AU Patient Summary Implementation Guide
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AU Patient Summary Implementation Guide - Downloaded Version 1.0.0-ballot See the Directory of published versions

## Resource Profile: AUPSMedicationRequest - Detailed Descriptions

Page standards status: Draft | Maturity Level: 1

Definitions for the au-ps-medicationrequest resource profile.

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

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

0. MedicationRequest
Definition | An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
Short | A request for a medication for a patient in an Australian healthcare contextOrdering of medication for patient or group
Control | 0..*
Is Modifier | false
Complies with Profile | This profile complies with the profile MedicationRequest (IPS)
Summary | false
Alternate Names | Prescription, Order
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.extension:sexParameterForClinicalUse
Slice Name | sexParameterForClinicalUse
Definition | A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..
Short | A context-specific sex parameter for clinical use
Control | 0..*
Type | Extension(Patient Sex Parameter For Clinical Use) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
6. MedicationRequest.extension:subsidisedConcurrentSupply
Slice Name | subsidisedConcurrentSupply
Definition | The grounds which authorise a PBS or RPBS subsidy for the concurrent supply of a medication item specified in a prescription and all of its repeats.
Short | Grounds for concurrent supply of medication
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Subsidised Concurrent Supply) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. MedicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MedicationRequest.status
Definition | A code specifying the current state of the order. Generally, this will be active or completed state.
Short | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` ) A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MedicationRequest.intent
Definition | Whether the request is a proposal, plan, or an original order.
Short | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` ) The kind of medication order.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. MedicationRequest.doNotPerform
Definition | If true indicates that the provider is asking for the medication request not to occur.
Short | True if request is prohibiting action
Comments | If do not perform is not specified, the request is a positive request e.g. "do perform".
Control | 0..1
Type | boolean
Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Pattern Value | `false`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MedicationRequest.medication[x]
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Medication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. To improve global interoperability, IPS strongly encourages the use of a reference to a Medication resource, and medicationCodeableConcept is only recommended for cases where no other information than a simple code is available. AU PS does not adopt the IPS guidance that systems should only populate a Medication reference when more information than a simple code is available; either medicationReference or medicationCodeableConcept can be used. Future releases of AU PS, based on implementation experience in Australia may adopt that IPS guidance. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 1..1
Binding | For example codes, see SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/medication-codes|4.0.1` ) A coded concept identifying substance or product that can be ordered.
Type | Choice of: CodeableConcept, Reference(Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationRequest.medication[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
18. MedicationRequest.medication[x]:medicationCodeableConcept
Slice Name | medicationCodeableConcept
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Coded Prescribed MedicationMedication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 01..1
Binding | For example codes, see SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/medication-codes|4.0.1` )
Type | CodeableConcept(Codeable Concept (IPS)), Reference(Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. MedicationRequest.medication[x]:medicationCodeableConcept.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationRequest.medication[x].coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
22. MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs
Slice Name | pbs
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Binding | The codes SHALL be taken from For codes, see PBS Item Codes (required to `http://terminology.hl7.org.au/ValueSet/pbs-item` )
Type | Coding
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs.extension:medicationClass
Slice Name | medicationClass
Definition | The type of information covered by the medication coding, e.g. branded product with no strength or form.
Short | Medication type
Control | 0..1
Type | Extension(Medication Type) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt
Slice Name | amt
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Binding | The codes SHALL be taken from For codes, see Australian Medication (required to `https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1` )
Type | Coding
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt.extension:medicationClass
Slice Name | medicationClass
Definition | The type of information covered by the medication coding, e.g. branded product with no strength or form.
Short | Medication type
Control | 0..1
Type | Extension(Medication Type) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. MedicationRequest.medication[x]:medicationReference
Slice Name | medicationReference
Definition | Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.
Short | Prescribed MedicationMedication to be taken
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.
Control | 01..1
Type | Reference(AU PS Medication, Medication), CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. MedicationRequest.subject
Definition | A link to a resource representing the person or set of individuals to whom the medication will be given.
Short | Who or group medication request is for
Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.
Control | 1..1
