<status value="draft"/> <date value="2023-11-29T14:36:10+00:00"/> <publisher value="The Linked Care Consortium"/> <contact> <name value="The Linked Care Consortium"/> <telecom> <system value="url"/> <value value="https://www.linkedcare.at/"/> </telecom> </contact> <description value="Linked Care profile for individual proposal positions. A list of proposal positions is first received as contained resources in a LINCA Proposal. Then the Linked Care FHIR server creates an instance for each contained item. These instances are send to the assigned practicioner(s) for authorization."/> <fhirVersion value="5.0.0"/> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="script10.6"/> <uri value="http://ncpdp.org/SCRIPT10_6"/> <name value="Mapping to NCPDP SCRIPT 10.6"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 V2 Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="MedicationRequest"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <derivation value="constraint"/> <snapshot> <element id="MedicationRequest"> <path value="MedicationRequest"/> <short value="Ordering of medication for patient or group"/> <definition value="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."/> <alias value="Prescription"/> <alias value="Order"/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="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"/> <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/> </extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity, Role, or Act,CombinedMedicationRequest"/> </mapping> <mapping> <identity value="workflow"/> <map value="Request"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.medication"/> </mapping> </element> <element id="MedicationRequest.id"> <path value="MedicationRequest.id"/> <short value="LinkedCare Proposal Id, assigned by the Linked Care Fhir Server. Any initial value will be overwritten"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="MedicationRequest.meta"> <path value="MedicationRequest.meta"/> <short value="Metadata about the resource"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="MedicationRequest.implicitRules"> <path value="MedicationRequest.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="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."/> <comment value="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 its narrative along with other profiles, value sets, etc."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation"/> <isSummary value="true"/> </element> <element id="MedicationRequest.language"> <path value="MedicationRequest.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="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)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </additional> </binding> </element> <element id="MedicationRequest.text"> <path value="MedicationRequest.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="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."/> <comment value="Contained resources do not have a 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."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="MedicationRequest.contained"> <path value="MedicationRequest.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/> <comment value="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."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="0"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.extension"> <path value="MedicationRequest.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.modifierExtension"> <path value="MedicationRequest.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.identifier"> <path value="MedicationRequest.identifier"/> <short value="external ID(s), e.g.: can be used to refer to a care software database record"/> <definition value="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."/> <comment value="This is a business identifier, not a resource identifier."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.identifier"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Header/PrescriberOrderNumber"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="ORC-2-Placer Order Number / ORC-3-Filler Order Number"/> </mapping> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="MedicationRequest.basedOn"> <path value="MedicationRequest.basedOn"/> <short value="If this item is a correction of a previous element in the chain, set to a reference to that previous element"/> <definition value="A plan or request that is fulfilled in whole or in part by this medication request."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.basedOn"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.basedOn"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"/> </mapping> </element> <element id="MedicationRequest.priorPrescription"> <path value="MedicationRequest.priorPrescription"/> <short value="Reference to an order/prescription that is being replaced by this MedicationRequest"/> <definition value="Reference to an order/prescription that is being replaced by this MedicationRequest."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.priorPrescription"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.replaces"/> </mapping> <mapping> <identity value="script10.6"/> <map value="not mapped"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]"/> </mapping> </element> <element id="MedicationRequest.groupIdentifier"> <path value="MedicationRequest.groupIdentifier"/> <short value="Composite request this is part of"/> <definition value="A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time."/> <requirements value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.groupIdentifier"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.groupIdentifier"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id"/> </mapping> </element> <element id="MedicationRequest.status"> <path value="MedicationRequest.status"/> <short value="In new proposals, the status must be set to unknown. The Linked Care server will set it to active in the instantiated copies of the positions. Possible values: active, cancelled (end-of-chain), unknown"/> <definition value="A code specifying the current state of the order. Generally, this will be active or completed state."/> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Clinical decision support systems should take the status into account when determining which medications to include in their algorithms."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="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"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestStatus"/> </extension> <strength value="required"/> <description value="A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.status"/> </mapping> <mapping> <identity value="script10.6"/> <map value="no mapping"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="rim"/> <map value=".statusCode"/> </mapping> </element> <element id="MedicationRequest.statusReason"> <path value="MedicationRequest.statusReason"/> <short value="Reason for current status"/> <definition value="Captures the reason for the current state of the MedicationRequest."