  fhir:performer  ( [ Reference(CareTeam|DeviceDefinition|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Intended performer of administration
  fhir:device  ( [ CodeableReference(DeviceDefinition) ] ... ) ; # 0..* Intended type of device for the administration
  fhir:recorder [ Reference(Practitioner|PractitionerRole) ] ; # 0..1 Person who entered the request
  fhir:reason  ( [ CodeableReference(Condition|Observation) ] ... ) ; # 0..* Reason or indication for ordering or not ordering the medication
  fhir:courseOfTherapyType [ CodeableConcept ] ; # 0..1 Overall pattern of medication administration
  fhir:insurance  ( [ Reference(ClaimResponse|Coverage) ] ... ) ; # 0..* Associated insurance coverage
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Information about the prescription
  fhir:renderedDosageInstruction [ markdown ] ; # 0..1 Full representation of the dosage instructions
  fhir:effectiveDosePeriod [ Period ] ; # 0..1 Period over which the medication is to be taken
  fhir:dosageInstruction  ( [ Dosage ] ... ) ; # 0..* Specific instructions for how the medication should be taken
  fhir:dispenseRequest [ # 0..1 Medication supply authorization
    fhir:initialFill [ # 0..1 First fill details
      fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 First fill quantity
      fhir:duration [ Duration ] ; # 0..1 First fill duration
    ] ;
    fhir:dispenseInterval [ Duration ] ; # 0..1 Minimum period of time between dispenses
    fhir:validityPeriod [ Period ] ; # 0..1 Time period supply is authorized for
    fhir:numberOfRepeatsAllowed [ unsignedInt ] ; # 0..1 Number of refills authorized
    fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of medication to supply per dispense
    fhir:expectedSupplyDuration [ Duration ] ; # 0..1 Number of days supply per dispense
    fhir:dispenser [ Reference(Organization) ] ; # 0..1 Intended performer of dispense
    fhir:dispenserInstruction  ( [ Annotation ] ... ) ; # 0..* Additional information for the dispenser
    fhir:doseAdministrationAid [ CodeableConcept ] ; # 0..1 Type of adherence packaging to use for the dispense
  ] ;
  fhir:substitution [ # 0..1 Any restrictions on medication substitution
    # allowed[x] : 1..1 Whether substitution is allowed or not. One of these 2
      fhir:allowed [  a fhir:boolean ; boolean ]
      fhir:allowed [  a fhir:CodeableConcept ; CodeableConcept ]
    fhir:reason [ CodeableConcept ] ; # 0..1 Why should (not) substitution be made
  ] ;
  fhir:eventHistory  ( [ Reference(Provenance) ] ... ) ; # 0..* A list of events of interest in the lifecycle
]

Changes from both R4 and R4B

MedicationRequest
MedicationRequest.status
  • Add code ended
MedicationRequest.statusChanged
  • Added Element
MedicationRequest.medication
  • Renamed from medication[x] to medication
  • Add Type CodeableReference
  • Remove Types CodeableConcept, Reference(Medication)
MedicationRequest.informationSource
  • Added Element
MedicationRequest.reported
  • Renamed from reported[x] to reported
  • Remove Type Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
MedicationRequest.performerType
  • Add Binding `http://hl7.org/fhir/ValueSet/medication-intended-performer-role` (extensible)
MedicationRequest.performer
  • Max Cardinality changed from 1 to *
  • Type Reference: Added Target Types DeviceDefinition, HealthcareService
  • Type Reference: Removed Target Type Device
MedicationRequest.device
  • Added Element
MedicationRequest.reason
  • Added Element
MedicationRequest.courseOfTherapyType
  • Add Binding `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` (extensible)
MedicationRequest.renderedDosageInstruction
  • Added Element
MedicationRequest.effectiveDosePeriod
  • Added Element
MedicationRequest.dispenseRequest.dispenser
  • Added Element
MedicationRequest.dispenseRequest.dispenserInstruction
  • Added Element
MedicationRequest.dispenseRequest.doseAdministrationAid
  • Added Element
MedicationRequest.reasonCode
  • Deleted (-> reason)
MedicationRequest.reasonReference
  • Deleted (-> reason)
MedicationRequest.instantiatesCanonical
  • Deleted
MedicationRequest.instantiatesUri
  • Deleted
MedicationRequest.dispenseRequest.performer
  • Deleted
MedicationRequest.detectedIssue
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest TUDomainResourceOrdering of medication for patient or group

