AU Core Implementation Guide
1.1.0-preview - Preview

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## Resource Profile: AU Core MedicationRequest

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationrequest | Version: 1.1.0-preview
Standards status: Trial-use | Maturity Level: 2 | Computable Name: AUCoreMedicationRequest
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for a MedicationRequest resource to record, search, and fetch medication orders and requests (i.e. prescriptions) associated with a patient. It is based on the AU Base Medication Request profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the MedicationRequest when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

### Usage scenarios

The following are supported usage scenarios for this profile:

- Query medication orders or prescriptions for a patient (current and historical)
- Record or update medication orders or prescriptions for a patient

### Profile specific implementation guidance

- See the Medicine Information page for guidance on how medicinal product identification can be structured in FHIR conformant to AU Core.
- When recording “self-prescribed” medication, `MedicationRequest.requester` references the Patient or RelatedPerson as the prescriber.
- MedicationRequest resources can represent a medication using either a code with `MedicationRequest.medicationCodeableConcept`, or reference a Medication resource with `MedicationRequest.medicationReference`.
  - Although both are marked as Must Support, responders are not required to support both a code and a reference, but they SHALL support at least one of these elements
  - A requester SHALL support both elements
  - When referencing a Medication resource, it is preferred the resource is contained but it may be an external resource
  - If an external reference to a Medication resource is used, the responder SHALL support the `_include` parameter for searching this element
  - The requester SHALL support all method
- The MedicationRequest resource can represent the clinical indication as a code with `MedicationRequest.reasonCode`, or a reference with `MedicationRequest.reasonReference` to a Condition or other resource.
  - Although both are marked as Must Support, responders are not required to support both a code and a reference, but they SHALL support at least one of these elements
  - A requester SHALL support both elements

Usage:

- Examples for this Resource Profile: MedicationRequest/paracetamol-codeine, MedicationRequest/reaptan and MedicationRequest/simvastatin
- CapabilityStatements using this Resource Profile: AU Core Requester CapabilityStatement and AU Core Responder CapabilityStatement

Changes since version 1.0.0:

- The resource metadata has changed (description)

