My Health Record FHIR IG
1.2.0 - active

My Health Record FHIR IG - Local Development build (v1.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: ADHAMedicationRequestPBSClaim - Detailed Descriptions

Active as of 2024-09-19

Definitions for the dh-medicationrequest-pbs-claim-1 resource profile.

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

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

0. MedicationRequest
Definition | A PBS claim item includes information about pharmaceutical items prescribed and dispensed to an individual that were partially or fully funded under the PBS or Repatriation Pharmaceutical Benefits Scheme (RPBS).
Short | PBS or RPBS claim item
2. MedicationRequest.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
4. MedicationRequest.status
Must Support | true
Fixed Value | `unknown`
6. MedicationRequest.intent
Must Support | true
Fixed Value | `order`
8. MedicationRequest.medication[x]:medicationReference
Slice Name | medicationReference
Control | 1..? This element is affected by the following invariants: inv-dh-pbs-03
Type | Reference(ADHA Core Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
Invariants | inv-dh-pbs-03: At least reference shall be present (`reference.exists()`)
10. MedicationRequest.subject
Type | Reference(ADHA Core Patient)
Must Support | true
Invariants | inv-dh-medreq-01: At least reference or a valid identifier shall be present (`reference.exists() or identifier.where(system.count() + value.count() >1).exists()`)
12. MedicationRequest.authoredOn
Control | 1..?
Must Support | true
14. MedicationRequest.dispenseRequest
Control | 1..?
Must Support | true
16. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
Must Support | true
18. MedicationRequest.dispenseRequest.quantity
Control | 1..?
Must Support | true