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierExternal ids for this request

... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)A plan or request that is fulfilled in whole or in part by this medication request

... priorPrescription 0..1Reference(MedicationRequest)Reference to an order/prescription that is being replaced by this MedicationRequest
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... status ?!Σ1..1codeactive | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
Binding: medicationrequest Status (Required)
... statusReason 0..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (Example)
... statusChanged 0..1dateTimeWhen the status was changed
... intent ?!Σ1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (Required)
... category 0..*CodeableConceptGrouping or category of medication request
Binding: medicationRequest Administration Location Codes (Example)

... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (Required)
... doNotPerform ?!Σ0..1booleanTrue if patient is to stop taking or not to start taking the medication
... medication Σ1..1CodeableReference(Medication)Medication to be taken
Binding: SNOMED CT Medication Codes (Example)
... subject Σ1..1Reference(Patient | Group)Individual or group for whom the medication has been requested
... informationSource 0..*Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)The person or organization who provided the information about this request, if the source is someone other than the requestor

... encounter 0..1Reference(Encounter)Encounter created as part of encounter/admission/stay
... supportingInformation 0..*Reference(Any)Information to support fulfilling of the medication

... authoredOn Σ0..1dateTimeWhen request was initially authored
... requester Σ0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)Who/What requested the Request
... reported Σ0..1booleanReported rather than primary record
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: Medication Intended Performer Role (Extensible)
... performer 0..*Reference(Practitioner | PractitionerRole | Organization | Patient | DeviceDefinition | RelatedPerson | CareTeam | HealthcareService)Intended performer of administration

... device 0..*CodeableReference(DeviceDefinition)Intended type of device for the administration

... recorder 0..1Reference(Practitioner | PractitionerRole)Person who entered the request
... reason 0..*CodeableReference(Condition | Observation)Reason or indication for ordering or not ordering the medication
Binding: Condition/Problem/Diagnosis Codes (Example)

... courseOfTherapyType 0..1CodeableConceptOverall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (Extensible)
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage

... note 0..*AnnotationInformation about the prescription

... renderedDosageInstruction 0..1markdownFull representation of the dosage instructions
... effectiveDosePeriod 0..1PeriodPeriod over which the medication is to be taken
... dosageInstruction 0..*DosageSpecific instructions for how the medication should be taken

... dispenseRequest 0..1BackboneElementMedication supply authorization
.... initialFill 0..1BackboneElementFirst fill details
..... quantity 0..1SimpleQuantityFirst fill quantity
..... duration 0..1DurationFirst fill duration
.... dispenseInterval 0..1DurationMinimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed 0..1unsignedIntNumber of refills authorized
.... quantity 0..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... dispenser 0..1Reference(Organization)Intended performer of dispense
.... dispenserInstruction 0..*AnnotationAdditional information for the dispenser

.... doseAdministrationAid 0..1CodeableConceptType of adherence packaging to use for the dispense
Binding: Medication Dose Aids (Example)
... substitution 0..1BackboneElementAny restrictions on medication substitution
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode icon (Preferred)
..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason icon (Example)
... eventHistory TU0..*Reference(Provenance)A list of events of interest in the lifecycle