### Formal Views of Profile Content

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

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

This structure is derived from AUBaseMedicationRequest

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | AUBaseMedicationRequest | A request for a medication for a patient in an Australian healthcare context
status | SO | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
intent | SO | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for medication[x] | SO | 1..1 | CodeableConcept, Reference(Medication) | Medication to be taken Slice: Unordered, Closed by type:$this
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medication[x]:medicationCodeableConcept |  | 0..1 | CodeableConcept | Coded Prescribed Medication
Slices for coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:pbs | SO | 0..* | Coding | Code defined by a terminology system Binding: PBS Item Codes (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding:amt | SO | 0..* | Coding | Code defined by a terminology system Binding: Australian Medication (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medication[x]:medicationReference | O | 0..1 | Reference(AU Core Medication) | Prescribed Medication
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
subject | SO | 1..1 | Reference(AU Core Patient) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter | SO | 0..1 | Reference(AU Core Encounter) | Encounter created as part of encounter/admission/stay
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
authoredOn | SO C | 1..1 | dateTime | Created date au-core-medreq-01: Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
requester | SO | 1..1 | Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) | Who/What requested the Request
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonCode | SO | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonReference | SO | 0..* | Reference(AU Core Condition | Observation) | Condition or observation that supports why the prescription is being written
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dosageInstruction | SO | 0..* | AUBaseDosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs | required | PBSItemCodes `http://terminology.hl7.org.au/ValueSet/pbs-item`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt | required | AustralianMedication `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` from https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
au-core-medreq-01 | error | MedicationRequest.authoredOn | Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present : $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10) |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | AUBaseMedicationRequest | A request for a medication for a patient in an Australian healthcare context dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!SO Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
intent | ?!SO Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action ele-1: All FHIR elements must have a @value or children
Slices for medication[x] | SO Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Prescribed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
ele-1: All FHIR elements must have a @value or children
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
coding:All Slices |  |  |  | Content/Rules for all slices
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:pbs | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: PBS Item Codes (required) ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:amt | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: Australian Medication (required) ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
medication[x]:medicationReference | O Σ | 0..1 | Reference(AU Core Medication) | Prescribed Medication ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
subject | SO Σ | 1..1 | Reference(AU Core Patient) | Who or group medication request is for ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter | SO | 0..1 | Reference(AU Core Encounter) | Encounter created as part of encounter/admission/stay ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
supportingInformation:bodyHeight |  | 0..1 | Reference(Observation Body Height Profile) | Observation of Body Height ele-1: All FHIR elements must have a @value or children
supportingInformation:bodyWeight |  | 0..1 | Reference(Observation Body Weight Profile) | Observation of Body Weight ele-1: All FHIR elements must have a @value or children
authoredOn | SO Σ C | 1..1 | dateTime | Created date ele-1: All FHIR elements must have a @value or children au-core-medreq-01: Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
requester | SO Σ | 1..1 | Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) | Who/What requested the Request ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonCode | SO | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Reason for Request (preferred) ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonReference | SO | 0..* | Reference(AU Core Condition | Observation) | Condition or observation that supports why the prescription is being written ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dosageInstruction | SO | 0..* | AUBaseDosage | How the medication should be taken ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` from the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard
MedicationRequest.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs | required | PBSItemCodes `http://terminology.hl7.org.au/ValueSet/pbs-item`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt | required | AustralianMedication `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` from https://tx.ontoserver.csiro.au/fhir
MedicationRequest.reasonCode | preferred | ReasonForRequest `https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1` from https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
au-core-medreq-01 | error | MedicationRequest.authoredOn | Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present : $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10) |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | AUBaseMedicationRequest | A request for a medication for a patient in an Australian healthcare context
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier, AUETPPrescriptionIdentifier, AULocalPrescriptionIdentifier | External ids for this request
status | ?!SO Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!SO Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
Slices for medication[x] | SO Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Prescribed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:pbs | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: PBS Item Codes (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:amt | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: Australian Medication (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Medication primary text
medication[x]:medicationReference | O Σ | 0..1 | Reference(AU Core Medication) | Prescribed Medication
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
subject | SO Σ | 1..1 | Reference(AU Core Patient) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter | SO | 0..1 | Reference(AU Core Encounter) | Encounter created as part of encounter/admission/stay
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:bodyHeight |  | 0..1 | Reference(Observation Body Height Profile) | Observation of Body Height
supportingInformation:bodyWeight |  | 0..1 | Reference(Observation Body Weight Profile) | Observation of Body Weight
authoredOn | SO Σ C | 1..1 | dateTime | Created date au-core-medreq-01: Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
requester | SO Σ | 1..1 | Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) | Who/What requested the Request
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode | SO | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Reason for Request (preferred)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonReference | SO | 0..* | Reference(AU Core Condition | Observation) | Condition or observation that supports why the prescription is being written
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | SO | 0..* | AUBaseDosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dispenseRequest |  | 0..1 | BackboneElement | Requested dispensing
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Maximum repeats authorised
quantity |  | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Brand substitution details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Brand substitution flag Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: Medicine Substitution Reason (preferred)
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` from the FHIR Standard
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` from the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` from the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` from the FHIR Standard
MedicationRequest.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs | required | PBSItemCodes `http://terminology.hl7.org.au/ValueSet/pbs-item`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt | required | AustralianMedication `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` from https://tx.ontoserver.csiro.au/fhir
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` from the FHIR Standard
MedicationRequest.reasonCode | preferred | ReasonForRequest `https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1` from https://tx.ontoserver.csiro.au/fhir
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` from the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationRequest.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` from https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
au-core-medreq-01 | error | MedicationRequest.authoredOn | Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present : $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10) |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from AUBaseMedicationRequest

Summary

Mandatory: 2 elements
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- AU Core Medication (http://hl7.org.au/fhir/core/StructureDefinition/au-core-medication)
- AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)
- AU Core Encounter (http://hl7.org.au/fhir/core/StructureDefinition/au-core-encounter)
- AU Core Practitioner (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitioner)
- AU Core PractitionerRole (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole)
- AU Core Organization (http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization)
- AU Core RelatedPerson (http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson)
- AU Core Condition (http://hl7.org.au/fhir/core/StructureDefinition/au-core-condition)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x] (Closed)
- The element 1 is sliced based on the value of MedicationRequest.medication[x].coding