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

0. MedicationRequest
Definition | A PBS claim item includes information about pharmaceutical items prescribed and dispensed to an individual that were partially or fully funded under the PBS or Repatriation Pharmaceutical Benefits Scheme (RPBS). An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Short | PBS or RPBS claim itemOrdering of medication for patient or group
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Prescription, Order
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.extension:subsidisedConcurrentSupply
Slice Name | subsidisedConcurrentSupply
Definition | The grounds which authorise a PBS or RPBS subsidy for the concurrent supply of a medication item specified in a prescription and all of its repeats.
Short | Grounds for concurrent supply of medication
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Subsidised Concurrent Supply) (Extension Type: Coding)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. MedicationRequest.identifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier(Identifier, AU ETP Prescription Identifier, AU Local Prescription Identifier)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationRequest.status
Definition | A code specifying the current state of the order. Generally, this will be active or completed state.
Short | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` ) A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `unknown`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MedicationRequest.intent
Definition | Whether the request is a proposal, plan, or an original order.
Short | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` ) The kind of medication order.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `order`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. MedicationRequest.doNotPerform
Definition | If true indicates that the provider is asking for the medication request not to occur.
Short | True if request is prohibiting action
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform".
Control | 0..1
Type | boolean
Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MedicationRequest.medication[x]
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Medication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1
Type | Reference(Medication), CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationRequest.medication[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
18. MedicationRequest.medication[x]:medicationReference
Slice Name | medicationReference
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Prescribed MedicationMedication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1 This element is affected by the following invariants: inv-dh-pbs-03
Type | Reference(ADHA Core Medication, Medication), CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) inv-dh-pbs-03: At least reference shall be present (`reference.exists()`)
20. MedicationRequest.medication[x]:medicationCodeableConcept
Slice Name | medicationCodeableConcept
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Coded Prescribed MedicationMedication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 01..1
Binding | For example codes, see SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes (example to `http://hl7.org/fhir/ValueSet/medication-codes` )
Additional Bindings | Purpose | Documentation
Australian Medication | Preferred | This value set is for use when AMT (Australian Medicines Terminology) codes are preferred.
PBS Item Codes | Preferred | This value set is for use when PBS (Pharmaceutical Benefits Scheme) item codes are preferred.
MIMS | Preferred | This value set is for use when MIMS (Monthly Index of Medical Specialties) codes are preferred.
GTIN | Preferred | This value set is for use when GTIN (Global Trade Item Number) codes are preferred.
Type | CodeableConcept, Reference(Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. MedicationRequest.subject
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given.
Short | Who or group medication request is for
Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.
Control | 1..1 This element is affected by the following invariants: inv-dh-medreq-01
Type | Reference(ADHA Core Patient, Patient, Group)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) inv-dh-medreq-01: At least reference or a valid identifier shall be present (`reference.exists() or identifier.where(system.count() + value.count() >1).exists()`)
24. MedicationRequest.supportingInformation
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Information to support ordering of the medication
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationRequest.supportingInformation`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
26. MedicationRequest.supportingInformation:bodyHeight
Slice Name | bodyHeight
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Observation of Body HeightInformation to support ordering of the medication
Control | 0..1*
Type | Reference(Observation Body Height Profile, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. MedicationRequest.supportingInformation:bodyWeight
Slice Name | bodyWeight
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Observation of Body WeightInformation to support ordering of the medication
Control | 0..1*
Type | Reference(Observation Body Weight Profile, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. MedicationRequest.authoredOn
Definition | The date (and perhaps time) when the prescription was initially written or authored on.
Short | Created dateWhen request was initially authored
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. MedicationRequest.dispenseRequest
Definition | Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Short | Requested dispensingMedication supply authorization
Control | 10..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. MedicationRequest.dispenseRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
Definition | An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
Short | Maximum repeats authorisedNumber of refills authorized
Comments | If displaying "number of authorized fills", add 1 to this number.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. MedicationRequest.dispenseRequest.quantity
Definition | The amount that is to be dispensed for one fill.
Short | Amount of medication to supply per dispense
Control | 10..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. MedicationRequest
Definition | A PBS claim item includes information about pharmaceutical items prescribed and dispensed to an individual that were partially or fully funded under the PBS or Repatriation Pharmaceutical Benefits Scheme (RPBS).
Short | PBS or RPBS claim item
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Prescription, Order
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. MedicationRequest.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. MedicationRequest.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. MedicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. MedicationRequest.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. MedicationRequest.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. MedicationRequest.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. MedicationRequest.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. MedicationRequest.extension:subsidisedConcurrentSupply
Slice Name | subsidisedConcurrentSupply
Definition | The grounds which authorise a PBS or RPBS subsidy for the concurrent supply of a medication item specified in a prescription and all of its repeats.
Short | Grounds for concurrent supply of medication
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Subsidised Concurrent Supply) (Extension Type: Coding)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. MedicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. MedicationRequest.identifier
Definition | Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External ids for this request
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier(Identifier, AU ETP Prescription Identifier, AU Local Prescription Identifier)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. MedicationRequest.status
Definition | A code specifying the current state of the order. Generally, this will be active or completed state.
Short | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from medicationrequest Status (required to `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` ) A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `unknown`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. MedicationRequest.statusReason
Definition | Captures the reason for the current state of the MedicationRequest.