/> <comment value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.statusReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestStatusReason"/> </extension> <strength value="example"/> <description value="Identifies the reasons for a given status."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-status-reason"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.statusReason"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"/> </mapping> </element> <element id="MedicationRequest.statusChanged"> <path value="MedicationRequest.statusChanged"/> <short value="When the status was changed"/> <definition value="The date (and perhaps time) when the status was changed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.statusChanged"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="subjectOf Observation[code = statusChange].value = date"/> </mapping> </element> <element id="MedicationRequest.intent"> <path value="MedicationRequest.intent"/> <short value="Possible values: proposal (default in contained and instance of proposal), order (default in prescriptions), reflex-order (automatically created orders due to an ad-hoc prescription)"/> <definition value="Whether the request is a proposal, plan, or an original order."/> <comment value="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."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.intent"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="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"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestIntent"/> </extension> <strength value="required"/> <description value="The kind of medication order."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.intent"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="rim"/> <map value=".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"/> </mapping> </element> <element id="MedicationRequest.category"> <path value="MedicationRequest.category"/> <short value="Grouping or category of medication request"/> <definition value="An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication."/> <comment value="The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestAdministrationLocation"/> </extension> <strength value="example"/> <description value="A coded concept identifying where the medication is to be consumed or administered."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-admin-location"/> </binding> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value"/> </mapping> </element> <element id="MedicationRequest.priority"> <path value="MedicationRequest.priority"/> <short value="routine | urgent | asap | stat"/> <definition value="Indicates how quickly the Medication Request should be addressed with respect to other requests."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.priority"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestPriority"/> </extension> <strength value="required"/> <description value="Identifies the level of importance to be assigned to actioning the request."/> <valueSet value="http://hl7.org/fhir/ValueSet/request-priority|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.priority"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.grade"/> </mapping> <mapping> <identity value="rim"/> <map value=".priorityCode"/> </mapping> </element> <element id="MedicationRequest.doNotPerform"> <path value="MedicationRequest.doNotPerform"/> <short value="True if patient is to stop taking or not to start taking the medication"/> <definition value="If true, indicates that the provider is asking for the patient to either stop taking or to not start taking the specified medication. For example, the patient is taking an existing medication and the provider is changing their medication. They want to create two seperate requests: one to stop using the current medication and another to start the new medication."/> <comment value="If do not perform is not specified, the request is a positive request e.g. "do perform"."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.doNotPerform"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="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.)"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.actionNegationInd"/> </mapping> </element> <element id="MedicationRequest.medication"> <path value="MedicationRequest.medication"/> <short value="Medication in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP)."/> <definition value="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."/> <comment value="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."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.medication"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/linca-medication"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/CodeSystem-asp-liste"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.code"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="RXE-2-Give Code / RXO-1 Requested Give Code / RXC-2 Component Code"/> </mapping> <mapping> <identity value="rim"/> <map value="consumable.administrableMedication"/> </mapping> </element> <element id="MedicationRequest.subject"> <path value="MedicationRequest.subject"/> <short value="Each LINCAProposalMedicationRequest is associated with one patient. The patient data is conformant to the HL7 Austria patient and must be clearly identifiable."/> <definition value="The individual or group for whom the medication has been requested."/> <comment value="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."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.subject"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/at-core-patient"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.subject"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT)"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3 Patient ID List"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].role"/> </mapping> </element> <element id="MedicationRequest.informationSource"> <path value="MedicationRequest.informationSource"/> <short value="This contains the identity of the proposal placer (OID in case of organizations, eID in case of individuals)"/> <definition value="The person or organization who provided the information about this request, if the source is someone other than the requestor. This is often used when the MedicationRequest is reported by another person."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.informationSource"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practitioner or Related Person or Practitioner Role or Organization"/> </mapping> </element> <element id="MedicationRequest.encounter"> <path value="MedicationRequest.encounter"/> <short value="Encounter created as part of encounter/admission/stay"/> <definition value="The Encounter during which this [x] was created or to which the creation of this record is tightly associated."