Maturity: 2

Differential View

This structure is derived from AUBaseMedicationRequest

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | AUBaseMedicationRequest | A request for a medication for a patient in an Australian healthcare context
status | SO | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
intent | SO | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for medication[x] | SO | 1..1 | CodeableConcept, Reference(Medication) | Medication to be taken Slice: Unordered, Closed by type:$this
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medication[x]:medicationCodeableConcept |  | 0..1 | CodeableConcept | Coded Prescribed Medication
Slices for coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:pbs | SO | 0..* | Coding | Code defined by a terminology system Binding: PBS Item Codes (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
coding:amt | SO | 0..* | Coding | Code defined by a terminology system Binding: Australian Medication (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medication[x]:medicationReference | O | 0..1 | Reference(AU Core Medication) | Prescribed Medication
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
subject | SO | 1..1 | Reference(AU Core Patient) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter | SO | 0..1 | Reference(AU Core Encounter) | Encounter created as part of encounter/admission/stay
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
authoredOn | SO C | 1..1 | dateTime | Created date au-core-medreq-01: Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
requester | SO | 1..1 | Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) | Who/What requested the Request
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonCode | SO | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonReference | SO | 0..* | Reference(AU Core Condition | Observation) | Condition or observation that supports why the prescription is being written
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dosageInstruction | SO | 0..* | AUBaseDosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs | required | PBSItemCodes `http://terminology.hl7.org.au/ValueSet/pbs-item`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt | required | AustralianMedication `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` from https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
au-core-medreq-01 | error | MedicationRequest.authoredOn | Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present : $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10) |

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | AUBaseMedicationRequest | A request for a medication for a patient in an Australian healthcare context dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!SO Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
intent | ?!SO Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action ele-1: All FHIR elements must have a @value or children
Slices for medication[x] | SO Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Prescribed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
ele-1: All FHIR elements must have a @value or children
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
coding:All Slices |  |  |  | Content/Rules for all slices
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:pbs | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: PBS Item Codes (required) ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:amt | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: Australian Medication (required) ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
medication[x]:medicationReference | O Σ | 0..1 | Reference(AU Core Medication) | Prescribed Medication ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
subject | SO Σ | 1..1 | Reference(AU Core Patient) | Who or group medication request is for ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter | SO | 0..1 | Reference(AU Core Encounter) | Encounter created as part of encounter/admission/stay ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
supportingInformation:bodyHeight |  | 0..1 | Reference(Observation Body Height Profile) | Observation of Body Height ele-1: All FHIR elements must have a @value or children
supportingInformation:bodyWeight |  | 0..1 | Reference(Observation Body Weight Profile) | Observation of Body Weight ele-1: All FHIR elements must have a @value or children
authoredOn | SO Σ C | 1..1 | dateTime | Created date ele-1: All FHIR elements must have a @value or children au-core-medreq-01: Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
requester | SO Σ | 1..1 | Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) | Who/What requested the Request ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonCode | SO | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Reason for Request (preferred) ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonReference | SO | 0..* | Reference(AU Core Condition | Observation) | Condition or observation that supports why the prescription is being written ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dosageInstruction | SO | 0..* | AUBaseDosage | How the medication should be taken ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` from the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard
MedicationRequest.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs | required | PBSItemCodes `http://terminology.hl7.org.au/ValueSet/pbs-item`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt | required | AustralianMedication `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` from https://tx.ontoserver.csiro.au/fhir
MedicationRequest.reasonCode | preferred | ReasonForRequest `https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1` from https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
au-core-medreq-01 | error | MedicationRequest.authoredOn | Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present : $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10) |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | AUBaseMedicationRequest | A request for a medication for a patient in an Australian healthcare context
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier, AUETPPrescriptionIdentifier, AULocalPrescriptionIdentifier | External ids for this request
status | ?!SO Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!SO Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
Slices for medication[x] | SO Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Prescribed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:pbs | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: PBS Item Codes (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:amt | SO Σ | 0..* | Coding | Code defined by a terminology system Binding: Australian Medication (required)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Medication primary text
medication[x]:medicationReference | O Σ | 0..1 | Reference(AU Core Medication) | Prescribed Medication
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
subject | SO Σ | 1..1 | Reference(AU Core Patient) | Who or group medication request is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter | SO | 0..1 | Reference(AU Core Encounter) | Encounter created as part of encounter/admission/stay
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Slices for supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication Slice: Unordered, Open by profile:resolve()
supportingInformation:bodyHeight |  | 0..1 | Reference(Observation Body Height Profile) | Observation of Body Height
supportingInformation:bodyWeight |  | 0..1 | Reference(Observation Body Weight Profile) | Observation of Body Weight
authoredOn | SO Σ C | 1..1 | dateTime | Created date au-core-medreq-01: Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
requester | SO Σ | 1..1 | Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson) | Who/What requested the Request
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode | SO | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Reason for Request (preferred)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reasonReference | SO | 0..* | Reference(AU Core Condition | Observation) | Condition or observation that supports why the prescription is being written
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | SO | 0..* | AUBaseDosage | How the medication should be taken
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
dispenseRequest |  | 0..1 | BackboneElement | Requested dispensing
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Maximum repeats authorised
quantity |  | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Brand substitution details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Brand substitution flag Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: Medicine Substitution Reason (preferred)
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | medicationrequest Status `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` from the FHIR Standard
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` from the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` from the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` from the FHIR Standard
MedicationRequest.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs | required | PBSItemCodes `http://terminology.hl7.org.au/ValueSet/pbs-item`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt | required | AustralianMedication `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` from https://tx.ontoserver.csiro.au/fhir
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` from the FHIR Standard
MedicationRequest.reasonCode | preferred | ReasonForRequest `https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1` from https://tx.ontoserver.csiro.au/fhir
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` from the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationRequest.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` from https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
au-core-medreq-01 | error | MedicationRequest.authoredOn | Date shall be precise to the day or, if not available, the Data Absent Reason extension shall be present : $this.hasValue() implies (extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').value.exists().not() and $this.toString().length() >= 10) |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from AUBaseMedicationRequest