Short | Reason for current status
Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.
Control | 0..1
Binding | For example codes, see medicationRequest Status Reason Codes (example to `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` ) Identifies the reasons for a given status.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. MedicationRequest.intent
Definition | Whether the request is a proposal, plan, or an original order.
Short | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from medicationRequest Intent (required to `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` ) The kind of medication order.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Fixed Value | `order`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. MedicationRequest.category
Definition | Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Short | Type of medication usage
Comments | The category can be used to include where the medication is expected to be consumed or other types of requests.
Control | 0..*
Binding | For example codes, see medicationRequest Category Codes (example to `http://hl7.org/fhir/ValueSet/medicationrequest-category` ) A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. MedicationRequest.priority
Definition | Indicates how quickly the Medication Request should be addressed with respect to other requests.
Short | routine | urgent | asap | stat
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority (required to `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` ) Identifies the level of importance to be assigned to actioning the request.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. MedicationRequest.doNotPerform
Definition | If true indicates that the provider is asking for the medication request not to occur.
Short | True if request is prohibiting action
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform".
Control | 0..1
Type | boolean
Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. MedicationRequest.reported[x]
Definition | Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.
Short | Reported rather than primary record
Control | 0..1
Type | Choice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. MedicationRequest.medication[x]
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Medication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1
Type | Reference
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `MedicationRequest.medication[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
38. MedicationRequest.medication[x]:medicationReference
Slice Name | medicationReference
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Prescribed Medication
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1 This element is affected by the following invariants: inv-dh-pbs-03
Type | Reference(ADHA Core Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) inv-dh-pbs-03: At least reference shall be present (`reference.exists()`)
40. MedicationRequest.medication[x]:medicationCodeableConcept
Slice Name | medicationCodeableConcept
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Coded Prescribed Medication
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 0..1
Binding | For example codes, see SNOMEDCTMedicationCodes (example to `http://hl7.org/fhir/ValueSet/medication-codes` )
Additional Bindings | Purpose | Documentation
Australian Medication | Preferred | This value set is for use when AMT (Australian Medicines Terminology) codes are preferred.
PBS Item Codes | Preferred | This value set is for use when PBS (Pharmaceutical Benefits Scheme) item codes are preferred.
MIMS | Preferred | This value set is for use when MIMS (Monthly Index of Medical Specialties) codes are preferred.
GTIN | Preferred | This value set is for use when GTIN (Global Trade Item Number) codes are preferred.
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. MedicationRequest.medication[x]:medicationCodeableConcept.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
44. MedicationRequest.medication[x]:medicationCodeableConcept.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.medication[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. MedicationRequest.medication[x]:medicationCodeableConcept.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. MedicationRequest.medication[x]:medicationCodeableConcept.coding.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
50. MedicationRequest.medication[x]:medicationCodeableConcept.coding.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationRequest.medication[x].coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
52. MedicationRequest.medication[x]:medicationCodeableConcept.coding.extension:medicationClass
Slice Name | medicationClass
Definition | The type of information covered by the medication coding, e.g. branded product with no strength or form.
Short | Medication type
Control | 0..1
Type | Extension(Medication Type) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
54. MedicationRequest.medication[x]:medicationCodeableConcept.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. MedicationRequest.medication[x]:medicationCodeableConcept.coding.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. MedicationRequest.medication[x]:medicationCodeableConcept.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. MedicationRequest.medication[x]:medicationCodeableConcept.coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. MedicationRequest.medication[x]:medicationCodeableConcept.coding.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. MedicationRequest.medication[x]:medicationCodeableConcept.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. This may be a brand or generic name as suitable for the intent of the entry.
Short | Medication primary text
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. MedicationRequest.subject
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given.
Short | Who or group medication request is for
Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.
Control | 1..1 This element is affected by the following invariants: inv-dh-medreq-01
Type | Reference(ADHA Core Patient)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) inv-dh-medreq-01: At least reference or a valid identifier shall be present (`reference.exists() or identifier.where(system.count() + value.count() >1).exists()`)
68. MedicationRequest.encounter
Definition | The Encounter during which this [x] was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of encounter/admission/stay
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. MedicationRequest.supportingInformation
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Information to support ordering of the medication
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `MedicationRequest.supportingInformation`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
72. MedicationRequest.supportingInformation:bodyHeight
Slice Name | bodyHeight
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Observation of Body Height
Control | 0..1
Type | Reference(Observation Body Height Profile)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. MedicationRequest.supportingInformation:bodyWeight
Slice Name | bodyWeight
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Observation of Body Weight
Control | 0..1
Type | Reference(Observation Body Weight Profile)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. MedicationRequest.authoredOn
Definition | The date (and perhaps time) when the prescription was initially written or authored on.
Short | Created date
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. MedicationRequest.requester
Definition | The individual, organization, or device that initiated the request and has responsibility for its activation.
Short | Who/What requested the Request
Control | 0..1
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. MedicationRequest.performer
Definition | The specified desired performer of the medication treatment (e.g. the performer of the medication administration).
Short | Intended performer of administration
Control | 0..1
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. MedicationRequest.performerType
Definition | Indicates the type of performer of the administration of the medication.
Short | Desired kind of performer of the medication administration
Comments | If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.
Control | 0..1
Binding | For example codes, see ProcedurePerformerRoleCodes (example to `http://hl7.org/fhir/ValueSet/performer-role` ) Identifies the type of individual that is desired to administer the medication.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. MedicationRequest.recorder