/> <comment value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.encounter"/> </mapping> <mapping> <identity value="script10.6"/> <map value="no mapping"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="v2"/> <map value="PV1-19 Visit Number"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]"/> </mapping> </element> <element id="MedicationRequest.supportingInformation"> <path value="MedicationRequest.supportingInformation"/> <short value="First Element is reserved for reference to origin (LINCARequestOrchestration) assigned on LinkedCare Platform. Used to link instantiated proposal items back to the proposal header (LINCARequestOrchestration)."/> <definition value="Information to support fulfilling (i.e. dispensing or administering) of the medication, for example, patient height and weight, a MedicationStatement for the patient)."/> <comment value="This attribute can be used to reference a MedicationStatement about the patients' medication use."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.supportingInformation"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.supportingInfo"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"/> </mapping> </element> <element id="MedicationRequest.authoredOn"> <path value="MedicationRequest.authoredOn"/> <short value="When request was initially authored"/> <definition value="The date (and perhaps time) when the prescription was initially written or authored on."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.authoredOn"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.authoredOn"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/WrittenDate"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="v2"/> <map value="RXE-32 Original Order Date/Time / ORC-9-Date Time of Transaction"/> </mapping> <mapping> <identity value="rim"/> <map value="author.time"/> </mapping> </element> <element id="MedicationRequest.requester"> <path value="MedicationRequest.requester"/> <short value="Username/account name as specified by placer"/> <definition value="The individual, organization, or device that initiated the request and has responsibility for its activation."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.requester"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.requester"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.author"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].role"/> </mapping> </element> <element id="MedicationRequest.reported"> <path value="MedicationRequest.reported"/> <short value="Reported rather than primary record"/> <definition value="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."/> <comment value="If not populated, then assume that this is the original record and not reported"/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.reported"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=INF].role"/> </mapping> </element> <element id="MedicationRequest.performerType"> <path value="MedicationRequest.performerType"/> <short value="Desired kind of performer of the medication administration"/> <definition value="Indicates the type of performer of the administration of the medication."/> <comment value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.performerType"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestPerformerType"/> </extension> <strength value="extensible"/> <description value="Identifies the type of individual that is desired to administer the medication."/> <valueSet value="http://hl7.org/fhir/ValueSet/medication-intended-performer-role"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.performerType"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code"/> </mapping> </element> <element id="MedicationRequest.performer"> <path value="MedicationRequest.performer"/> <short value="The authorizing practitioner for this proposal item (identified by their OID according to GDA Index)"/> <definition value="The specified desired performer of the medication treatment (e.g. the performer of the medication administration). For devices, this is the device that is intended to perform the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.performer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.performer"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/> </mapping> </element> <element id="MedicationRequest.device"> <path value="MedicationRequest.device"/> <short value="Intended type of device for the administration"/> <definition value="The intended type of device that is to be used for the administration of the medication (for example, PCA Pump)."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.device"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceDefinition"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/> </mapping> </element> <element id="MedicationRequest.recorder"> <path value="MedicationRequest.recorder"/> <short value="Person who entered the request"/> <definition value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.recorder"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.who"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)"/> </mapping> </element> <element id="MedicationRequest.reason"> <path value="MedicationRequest.reason"/> <short value="Reason or indication for ordering or not ordering the medication"/> <definition value="The reason or the indication for ordering or not ordering the medication."/> <comment value="This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.reason"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestReason"/> </extension> <strength value="example"/> <description value="A coded concept indicating why the medication was ordered."/> <valueSet value="http://hl7.org/fhir/ValueSet/condition-code"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.reason"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.why[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="ORC-16 Order Control Code Reason /RXE-27 Give Indication/RXO-20-Indication / RXD-21 Indication / RXG-22 Indication / RXA-19 Indication"/> </mapping> <mapping> <identity value="rim"/> <map value="reason.observation.reasonCode | reason.observation[code=ASSERTION].value"/> </mapping> </element> <element id="MedicationRequest.courseOfTherapyType"> <path value="MedicationRequest.courseOfTherapyType"/> <short value="Overall pattern of medication administration"/> <definition value="The description of the overall pattern of the administration of the medication to the patient."/> <comment value="This attribute should not be confused with the protocol of the medication."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.courseOfTherapyType"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestCourseOfTherapy"/> </extension> <strength value="extensible"/> <description value="Identifies the overall pattern of medication administratio."