Summary

Mandatory: 2 elements
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- AU Core Medication (http://hl7.org.au/fhir/core/StructureDefinition/au-core-medication)
- AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)
- AU Core Encounter (http://hl7.org.au/fhir/core/StructureDefinition/au-core-encounter)
- AU Core Practitioner (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitioner)
- AU Core PractitionerRole (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole)
- AU Core Organization (http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization)
- AU Core RelatedPerson (http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson)
- AU Core Condition (http://hl7.org.au/fhir/core/StructureDefinition/au-core-condition)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x] (Closed)
- The element 1 is sliced based on the value of MedicationRequest.medication[x].coding

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

### Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

FHIR search operations are described here and the syntax used to describe AU Core interactions is defined here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Parameter(s) | Conformance | Type(s) | Requirements (when used alone or in combination)
--- | --- | --- | ---
patient | SHALL | `reference` | The requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both. The requester SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
patient+status | SHALL | `reference`+`token` |
patient+intent | SHOULD | `reference`+`token` |
patient+intent+status | SHOULD | `reference`+`token`+`token` |
_id | SHOULD | `token` |
patient+intent+authoredon | SHOULD | `reference`+`token`+`date` |
authoredon | MAY | `date` | A requester SHALL provide a value precise to the second + time offset. A responder SHALL support a value precise to the second + time offset. The requester SHALL support these search comparators `gt`, `lt`, `ge`, `le`. The responder SHALL support these search comparators `gt`, `lt`, `ge`, `le`. The requester SHOULD support `multipleAnd`, and if `multipleAnd` is supported, SHALL support the search comparators `gt`, `lt`, `ge`, `le`. The responder SHOULD support `multipleAnd`, and if `multipleAnd` is supported, SHALL support the search comparators `gt`, `lt`, `ge`, `le`.
intent | MAY | `token` | The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.
status | MAY | `token` | The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both. The requester SHALL support `multipleOr`. The responder SHALL support `multipleOr`.