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<MedicationRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External ids for this request --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) A plan or request that is fulfilled in whole or in part by this medication request --></basedOn>
 <priorPrescription><!-- 0..1 Reference(MedicationRequest) Reference to an order/prescription that is being replaced by this MedicationRequest --></priorPrescription>
 <groupIdentifier><!-- 0..1 Identifier Composite request this is part of --></groupIdentifier>
 <status value="[code]"/><!-- 1..1 active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <statusChanged value="[dateTime]"/><!-- 0..1 When the status was changed -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option -->
 <category><!-- 0..* CodeableConcept Grouping or category of medication request --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if patient is to stop taking or not to start taking the medication -->
 <medication><!-- 1..1 CodeableReference(Medication) Medication to be taken --></medication>
 <subject><!-- 1..1 Reference(Group|Patient) Individual or group for whom the medication has been requested --></subject>
 <informationSource><!-- 0..* Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) The person or organization who provided the information about this request, if the source is someone other than the requestor --></informationSource>
 <encounter><!-- 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Information to support fulfilling of the medication --></supportingInformation>
 <authoredOn value="[dateTime]"/><!-- 0..1 When request was initially authored -->
 <requester><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who/What requested the Request --></requester>
 <reported value="[boolean]"/><!-- 0..1 Reported rather than primary record -->
 <performerType><!-- 0..1 CodeableConcept Desired kind of performer of the medication administration --></performerType>
 <performer><!-- 0..* Reference(CareTeam|DeviceDefinition|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Intended performer of administration --></performer>
 <device><!-- 0..* CodeableReference(DeviceDefinition) Intended type of device for the administration --></device>
 <recorder><!-- 0..1 Reference(Practitioner|PractitionerRole) Person who entered the request --></recorder>
 <reason><!-- 0..* CodeableReference(Condition|Observation) Reason or indication for ordering or not ordering the medication --></reason>
 <courseOfTherapyType><!-- 0..1 CodeableConcept Overall pattern of medication administration --></courseOfTherapyType>
 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <note><!-- 0..* Annotation Information about the prescription --></note>
 <renderedDosageInstruction value="[markdown]"/><!-- 0..1 Full representation of the dosage instructions -->
 <effectiveDosePeriod><!-- 0..1 Period Period over which the medication is to be taken --></effectiveDosePeriod>
 <dosageInstruction><!-- 0..* Dosage Specific instructions for how the medication should be taken --></dosageInstruction>
 <dispenseRequest>  <!-- 0..1 Medication supply authorization -->
  <initialFill>  <!-- 0..1 First fill details -->
   <quantity><!-- 0..1 Quantity(SimpleQuantity) First fill quantity --></quantity>
   <duration><!-- 0..1 Duration First fill duration --></duration>
  </initialFill>
  <dispenseInterval><!-- 0..1 Duration Minimum period of time between dispenses --></dispenseInterval>
  <validityPeriod><!-- 0..1 Period Time period supply is authorized for --></validityPeriod>
  <numberOfRepeatsAllowed value="[unsignedInt]"/><!-- 0..1 Number of refills authorized -->
  <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of medication to supply per dispense --></quantity>
  <expectedSupplyDuration><!-- 0..1 Duration Number of days supply per dispense --></expectedSupplyDuration>
  <dispenser><!-- 0..1 Reference(Organization) Intended performer of dispense --></dispenser>
  <dispenserInstruction><!-- 0..* Annotation Additional information for the dispenser --></dispenserInstruction>
  <doseAdministrationAid><!-- 0..1 CodeableConcept Type of adherence packaging to use for the dispense --></doseAdministrationAid>
 </dispenseRequest>
 <substitution>  <!-- 0..1 Any restrictions on medication substitution -->
  <allowed[x]><!-- 1..1 boolean|CodeableConcept Whether substitution is allowed or not icon --></allowed[x]>
  <reason><!-- 0..1 CodeableConcept Why should (not) substitution be made icon --></reason>
 </substitution>
 <eventHistory><!-- 0..* Reference(Provenance) A list of events of interest in the lifecycle --></eventHistory>
</MedicationRequest>