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy"/> </binding> <mapping> <identity value="rim"/> <map value="Act.code where classCode = LIST and moodCode = EVN"/> </mapping> </element> <element id="MedicationRequest.insurance"> <path value="MedicationRequest.insurance"/> <short value="Associated insurance coverage"/> <definition value="Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.insurance"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Coverage"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ClaimResponse"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.insurance"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COVBY].target"/> </mapping> </element> <element id="MedicationRequest.note"> <path value="MedicationRequest.note"/> <short value="Information about the prescription"/> <definition value="Extra information about the prescription that could not be conveyed by the other attributes."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.note"/> </mapping> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/Note"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value"/> </mapping> </element> <element id="MedicationRequest.renderedDosageInstruction"> <path value="MedicationRequest.renderedDosageInstruction"/> <short value="Full representation of the dosage instructions"/> <definition value="The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses."/> <requirements value="The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.renderedDosageInstruction"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.text"/> </mapping> </element> <element id="MedicationRequest.effectiveDosePeriod"> <path value="MedicationRequest.effectiveDosePeriod"/> <short value="Period over which the medication is to be taken"/> <definition value="The period over which the medication is to be taken. Where there are multiple dosageInstruction lines (for example, tapering doses), this is the earliest date and the latest end date of the dosageInstructions."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.effectiveDosePeriod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="substanceAdministration.effectiveTime"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction"> <path value="MedicationRequest.dosageInstruction"/> <short value="Specific instructions for how the medication should be taken"/> <definition value="Specific instructions for how the medication is to be used by the patient."/> <comment value="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. In general, each prescribed drug will be a separate Medication Request. When drug orders are grouped together at the time of order entry, but each of the drugs can be manipulated independently e.g. changing the status of one order to "completed" or "cancelled", changing another order status to "on-hold", the method to "group" all of the medication requests together is to use MedicationRequest.groupIdentifier element. All of the orders grouped together in this manner will have the same groupIdentifier, and separately, each order in the group may have a unique identifier. There are cases that require grouping of Medication orders together when it is necessary to specify optionality e.g. order two drugs at one time, but stating either of these drugs may be used to treat the patient. The use of a RequestOrchestration should be used as a parent for the Medication orders that require this type of grouping. An example when it may be necessary to group medication orders together is when you specify timing relationships e.g. order drug "xyz" with dose 123, then taper the same drug to a different dose after some interval of time precedence: e.g. give drug "abc" followed by drug "def" e.g. give drug 30 minutes before some procedure was performed more generically this supports - hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group. Note that one should NOT use the List or Composition resource to accomplish the above requirements. You may use List or Composition for other business requirements, but not to address the specific requirements of grouping medication orders."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.dosageInstruction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Dosage"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="see dosageInstruction mapping"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.id"> <path value="MedicationRequest.dosageInstruction.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.extension"> <path value="MedicationRequest.dosageInstruction.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.modifierExtension"> <path value="MedicationRequest.dosageInstruction.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneType.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.sequence"> <path value="MedicationRequest.dosageInstruction.sequence"/> <short value="The order of the dosage instructions"/> <definition value="Indicates the order in which the dosage instructions should be applied or interpreted."/> <requirements value="If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.sequence"/> <min value="0"/> <max value="1"/> </base> <type> <code value="integer"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TQ1-1"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.text"> <path value="MedicationRequest.dosageInstruction.text"/> <short value="Free text dosage instructions e.g. SIG"/> <definition value="Free text dosage instructions e.g. SIG."/> <requirements value="Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-6; RXE-21"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.additionalInstruction"> <path value="MedicationRequest.dosageInstruction.additionalInstruction"/> <short value="Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness""/> <definition value="Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps")."/> <comment value="Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or take "immediately following drug x") should be populated in dosage.text."/> <requirements value="Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded."/> <min value="0"/> <max value="*"/> <base> <path value="Dosage.additionalInstruction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdditionalInstruction"/> </extension> <strength value="example"/> <description value="A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery"."/> <valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXO-7"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.patientInstruction"> <path value="MedicationRequest.dosageInstruction.patientInstruction"/> <short value="Patient or consumer oriented instructions"/> <definition value="Instructions in terms that are understood by the patient or consumer."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.patientInstruction"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-7"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.timing"> <path value="MedicationRequest.dosageInstruction.timing"/> <short value="When medication should be administered"/> <definition value="When medication should be administered."/> <comment value="This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing."/> <requirements value="The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.timing"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Timing"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".effectiveTime"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.asNeeded"> <path value="MedicationRequest.dosageInstruction.asNeeded"/> <short value="Take "as needed""/> <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option)."