#### Mandatory Search Parameters

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the `patient` search parameter:
   - SHOULD support these `_include` parameters: `MedicationRequest:medication`
   - SHOULD support chained searching of patient canonical identifier `patient.identifier` (e.g. `patient.identifier=[system|][code]`)

   `GET [base]/MedicationRequest?patient={Type/}[id]` or optionally `GET [base]/MedicationRequest?patient.identifier=[system|][code]`

   Example:

   1. GET [base]/MedicationRequest?patient=5678
   2. GET [base]/MedicationRequest?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
   3. GET [base]/MedicationRequest?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952&_include=MedicationRequest:medication
   4. GET [base]/MedicationRequest?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient (how to search by reference and how to search by token)

2. SHALL support searching using the combination of the `patient` and `status` search parameters:
   - SHOULD support these `_include` parameters: `MedicationRequest:medication`
   - SHOULD support chained searching of patient canonical identifier `patient.identifier` (e.g. `patient.identifier=[system|][code]`)
   - SHALL support multipleOr search on `status` (e.g.`status={system|}[code],{system|}[code],...`)

   `GET [base]/MedicationRequest?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`

   Example:

   1. GET [base]/MedicationRequest?patient=5678&status=active
   2. GET [base]/MedicationRequest?patient=5678&status=active&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and status (how to search by reference and how to search by token)

#### Optional Search Parameters

The following search parameters and search parameter combinations SHOULD be supported:

1. SHOULD support searching using the `_id` search parameter:
   - SHOULD support these `_include` parameters: `MedicationRequest:medication`

   `GET [base]/MedicationRequest?_id=[id]`

   Example:

   1. GET [base]/MedicationRequest?_id=2169591
   2. GET [base]/MedicationRequest?_id=2169591&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle with the requested MedicationRequest, instead of just the resource itself, and allows for the inclusion of additional search parameters such as _include, _revinclude, or _lastUpdated (how to search by id of the resource)

2. SHOULD support searching using the combination of the `patient` and `intent` and `authoredon` search parameters:
   - SHOULD support these `_include` parameters: `MedicationRequest:medication`
   - SHOULD support chained searching of patient canonical identifier `patient.identifier` (e.g. `patient.identifier=[system|][code]`)
   - SHALL support these `authoredon` comparators: `gt,lt,ge,le`
   - SHOULD support multipleAnd search on `authoredon` (e.g.`authoredon=[date]&authoredon=[date]]&...`), and if multipleAnd is supported, SHALL support the search comparators `gt,lt,ge,le`

   `GET [base]/MedicationRequest?patient={Type/}[id]&intent={system|}[code]&authoredon={gt|lt|ge|le}[date]{&authoredon={gt|lt|ge|le}[date]&...}`

   Example:

   1. GET [base]/MedicationRequest?patient=5678&intent=order&authoredon=ge2020-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent and date (how to search by reference and how to search by token and how to search by date)

3. SHOULD support searching using the combination of the `patient` and `intent` search parameters:
   - SHOULD support these `_include` parameters: `MedicationRequest:medication`
   - SHOULD support chained searching of patient canonical identifier `patient.identifier` (e.g. `patient.identifier=[system|][code]`)

   `GET [base]/MedicationRequest?patient={Type/}[id]&intent={system|}[code]`

   Example:

   1. GET [base]/MedicationRequest?patient=5678&intent=order

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent (how to search by reference and how to search by token)

4. SHOULD support searching using the combination of the `patient` and `intent` and `status` search parameters:
   - SHOULD support these `_include` parameters: `MedicationRequest:medication`
   - SHOULD support chained searching of patient canonical identifier `patient.identifier` (e.g. `patient.identifier=[system|][code]`)
   - SHALL support multipleOr search on `status` (e.g.`status={system|}[code],{system|}[code],...`)

   `GET [base]/MedicationRequest?patient={Type/}[id]&intent={system|}[code]&status={system|}[code]{,{system|}[code],...}`

   Example:

   1. GET [base]/MedicationRequest?patient=5678&intent=order&status=active
   2. GET [base]/MedicationRequest?patient=5678&intent=order&status=active&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent and status (how to search by reference and how to search by token)