AU Core Implementation Guide
0.4.1-preview - Preview Australia flag

This page is part of the AU Core (v0.4.1-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core MedicationRequest

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationrequest Version: 0.4.1-preview
Standards status: Draft Maturity Level: 1 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.

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

Comparison with other national and international IGs

A resource conforming to this profile:

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access, International Patient Summary, or US Core MAY NOT conform to AU Core.

Profile specific implementation guidance

  • See the Medicine Information page for guidance
  • 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
  • The MedicationRequest resource can represent a reason 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:

Formal Views of Profile Content

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

This structure is derived from AUBaseMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
ObligationsActor
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
ObligationsActor
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
ObligationsActor
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 value:system
...... coding:pbs SO 0..* Coding PBS Item Code
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
...... coding:amt SO 0..* Coding AMT Medicines
ObligationsActor
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
ObligationsActor
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
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
... authoredOn SOC 1..1 dateTime Created date
au-core-medreq-03: Date shall be at least to day
ObligationsActor
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 Base Related Person) Who/What requested the Request
ObligationsActor
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
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
... reasonReference S 0..* Reference(AU Core Condition | Observation) Condition or observation that supports why the prescription is being written
... dosageInstruction SO 0..* AUBaseDosage Dosage information in an Australian healthcare context
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-medreq-03errorMedicationRequest.authoredOnDate shall be at least to day
: toString().length() >= 10

 

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.
patient+intent SHALL reference+token
patient+intent+status SHALL reference+token+token
_id SHOULD token
patient.identifier SHOULD reference.token The requester SHALL provide both the system and code values. The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
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.
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.

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 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)

  3. SHALL 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 code (e.g.code={system|}[code],{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 authored on date and intent (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 fetching a MedicationRequest using the _id search parameter:
    • SHOULD support these _include parameters: MedicationRequest:medication

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

    Example:

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

    Implementation Notes: Fetches a single MedicationRequest (how to search by the logical 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]]&...)

    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)