/> <comment value="Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.asNeeded"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <condition value="dos-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TQ1-9"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.asNeededFor"> <path value="MedicationRequest.dosageInstruction.asNeededFor"/> <short value="Take "as needed" (for x)"/> <definition value="Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept)."/> <comment value="Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed"."/> <min value="0"/> <max value="*"/> <base> <path value="Dosage.asNeededFor"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="dos-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAsNeededReason"/> </extension> <strength value="example"/> <description value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc."/> <valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason"/> </binding> <mapping> <identity value="v2"/> <map value="TQ1-9"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.site"> <path value="MedicationRequest.dosageInstruction.site"/> <short value="Body site to administer to"/> <definition value="Body site to administer to."/> <comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [http://hl7.org/fhir/StructureDefinition/bodySite](http://hl7.org/fhir/extensions/StructureDefinition-bodySite.html). May be a summary code, or a reference to a very precise definition of the location, or both."/> <requirements value="A coded specification of the anatomic site where the medication first enters the body."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.site"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAdministrationSite"/> </extension> <strength value="example"/> <description value="A coded concept describing the site location the medicine enters into or onto the body."/> <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXR-2"/> </mapping> <mapping> <identity value="rim"/> <map value=".approachSiteCode"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.route"> <path value="MedicationRequest.dosageInstruction.route"/> <short value="How drug should enter body"/> <definition value="How drug should enter body."/> <requirements value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.route"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RouteOfAdministration"/> </extension> <strength value="example"/> <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."/> <valueSet value="http://hl7.org/fhir/ValueSet/route-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXR-1"/> </mapping> <mapping> <identity value="rim"/> <map value=".routeCode"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.method"> <path value="MedicationRequest.dosageInstruction.method"/> <short value="Technique for administering medication"/> <definition value="Technique for administering medication."/> <comment value="Terminologies used often pre-coordinate this term with the route and or form of administration."/> <requirements value="A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.method"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAdministrationMethod"/> </extension> <strength value="example"/> <description value="A coded concept describing the technique by which the medicine is administered."/> <valueSet value="http://hl7.org/fhir/ValueSet/administration-method-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXR-4"/> </mapping> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.methodCode"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate"> <path value="MedicationRequest.dosageInstruction.doseAndRate"/> <short value="Amount of medication administered, to be administered or typical amount to be administered"/> <definition value="Depending on the resource,this is the amount of medication administered, to be administered or typical amount to be administered."/> <min value="0"/> <max value="*"/> <base> <path value="Dosage.doseAndRate"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Element"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TQ1-2"/> </mapping> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.doseQuantity; SubstanceAdministration.RateQuantity"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.id"> <path value="MedicationRequest.dosageInstruction.doseAndRate.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.extension"> <path value="MedicationRequest.dosageInstruction.doseAndRate.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.type"> <path value="MedicationRequest.dosageInstruction.doseAndRate.type"/> <short value="The kind of dose or rate specified"/> <definition value="The kind of dose or rate specified, for example, ordered or calculated."/> <requirements value="If the type is not populated, assume to be "ordered"."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DoseAndRateType"/> </extension> <strength value="example"/> <description value="The kind of dose or rate specified."/> <valueSet value="http://terminology.hl7.org/ValueSet/dose-rate-type"/> </binding> <mapping> <identity value="v2"/> <map value="RXO-21; RXE-23"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Amount of medication per dose"/> <definition value="Amount of medication per dose."/> <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours."/> <requirements value="The amount of therapeutic or other substance given at one administration event."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.dose[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Range"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-2, RXE-3"/> </mapping> <mapping> <identity value="rim"/> <map value=".doseQuantity"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x]"/> <sliceName value="doseQuantity"/> <short value="A fixed quantity (no comparator)"/> <definition value="The comparator is not used on a SimpleQuantity"/> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator."/> <requirements value="The amount of therapeutic or other substance given at one administration event."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.dose[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="qty-3"/> <severity value="error"/> <human value="If a code for the unit is present, the system SHALL also be present"/> <expression value="code.empty() or system.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Quantity"/> </constraint> <constraint> <key value="sqty-1"/> <severity value="error"/> <human value="The comparator is not used on a SimpleQuantity"/> <expression value="comparator.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> </constraint> <isModifier value="false"/> <mapping> <identity value="rim"/> <map value="n/a,PQ, IVL<PQ>, MO, CO, depending on the values"/> </mapping> <mapping> <identity value="v2"/> <map value="SN (see also Range) or CQ"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].value"/> <short value="Numerical value (with implicit precision)"/> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value."/> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)."/> <requirements value="Precision is handled implicitly in almost all cases of measurement."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.value"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="SN.2 / CQ - N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].comparator"/> <short value="< | <= | >= | > | ad - how to understand the value"/> <definition value="Not allowed to be used in this context"/> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology."/> <min value="0"/> <max value="0"/> <base> <path value="Quantity.comparator"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator"/> </extension> <strength value="required"/> <description value="How the Quantity should be understood and represented."/> <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0"/> </binding> <mapping> <identity value="v2"/> <map value="SN.1 / CQ.1"/> </mapping> <mapping> <identity value="rim"/> <map value="IVL properties"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].unit"/> <short value="Unit representation"/> <definition value="A human-readable form of the unit."/> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.unit"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.unit"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].system"/> <short value="System that defines coded unit form"/> <definition value="The identification of the system that provides the coded form of the unit."/> <requirements value="Need to know the system that defines the coded form of the unit."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="CO.codeSystem, PQ.translation.codeSystem"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].code"/> <short value="Coded form of the unit"/> <definition value="A computer processable form of the unit in some unit representation system."/> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system."/> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform"/> </binding> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.code, MO.currency, PQ.translation.code"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.rate[x]"> <path value="MedicationRequest.dosageInstruction.doseAndRate.rate[x]"/> <short value="Amount of medication per unit of time"/> <definition value="Amount of medication per unit of time."/> <comment value="It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammar where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour."/> <requirements value="Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.rate[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Ratio"/> </type> <type> <code value="Range"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXE22, RXE23, RXE-24"/> </mapping> <mapping> <identity value="rim"/> <map value=".rateQuantity"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.maxDosePerPeriod"> <path value="MedicationRequest.dosageInstruction.maxDosePerPeriod"/> <short value="Upper limit on medication per unit of time"/> <definition value="Upper limit on medication per unit of time."/> <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day"."/> <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours."/> <min value="0"/> <max value="*"/> <base> <path value="Dosage.maxDosePerPeriod"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Ratio"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-23, RXE-19"/> </mapping> <mapping> <identity value="rim"/> <map value=".maxDoseQuantity"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.maxDosePerAdministration"> <path value="MedicationRequest.dosageInstruction.maxDosePerAdministration"/> <short value="Upper limit on medication per administration"/> <definition value="Upper limit on medication per administration."/> <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg."/> <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.maxDosePerAdministration"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="not supported"/> </mapping> </element> <element id="MedicationRequest.dosageInstruction.maxDosePerLifetime"> <path value="MedicationRequest.dosageInstruction.maxDosePerLifetime"/> <short value="Upper limit on medication per lifetime of the patient"/> <definition value="Upper limit on medication per lifetime of the patient."/> <requirements value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.maxDosePerLifetime"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="not supported"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest"> <path value="MedicationRequest.dispenseRequest"/> <short value="Medication supply authorization"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/ExpirationDate"/> </mapping> <mapping> <identity value="rim"/> <map value="component.supplyEvent"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.id"> <path value="MedicationRequest.dispenseRequest.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.extension"> <path value="MedicationRequest.dispenseRequest.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.modifierExtension"> <path value="MedicationRequest.dispenseRequest.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill"> <path value="MedicationRequest.dispenseRequest.initialFill"/> <short value="First fill details"/> <definition value="Indicates the quantity or duration for the first dispense of the medication."/> <comment value="If populating this element, either the quantity or the duration must be included."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.initialFill"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.id"> <path value="MedicationRequest.dispenseRequest.initialFill.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.extension"> <path value="MedicationRequest.dispenseRequest.initialFill.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.modifierExtension"> <path value="MedicationRequest.dispenseRequest.initialFill.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.quantity"> <path value="MedicationRequest.dispenseRequest.initialFill.quantity"/> <short value="First fill quantity"/> <definition value="The amount or quantity to provide as part of the first dispense."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.initialFill.quantity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Supply.quantity[moodCode=RQO]"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.initialFill.duration"> <path value="MedicationRequest.dispenseRequest.initialFill.duration"/> <short value="First fill duration"/> <definition value="The length of time that the first dispense is expected to last."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.initialFill.duration"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Duration"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Supply.effectivetime[moodCode=RQO]"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.dispenseInterval"> <path value="MedicationRequest.dispenseRequest.dispenseInterval"/> <short value="Minimum period of time between dispenses"/> <definition value="The minimum period of time that must occur between dispenses of the medication."