| Australian Digital Health Agency Medicare Records FHIR Implementation Guide 2.1.0

Australian Digital Health Agency Medicare Records FHIR Implementation Guide. The current version which supersedes this version is 2.2.0. It is based on FHIR® version 3.0.2. See the Directory of published versions for a list of available versions.

### StructureDefinition: ADHA PBS MedicationRequest [Active]

The purpose of this profile is to define a representation of the prescription item claimed in a claim against the Pharmaceutical Benefits Schedule (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS) for the electronic exchange of health information between Medicare repositories and the My Health Record system infrastructure in Australia.

##### Usage scenarios

The following are the usage scenarios expected:

- An individual’s PBS claim item records are uploaded to the My Health Record system from a Medicare repository

##### Each MedicationRequest SHALL have

1. a profile assertion to this profile
2. an intent
3. a medication
4. a patient
5. a date of prescribing
6. a number of repeats allowed
7. an amount of medication per dispense

##### Must Support

In the context of this profile Must Support SHALL be interpreted as follows.

- The system SHALL be able to store and retrieve the following elements:
  - status
  - intent
  - medication
  - authoredOn
  - dispenseRequest
  - dispenseRequest.numberOfRepeatsAllowed
  - dispenseRequest.quantity
- The system SHALL be able to take the following elements into account when performing processing:
  - identifier
  - subject

##### Profile-specific implementation guidance

- The patient resource should be identified in the subject element with a logical reference, i.e. an Australian IHI
- The referenced medication resource will include the code for the medication and the manufacturer if known
- If the number of permitted repeats for a prescription are zero, the numberOfRepeatsAllowed element should not be included - the value of ‘0’ cannot be used

#### Formal Views of Profile Content

The official URL for this profile is:

    http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs

The purpose of this profile is to define a representation of the prescription item claimed in a claim against the Pharmaceutical Benefits Schedule (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS) for the electronic exchange of health information between Medicare repositories and the My Health Record system infrastructure in Australia.

This profile builds on MedicationRequest.

This profile was published on 2023-04-14 04:15:22+0000 as a active by Australian Digital Health Agency.

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

- Differential Table
- Snapshot Table
- All

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | MedicationRequest | Ordering of medication for patient or group inv-dh-mr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs'
meta |  | 1..1 | Meta | Metadata about the resource
profile |  | 1..* | uri | Profiles this resource claims to conform to
identifier | S | 0..* | Identifier | External ids for this request
status | S | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
intent | S | 1..1 | code | proposal | plan | order | instance-order Fixed Value: order
medicationReference:medicationReference | S | 1..1 | Reference(ADHA PBS Medication) {c} | Medication to be taken
subject | S | 1..1 | Reference(AU Base Patient) | Who or group medication request is for
authoredOn | S | 1..1 | dateTime | When request was initially authored
requester |  | 0..1 | BackboneElement | Who/What requested the Request
agent |  | 1..1 | Reference(AU Base Practitioner | AU Base Organisation) | Who ordered the initial medication(s)
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
numberOfRepeatsAllowed | S | 0..1 | positiveInt | Number of refills authorized
quantity | S | 1..1 | SimpleQuantity | Amount of medication to supply per dispense
performer |  | 0..1 | Reference(AU Base Organisation) | Intended dispenser
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | MedicationRequest | Ordering of medication for patient or group inv-dh-mr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs'
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 1..1 | Meta | Metadata about the resource
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
profile | Σ | 1..* | uri | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | External ids for this request
definition | Σ | 0..* | Reference(ActivityDefinition | PlanDefinition) | Protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
status | ?!S Σ | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription
intent | ?!S Σ | 1..1 | code | proposal | plan | order | instance-order Binding: MedicationRequestIntent (required): The kind of medication order Fixed Value: order
category |  | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred): A coded concept identifying where the medication ordered is expected to be consumed or administered
priority | Σ | 0..1 | code | routine | urgent | stat | asap Binding: MedicationRequestPriority (required): Identifies the level of importance to be assigned to actioning the request
Slices for medication[x] | Σ | 1..1 | Reference() | Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference | S Σ | 1..1 | Reference(ADHA PBS Medication) {c} | Medication to be taken
subject | S Σ | 1..1 | Reference(AU Base Patient) | Who or group medication request is for
context |  | 0..1 | Reference(Encounter | EpisodeOfCare) | Created during encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | Σ C | 0..1 | BackboneElement | Who/What requested the Request
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
agent | Σ | 1..1 | Reference(AU Base Practitioner | AU Base Organisation) | Who ordered the initial medication(s)
onBehalfOf | Σ C | 0..1 | Reference(Organization) | Organization agent is acting for
recorder |  | 0..1 | Reference(Practitioner) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (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
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction |  | 0..* | Dosage | How the medication should be taken
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed | S | 0..1 | positiveInt | Number of refills authorized
quantity | S | 1..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(AU Base Organisation) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
allowed | ?! | 1..1 | boolean | Whether substitution is allowed or not
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