JSON Template

{doco
  "resourceType" : "MedicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External ids for this request
  "basedOn" : [{ Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) }], // A plan or request that is fulfilled in whole or in part by this medication request
  "priorPrescription" : { Reference(MedicationRequest) }, // Reference to an order/prescription that is being replaced by this MedicationRequest
  "groupIdentifier" : { Identifier }, // Composite request this is part of
  "status" : "<code>", // R!  active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
  "statusReason" : { CodeableConcept }, // Reason for current status
  "statusChanged" : "<dateTime>", // When the status was changed
  "intent" : "<code>", // R!  proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  "category" : [{ CodeableConcept }], // Grouping or category of medication request
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if patient is to stop taking or not to start taking the medication
  "medication" : { CodeableReference(Medication) }, // R!  Medication to be taken
  "subject" : { Reference(Group|Patient) }, // R!  Individual or group for whom the medication has been requested
  "informationSource" : [{ Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }], // The person or organization who provided the information about this request, if the source is someone other than the requestor
  "encounter" : { Reference(Encounter) }, // Encounter created as part of encounter/admission/stay
  "supportingInformation" : [{ Reference(Any) }], // Information to support fulfilling of the medication
  "authoredOn" : "<dateTime>", // When request was initially authored
  "requester" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who/What requested the Request
  "reported" : <boolean>, // Reported rather than primary record
  "performerType" : { CodeableConcept }, // Desired kind of performer of the medication administration
  "performer" : [{ Reference(CareTeam|DeviceDefinition|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Intended performer of administration
  "device" : [{ CodeableReference(DeviceDefinition) }], // Intended type of device for the administration
  "recorder" : { Reference(Practitioner|PractitionerRole) }, // Person who entered the request
  "reason" : [{ CodeableReference(Condition|Observation) }], // Reason or indication for ordering or not ordering the medication
  "courseOfTherapyType" : { CodeableConcept }, // Overall pattern of medication administration
  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "note" : [{ Annotation }], // Information about the prescription
  "renderedDosageInstruction" : "<markdown>", // Full representation of the dosage instructions
  "effectiveDosePeriod" : { Period }, // Period over which the medication is to be taken
  "dosageInstruction" : [{ Dosage }], // Specific instructions for how the medication should be taken
  "dispenseRequest" : { // Medication supply authorization
    "initialFill" : { // First fill details
      "quantity" : { Quantity(SimpleQuantity) }, // First fill quantity
      "duration" : { Duration } // First fill duration
    },
    "dispenseInterval" : { Duration }, // Minimum period of time between dispenses
    "validityPeriod" : { Period }, // Time period supply is authorized for
    "numberOfRepeatsAllowed" : "<unsignedInt>", // Number of refills authorized
    "quantity" : { Quantity(SimpleQuantity) }, // Amount of medication to supply per dispense
    "expectedSupplyDuration" : { Duration }, // Number of days supply per dispense
    "dispenser" : { Reference(Organization) }, // Intended performer of dispense
    "dispenserInstruction" : [{ Annotation }], // Additional information for the dispenser
    "doseAdministrationAid" : { CodeableConcept } // Type of adherence packaging to use for the dispense
  },
  "substitution" : { // Any restrictions on medication substitution
    // allowed[x]: Whether substitution is allowed or not. One of these 2:
    "allowedBoolean" : <boolean>,
    "allowedCodeableConcept" : { CodeableConcept },
    "reason" : { CodeableConcept } // Why should (not) substitution be made icon
  },
  "eventHistory" : [{ Reference(Provenance) }] // A list of events of interest in the lifecycle
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External ids for this request
  fhir:basedOn  ( [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* A plan or request that is fulfilled in whole or in part by this medication request
  fhir:priorPrescription [ Reference(MedicationRequest) ] ; # 0..1 Reference to an order/prescription that is being replaced by this MedicationRequest
  fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite request this is part of
  fhir:status [ code ] ; # 1..1 active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown
  fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status
  fhir:statusChanged [ dateTime ] ; # 0..1 When the status was changed
  fhir:intent [ code ] ; # 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Grouping or category of medication request
  fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat
  fhir:doNotPerform [ boolean ] ; # 0..1 True if patient is to stop taking or not to start taking the medication
  fhir:medication [ CodeableReference(Medication) ] ; # 1..1 Medication to be taken
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Individual or group for whom the medication has been requested
  fhir:informationSource  ( [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* The person or organization who provided the information about this request, if the source is someone other than the requestor
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter created as part of encounter/admission/stay
  fhir:supportingInformation  ( [ Reference(Any) ] ... ) ; # 0..* Information to support fulfilling of the medication
  fhir:authoredOn [ dateTime ] ; # 0..1 When request was initially authored
  fhir:requester [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who/What requested the Request
  fhir:reported [ boolean ] ; # 0..1 Reported rather than primary record
  fhir:performerType [ CodeableConcept ] ; # 0..1 Desired kind of performer of the medication administration
  fhir:performer  ( [ Reference(CareTeam|DeviceDefinition|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Intended performer of administration
  fhir:device  ( [ CodeableReference(DeviceDefinition) ] ... ) ; # 0..* Intended type of device for the administration
  fhir:recorder [ Reference(Practitioner|PractitionerRole) ] ; # 0..1 Person who entered the request
  fhir:reason  ( [ CodeableReference(Condition|Observation) ] ... ) ; # 0..* Reason or indication for ordering or not ordering the medication
  fhir:courseOfTherapyType [ CodeableConcept ] ; # 0..1 Overall pattern of medication administration
  fhir:insurance  ( [ Reference(ClaimResponse|Coverage) ] ... ) ; # 0..* Associated insurance coverage
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Information about the prescription
  fhir:renderedDosageInstruction [ markdown ] ; # 0..1 Full representation of the dosage instructions
  fhir:effectiveDosePeriod [ Period ] ; # 0..1 Period over which the medication is to be taken
  fhir:dosageInstruction  ( [ Dosage ] ... ) ; # 0..* Specific instructions for how the medication should be taken
  fhir:dispenseRequest [ # 0..1 Medication supply authorization
    fhir:initialFill [ # 0..1 First fill details
      fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 First fill quantity
      fhir:duration [ Duration ] ; # 0..1 First fill duration
    ] ;
    fhir:dispenseInterval [ Duration ] ; # 0..1 Minimum period of time between dispenses
    fhir:validityPeriod [ Period ] ; # 0..1 Time period supply is authorized for
    fhir:numberOfRepeatsAllowed [ unsignedInt ] ; # 0..1 Number of refills authorized
    fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of medication to supply per dispense
    fhir:expectedSupplyDuration [ Duration ] ; # 0..1 Number of days supply per dispense
    fhir:dispenser [ Reference(Organization) ] ; # 0..1 Intended performer of dispense
    fhir:dispenserInstruction  ( [ Annotation ] ... ) ; # 0..* Additional information for the dispenser
    fhir:doseAdministrationAid [ CodeableConcept ] ; # 0..1 Type of adherence packaging to use for the dispense
  ] ;
  fhir:substitution [ # 0..1 Any restrictions on medication substitution
    # allowed[x] : 1..1 Whether substitution is allowed or not. One of these 2
      fhir:allowed [  a fhir:boolean ; boolean ]
      fhir:allowed [  a fhir:CodeableConcept ; CodeableConcept ]
    fhir:reason [ CodeableConcept ] ; # 0..1 Why should (not) substitution be made
  ] ;
  fhir:eventHistory  ( [ Reference(Provenance) ] ... ) ; # 0..* A list of events of interest in the lifecycle
]