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.dispenseInterval"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Duration"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Supply.effectivetime[moodCode=RQO]"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.validityPeriod"> <path value="MedicationRequest.dispenseRequest.validityPeriod"/> <short value="Time period supply is authorized for"/> <definition value="This indicates the validity period of a prescription (stale dating the Prescription)."/> <comment value="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."/> <requirements value="Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.validityPeriod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/Refills"/> </mapping> <mapping> <identity value="rim"/> <map value="effectiveTime"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"> <path value="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"/> <short value="Number of refills authorized"/> <definition value="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."/> <comment value="If displaying "number of authorized fills", add 1 to this number."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"/> <min value="0"/> <max value="1"/> </base> <type> <code value="unsignedInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/Quantity"/> </mapping> <mapping> <identity value="v2"/> <map value="RXE-12 Number of Refills"/> </mapping> <mapping> <identity value="rim"/> <map value="repeatNumber"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.quantity"> <path value="MedicationRequest.dispenseRequest.quantity"/> <short value="Amount of medication to supply per dispense"/> <definition value="The amount that is to be dispensed for one fill."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.quantity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/DaysSupply"/> </mapping> <mapping> <identity value="v2"/> <map value="RXD-4 Actual Dispense Amount / RXD-5.1 Actual Dispense Units.code / RXD-5.3 Actual Dispense Units.name of coding system"/> </mapping> <mapping> <identity value="rim"/> <map value="quantity"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.expectedSupplyDuration"> <path value="MedicationRequest.dispenseRequest.expectedSupplyDuration"/> <short value="Number of days supply per dispense"/> <definition value="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."/> <comment value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.expectedSupplyDuration"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Duration"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="script10.6"/> <map value="Message/Body/NewRx/MedicationPrescribed/Substitutions"/> </mapping> <mapping> <identity value="rim"/> <map value="expectedUseTime"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.dispenser"> <path value="MedicationRequest.dispenseRequest.dispenser"/> <short value="Reference to preferred pharmacy for pickup (OID according to GDA Index)"/> <definition value="Indicates the intended performing Organization that will dispense the medication as specified by the prescriber."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.dispenser"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.who"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.dispenserInstruction"> <path value="MedicationRequest.dispenseRequest.dispenserInstruction"/> <short value="Additional information for the dispenser"/> <definition value="Provides additional information to the dispenser, for example, counselling to be provided to the patient."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.dispenseRequest.dispenserInstruction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Supply.text"/> </mapping> </element> <element id="MedicationRequest.dispenseRequest.doseAdministrationAid"> <path value="MedicationRequest.dispenseRequest.doseAdministrationAid"/> <short value="Type of adherence packaging to use for the dispense"/> <definition value="Provides information about the type of adherence packaging to be supplied for the medication dispense."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.dispenseRequest.doseAdministrationAid"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestDoseAdministrationAid"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/medication-dose-aid"/> </binding> <mapping> <identity value="rim"/> <map value="Supply.administerableMedication.product.asContent.container.code"/> </mapping> </element> <element id="MedicationRequest.substitution"> <path value="MedicationRequest.substitution"/> <short value="Any restrictions on medication substitution"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.substitution"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="script10.6"/> <map value="specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions"/> </mapping> <mapping> <identity value="rim"/> <map value="subjectOf.substitutionPersmission"/> </mapping> </element> <element id="MedicationRequest.substitution.id"> <path value="MedicationRequest.substitution.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.substitution.extension"> <path value="MedicationRequest.substitution.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationRequest.substitution.modifierExtension"> <path value="MedicationRequest.substitution.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationRequest.substitution.allowed[x]"> <path value="MedicationRequest.substitution.allowed[x]"/> <short value="Whether substitution is allowed or not"/> <definition value="True if the prescriber allows a different drug to be dispensed from what was prescribed."/> <comment value="This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationRequest.substitution.allowed[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationRequestSubstitution"/> </extension> <strength value="preferred"/> <description value="Identifies the type of substitution allowed."/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/> </binding> <mapping> <identity value="script10.6"/> <map value="specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions"/> </mapping> <mapping> <identity value="v2"/> <map value="RXO-9 Allow Substitutions / RXE-9 Substitution Status"/> </mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> </element> <element id="MedicationRequest.substitution.reason"> <path value="MedicationRequest.substitution.reason"/> <short value="Why should (not) substitution be made"/> <definition value="Indicates the reason for the substitution, or why substitution must or must not be performed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationRequest.substitution.reason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationIntendedSubstitutionReason"/> </extension> <strength value="example"/> <description value="SubstanceAdminSubstitutionReason"/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"/> </binding> <mapping> <identity value="script10.6"/> <map value="not mapped"/> </mapping> <mapping> <identity value="v2"/> <map value="RXE-9 Substition status"/> </mapping> <mapping> <identity value="rim"/> <map value="reasonCode"/> </mapping> </element> <element id="MedicationRequest.eventHistory"> <path value="MedicationRequest.eventHistory"/> <short value="A list of events of interest in the lifecycle"/> <definition value="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."