Differential View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | MedicationRequest | Ordering of medication for patient or group inv-dh-mr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs'
meta |  | 1..1 | Meta | Metadata about the resource
profile |  | 1..* | uri | Profiles this resource claims to conform to
identifier | S | 0..* | Identifier | External ids for this request
status | S | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
intent | S | 1..1 | code | proposal | plan | order | instance-order Fixed Value: order
medicationReference:medicationReference | S | 1..1 | Reference(ADHA PBS Medication) {c} | Medication to be taken
subject | S | 1..1 | Reference(AU Base Patient) | Who or group medication request is for
authoredOn | S | 1..1 | dateTime | When request was initially authored
requester |  | 0..1 | BackboneElement | Who/What requested the Request
agent |  | 1..1 | Reference(AU Base Practitioner | AU Base Organisation) | Who ordered the initial medication(s)
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
numberOfRepeatsAllowed | S | 0..1 | positiveInt | Number of refills authorized
quantity | S | 1..1 | SimpleQuantity | Amount of medication to supply per dispense
performer |  | 0..1 | Reference(AU Base Organisation) | Intended dispenser
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | MedicationRequest | Ordering of medication for patient or group inv-dh-mr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs'
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 1..1 | Meta | Metadata about the resource
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
profile | Σ | 1..* | uri | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | External ids for this request
definition | Σ | 0..* | Reference(ActivityDefinition | PlanDefinition) | Protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
status | ?!S Σ | 0..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription
intent | ?!S Σ | 1..1 | code | proposal | plan | order | instance-order Binding: MedicationRequestIntent (required): The kind of medication order Fixed Value: order
category |  | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred): A coded concept identifying where the medication ordered is expected to be consumed or administered
priority | Σ | 0..1 | code | routine | urgent | stat | asap Binding: MedicationRequestPriority (required): Identifies the level of importance to be assigned to actioning the request
Slices for medication[x] | Σ | 1..1 | Reference() | Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference | S Σ | 1..1 | Reference(ADHA PBS Medication) {c} | Medication to be taken
subject | S Σ | 1..1 | Reference(AU Base Patient) | Who or group medication request is for
context |  | 0..1 | Reference(Encounter | EpisodeOfCare) | Created during encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | Σ C | 0..1 | BackboneElement | Who/What requested the Request
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
agent | Σ | 1..1 | Reference(AU Base Practitioner | AU Base Organisation) | Who ordered the initial medication(s)
onBehalfOf | Σ C | 0..1 | Reference(Organization) | Organization agent is acting for
recorder |  | 0..1 | Reference(Practitioner) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for writing the prescription Binding: Condition/Problem/Diagnosis Codes (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
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction |  | 0..* | Dosage | How the medication should be taken
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed | S | 0..1 | positiveInt | Number of refills authorized
quantity | S | 1..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(AU Base Organisation) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
allowed | ?! | 1..1 | boolean | Whether substitution is allowed or not
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

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron

#### 1.0.2 Quick Start

Below is an overview of the required search and read operations.

Summary of Search Criteria for StructureDefinition-medicationrequest-pbs

none defined