Changes from both R4 and R4B

MedicationRequest
MedicationRequest.status
  • Add code ended
MedicationRequest.statusChanged
  • Added Element
MedicationRequest.medication
  • Renamed from medication[x] to medication
  • Add Type CodeableReference
  • Remove Types CodeableConcept, Reference(Medication)
MedicationRequest.informationSource
  • Added Element
MedicationRequest.reported
  • Renamed from reported[x] to reported
  • Remove Type Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
MedicationRequest.performerType
  • Add Binding `http://hl7.org/fhir/ValueSet/medication-intended-performer-role` (extensible)
MedicationRequest.performer
  • Max Cardinality changed from 1 to *
  • Type Reference: Added Target Types DeviceDefinition, HealthcareService
  • Type Reference: Removed Target Type Device
MedicationRequest.device
  • Added Element
MedicationRequest.reason
  • Added Element
MedicationRequest.courseOfTherapyType
  • Add Binding `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` (extensible)
MedicationRequest.renderedDosageInstruction
  • Added Element
MedicationRequest.effectiveDosePeriod
  • Added Element
MedicationRequest.dispenseRequest.dispenser
  • Added Element
MedicationRequest.dispenseRequest.dispenserInstruction
  • Added Element
MedicationRequest.dispenseRequest.doseAdministrationAid
  • Added Element
MedicationRequest.reasonCode
  • Deleted (-> reason)
MedicationRequest.reasonReference
  • Deleted (-> reason)
MedicationRequest.instantiatesCanonical
  • Deleted
MedicationRequest.instantiatesUri
  • Deleted
MedicationRequest.dispenseRequest.performer
  • Deleted
MedicationRequest.detectedIssue
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

11.1.4.1 Terminology Bindings

PathValueSetTypeDocumentation
MedicationRequest.status MedicationrequestStatus (a valid code from MedicationRequest Status Codes)Required

MedicationRequest Status Codes
MedicationRequest.statusReason MedicationRequestStatusReasonCodes Example

MedicationRequest Status Reason Codes
MedicationRequest.intent MedicationRequestIntent (a valid code from MedicationRequest Intent Codes)Required

MedicationRequest Intent Codes
MedicationRequest.category MedicationRequestAdministrationLocationCodes Example