/> <comment value="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.)."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationRequest.eventHistory"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.relevantHistory"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/> </mapping> </element> </snapshot> <differential> <element id="MedicationRequest.id"> <path value="MedicationRequest.id"/> <short value="LinkedCare Proposal Id, assigned by the Linked Care Fhir Server. Any initial value will be overwritten"/> </element> <element id="MedicationRequest.contained"> <path value="MedicationRequest.contained"/> <max value="0"/> </element> <element id="MedicationRequest.identifier"> <path value="MedicationRequest.identifier"/> <short value="external ID(s), e.g.: can be used to refer to a care software database record"/> </element> <element id="MedicationRequest.basedOn"> <path value="MedicationRequest.basedOn"/> <short value="If this item is a correction of a previous element in the chain, set to a reference to that previous element"/> <max value="1"/> </element> <element id="MedicationRequest.status"> <path value="MedicationRequest.status"/> <short value="In new proposals, the status must be set to unknown. The Linked Care server will set it to active in the instantiated copies of the positions. Possible values: active, cancelled (end-of-chain), unknown"/> </element> <element id="MedicationRequest.intent"> <path value="MedicationRequest.intent"/> <short value="Possible values: proposal (default in contained and instance of proposal), order (default in prescriptions), reflex-order (automatically created orders due to an ad-hoc prescription)"/> </element> <element id="MedicationRequest.medication"> <path value="MedicationRequest.medication"/> <short value="Medication in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP)."/> <type> <code value="CodeableReference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/linca-medication"/> </type> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/CodeSystem-asp-liste"/> </binding> </element> <element id="MedicationRequest.subject"> <path value="MedicationRequest.subject"/> <short value="Each LINCAProposalMedicationRequest is associated with one patient. The patient data is conformant to the HL7 Austria patient and must be clearly identifiable."/> <type> <code value="Reference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/at-core-patient"/> </type> </element> <element id="MedicationRequest.informationSource"> <path value="MedicationRequest.informationSource"/> <short value="This contains the identity of the proposal placer (OID in case of organizations, eID in case of individuals)"/> <min value="1"/> <max value="1"/> </element> <element id="MedicationRequest.supportingInformation"> <path value="MedicationRequest.supportingInformation"/> <short value="First Element is reserved for reference to origin (LINCARequestOrchestration) assigned on LinkedCare Platform. Used to link instantiated proposal items back to the proposal header (LINCARequestOrchestration)."/> </element> <element id="MedicationRequest.requester"> <path value="MedicationRequest.requester"/> <short value="Username/account name as specified by placer"/> <min value="1"/> </element> <element id="MedicationRequest.performer"> <path value="MedicationRequest.performer"/> <short value="The authorizing practitioner for this proposal item (identified by their OID according to GDA Index)"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x]"/> <sliceName value="doseQuantity"/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> </element> <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code"> <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x].code"/> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform"/> </binding> </element> <element id="MedicationRequest.dispenseRequest.dispenser"> <path value="MedicationRequest.dispenseRequest.dispenser"/> <short value="Reference to preferred pharmacy for pickup (OID according to GDA Index)"/> </element> </differential> </StructureDefinition>

Name	Card.	Type	Description & Constraints
MedicationRequest		MedicationRequest
id	0..1	id	LinkedCare Proposal Id, assigned by the Linked Care Fhir Server. Any initial value will be overwritten
contained	0..0
identifier	0..*	Identifier	external ID(s), e.g.: can be used to refer to a care software database record
basedOn	0..1	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	If this item is a correction of a previous element in the chain, set to a reference to that previous element
status	1..1	code	In new proposals, the status must be set to unknown. The Linked Care server will set it to active in the instantiated copies of the positions. Possible values: active, cancelled (end-of-chain), unknown
intent	1..1	code	Possible values: proposal (default in contained and instance of proposal), order (default in prescriptions), reflex-order (automatically created orders due to an ad-hoc prescription)
medication	1..1	CodeableReference(LINCA Medication (LINCAMeds))	Medication in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP). Binding: https://termgit.elga.gv.at/CodeSystem-asp-liste (required)
subject	1..1	Reference(HL7® AT Core Patient Profile)	Each LINCAProposalMedicationRequest is associated with one patient. The patient data is conformant to the HL7 Austria patient and must be clearly identifiable.
informationSource	1..1	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	This contains the identity of the proposal placer (OID in case of organizations, eID in case of individuals)
supportingInformation	0..*	Reference(Resource)	First Element is reserved for reference to origin (LINCARequestOrchestration) assigned on LinkedCare Platform. Used to link instantiated proposal items back to the proposal header (LINCARequestOrchestration).
requester	1..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	Username/account name as specified by placer
performer	1..1	Reference(Practitioner)	The authorizing practitioner for this proposal item (identified by their OID according to GDA Index)
dosageInstruction
doseAndRate
Slices for dose[x]	0..1	Range, SimpleQuantity	Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity	0..1	SimpleQuantity	A fixed quantity (no comparator)
code	0..1	code	Coded form of the unit Binding: https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform (required)
dispenseRequest
dispenser	0..1	Reference(Organization)	Reference to preferred pharmacy for pickup (OID according to GDA Index)
Documentation for this format