Definition | The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
Short | Person who entered the request
Control | 0..1
Type | Reference(Practitioner, PractitionerRole)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. MedicationRequest.reasonCode
Definition | The reason or the indication for ordering or not ordering the medication.
Short | Reason or indication for ordering or not ordering the medication
Comments | This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
Control | 0..*
Binding | The codes SHOULD be taken from Reason for Request (preferred to `https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. MedicationRequest.reasonReference
Definition | Condition or observation that supports why the medication was ordered.
Short | Condition or observation that supports why the prescription is being written
Comments | This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Control | 0..*
Type | Reference(Condition, Observation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. MedicationRequest.instantiatesCanonical
Definition | The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
Short | Instantiates FHIR protocol or definition
Control | 0..*
Type | canonical
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. MedicationRequest.instantiatesUri
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.
Short | Instantiates external protocol or definition
Control | 0..*
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. MedicationRequest.basedOn
Definition | A plan or request that is fulfilled in whole or in part by this medication request.
Short | What request fulfills
Control | 0..*
Type | Reference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. MedicationRequest.groupIdentifier
Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.
Short | Composite request this is part of
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. MedicationRequest.courseOfTherapyType
Definition | The description of the overall patte3rn of the administration of the medication to the patient.
Short | Overall pattern of medication administration
Comments | This attribute should not be confused with the protocol of the medication.
Control | 0..1
Binding | For example codes, see medicationRequest Course of Therapy Codes (example to `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` ) Identifies the overall pattern of medication administratio.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. MedicationRequest.insurance
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Short | Associated insurance coverage
Control | 0..*
Type | Reference(Coverage, ClaimResponse)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. MedicationRequest.note
Definition | Extra information about the prescription that could not be conveyed by the other attributes.
Short | Information about the prescription
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. MedicationRequest.dosageInstruction
Definition | Indicates how the medication is/was taken or should be taken by the patient.
Short | Dosage information in an Australian healthcare context
Comments | There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
Control | 0..*
Type | Dosage(AU Base Dosage)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. MedicationRequest.dispenseRequest
Definition | Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
Short | Requested dispensing
Control | 1..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. MedicationRequest.dispenseRequest.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
110. MedicationRequest.dispenseRequest.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
112. MedicationRequest.dispenseRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. MedicationRequest.dispenseRequest.initialFill
Definition | Indicates the quantity or duration for the first dispense of the medication.
Short | First fill details
Comments | If populating this element, either the quantity or the duration must be included.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. MedicationRequest.dispenseRequest.initialFill.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
118. MedicationRequest.dispenseRequest.initialFill.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. MedicationRequest.dispenseRequest.initialFill.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
122. MedicationRequest.dispenseRequest.initialFill.quantity
Definition | The amount or quantity to provide as part of the first dispense.
Short | First fill quantity
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. MedicationRequest.dispenseRequest.initialFill.duration
Definition | The length of time that the first dispense is expected to last.
Short | First fill duration
Control | 0..1
Type | Duration
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. MedicationRequest.dispenseRequest.dispenseInterval
Definition | The minimum period of time that must occur between dispenses of the medication.
Short | Minimum period of time between dispenses
Control | 0..1
Type | Duration
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. MedicationRequest.dispenseRequest.validityPeriod
Definition | This indicates the validity period of a prescription (stale dating the Prescription).
Short | Time period supply is authorized for
Comments | It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.
Control | 0..1
Type | Period
Is Modifier | false
Summary | false
Requirements | Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
Definition | An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
Short | Maximum repeats authorised
Comments | If displaying "number of authorized fills", add 1 to this number.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. MedicationRequest.dispenseRequest.quantity
Definition | The amount that is to be dispensed for one fill.
Short | Amount of medication to supply per dispense
Control | 1..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. MedicationRequest.dispenseRequest.expectedSupplyDuration
Definition | Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
Short | Number of days supply per dispense
Comments | In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.
Control | 0..1
Type | Duration
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. MedicationRequest.dispenseRequest.performer
Definition | Indicates the intended dispensing Organization specified by the prescriber.
Short | Intended dispenser
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. MedicationRequest.substitution
Definition | Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.
Short | Brand substitution details
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
140. MedicationRequest.substitution.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
142. MedicationRequest.substitution.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
144. MedicationRequest.substitution.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
146. MedicationRequest.substitution.allowed[x]
Definition | True if the prescriber allows a different drug to be dispensed from what was prescribed.
Short | Brand substitution flag
Comments | This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.
Control | 1..1
Binding | For example codes, see ActSubstanceAdminSubstitutionCode (example to `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode` ) Identifies the type of substitution allowed.
Type | Choice of: boolean, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
148. MedicationRequest.substitution.reason
Definition | Indicates the reason for the substitution, or why substitution must or must not be performed.
Short | Why should (not) substitution be made
Control | 0..1
Binding | The codes SHOULD be taken from Medicine Substitution Reason (preferred to `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. MedicationRequest.priorPrescription
Definition | A link to a resource representing an earlier order related order or prescription.
Short | An order/prescription that is being replaced
Control | 0..1
Type | Reference(MedicationRequest)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. MedicationRequest.detectedIssue
Definition | Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.
Short | Clinical Issue with action
Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
Control | 0..*
Type | Reference(DetectedIssue)
Is Modifier | false
Summary | false
Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. MedicationRequest.eventHistory
Definition | Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
Short | A list of events of interest in the lifecycle
Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
Control | 0..*
Type | Reference(Provenance)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)