MedicationRequest Administration Location Codes
MedicationRequest.priority RequestPriority Required

Identifies the level of importance to be assigned to actioning the request.
MedicationRequest.medication SNOMEDCTMedicationCodes Example

This value set includes all drug or medicament substance codes and all pharmaceutical/biologic products from SNOMED CT - provided as an exemplar value set.
MedicationRequest.performerType MedicationIntendedPerformerRole Extensible

Medication Intended Performer Role
MedicationRequest.reason ConditionProblemDiagnosisCodes Example

Example value set for Condition/Problem/Diagnosis codes.
MedicationRequest.courseOfTherapyType MedicationRequestCourseOfTherapyCodes Extensible

MedicationRequest Course of Therapy Codes
MedicationRequest.dispenseRequest.doseAdministrationAid MedicationDoseAids (a valid code from Medication dose aid)Example

Medication Dose Aids
MedicationRequest.substitution.allowed[x] ActSubstanceAdminSubstitutionCode icon Preferred

No description
MedicationRequest.substitution.reason SubstanceAdminSubstitutionReason icon Example

No description

11.1.4.2 Dosage Instructions

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.

11.1.4.2.1 Grouping Medication Requests

In general, each prescribed drug will be a separate Medication Request.

When drug orders are grouped together at the time of order entry, but each of the drugs can be manipulated independently e.g. changing the status of one order to "completed" or "cancelled", changing another order status to "on-hold", the method to "group" all of the medication requests together is to use MedicationRequest.groupIdentifier element. All of the orders grouped together in this manner will have the same groupIdentifier, and separately, each order in the group may have a unique identifier.

There are cases that require grouping of Medication orders together when it is necessary to specify optionality e.g. order two drugs at one time, but stating either of these drugs may be used to treat the patient. The use of a RequestOrchestration should be used as a parent for the Medication orders that require this type of grouping. An example when it may be necessary to group medication orders together is when you specify:

  • timing relationships e.g. order drug "xyz" with dose 123, then taper the same drug to a different dose after some interval of time precedence. For example:
    • give drug "abc" followed by drug "def"
    • give drug 30 minutes before some procedure was performed.
  • more generically this supports - hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group.

Note that one should NOT use the List or Composition resource to accomplish the above requirements. You may use List or Composition for other business requirements, but not to address the specific requirements of grouping medication orders.

11.1.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
authoredondateReturn prescriptions written on this dateMedicationRequest.authoredOn
categorytokenReturns prescriptions with different categoriesMedicationRequest.category
codetokenReturn prescriptions of this medication codeMedicationRequest.medication.concept22 Resources
combo-datedateReturns medication request to be administered on a specific date or within a date rangeMedicationRequest.dosageInstruction.timing.event | (MedicationRequest.dosageInstruction.timing.repeat.bounds.ofType(Period))
encounterreferenceReturn prescriptions with this encounter identifierMedicationRequest.encounter
(Encounter)		2 Resources
group-identifiertokenComposite request this is part ofMedicationRequest.groupIdentifier
identifiertokenReturn prescriptions with this external identifierMedicationRequest.identifier65 Resources
intended-dispenserreferenceReturns prescriptions intended to be dispensed by this OrganizationMedicationRequest.dispenseRequest.dispenser
(Organization)
intended-performerreferenceReturns the intended performer of the administration of the medication requestMedicationRequest.performer
(Practitioner, Organization, CareTeam, DeviceDefinition, Patient, HealthcareService, PractitionerRole, RelatedPerson)
intended-performertypetokenReturns requests for a specific type of performerMedicationRequest.performerType
intenttokenReturns prescriptions with different intentsMedicationRequest.intent
medicationreferenceReturn prescriptions for this medication referenceMedicationRequest.medication.reference4 Resources
patientreferenceReturns prescriptions for a specific patientMedicationRequest.subject.where(resolve() is Patient)
(Patient)		66 Resources
prioritytokenReturns prescriptions with different prioritiesMedicationRequest.priority
requesterreferenceReturns prescriptions prescribed by this prescriberMedicationRequest.requester
(Practitioner, Organization, Device, Patient, PractitionerRole, RelatedPerson)
statustokenStatus of the prescriptionMedicationRequest.status4 Resources
subjectreferenceThe identity of a patient to list orders forMedicationRequest.subject
(Group, Patient)
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