Type | Reference(AU PS Patient, Patient, Group)
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. MedicationRequest.subject.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 10..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. MedicationRequest.encounter
Definition | The Encounter during which this [x] was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of encounter/admission/stay
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.
Control | 0..1
Type | Reference(AU PS Encounter, Encounter)
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. MedicationRequest.supportingInformation
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Information to support ordering of the medication
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationRequest.supportingInformation`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
40. MedicationRequest.supportingInformation:bodyHeight
Slice Name | bodyHeight
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Observation of Body HeightInformation to support ordering of the medication
Control | 0..1*
Type | Reference(Observation Body Height Profile, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. MedicationRequest.supportingInformation:bodyWeight
Slice Name | bodyWeight
Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication.
Short | Observation of Body WeightInformation to support ordering of the medication
Control | 0..1*
Type | Reference(Observation Body Weight Profile, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. MedicationRequest.authoredOn
Definition | The date (and perhaps time) when the prescription was initially written or authored on.
Short | Created dateWhen request was initially authored
Control | 10..1 This element is affected by the following invariants: au-core-medreq-01
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) au-core-medreq-01: 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)`)
46. MedicationRequest.requester
Definition | The individual, organization, or device that initiated the request and has responsibility for its activation.
Short | Who/What requested the Request
Control | 10..1
Type | Reference(AU PS Practitioner, AU PS PractitionerRole, AU PS Organization, AU PS Patient, AU PS RelatedPerson, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. MedicationRequest.reasonCode
Definition | The reason or the indication for ordering or not ordering the medication.
Short | Reason or indication for ordering or not ordering the medication
Comments | This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
Control | 0..*
Binding | The codes SHOULD be taken from For example codes, see Reason for Request http://hl7.org/fhir/ValueSet/condition-code|4.0.1 (preferred to `https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1` )
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. MedicationRequest.reasonReference
Definition | Condition or observation that supports why the medication was ordered.
Short | Condition or observation that supports why the prescription is being written
Comments | This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.
Control | 0..*
Type | Reference(AU PS Condition, Observation, Condition, Observation)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. MedicationRequest.dosageInstruction
Definition | Indicates how the medication is to be used by the patient.
Short | How the medication should be taken
Comments | There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
Control | 0..*
Type | Dosage(AU Base Dosage)
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. MedicationRequest.dosageInstruction.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
56. MedicationRequest.dosageInstruction.text
Definition | Free text dosage instructions e.g. SIG.
Short | Free text dosage instructions e.g. SIG
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Requirements | 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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. MedicationRequest.dosageInstruction.timing
Definition | When medication should be administered.
Short | When medication should be administered
Comments | 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.
Control | 0..1
Type | Timing
Is Modifier | false
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
Summary | true
Requirements | 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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. MedicationRequest
Complies with Profile | This profile complies with the profile MedicationRequest (IPS)
2. MedicationRequest.status
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
4. MedicationRequest.intent
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
6. MedicationRequest.doNotPerform
Pattern Value | `false`
8. MedicationRequest.medication[x]
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. To improve global interoperability, IPS strongly encourages the use of a reference to a Medication resource, and medicationCodeableConcept is only recommended for cases where no other information than a simple code is available. AU PS does not adopt the IPS guidance that systems should only populate a Medication reference when more information than a simple code is available; either medicationReference or medicationCodeableConcept can be used. Future releases of AU PS, based on implementation experience in Australia may adopt that IPS guidance.
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
10. MedicationRequest.medication[x]:medicationCodeableConcept
Slice Name | medicationCodeableConcept
Type | CodeableConcept(Codeable Concept (IPS))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
12. MedicationRequest.medication[x]:medicationCodeableConcept.coding:pbs
Slice Name | pbs
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
14. MedicationRequest.medication[x]:medicationCodeableConcept.coding:amt
Slice Name | amt
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
16. MedicationRequest.medication[x]:medicationReference
Slice Name | medicationReference
Type | Reference(AU PS Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
18. MedicationRequest.subject
Type | Reference(AU PS Patient)
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
20. MedicationRequest.subject.reference
Control | 1..?
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate | AU PS Producer
SHALL:handle | AU PS Consumer
22. MedicationRequest.encounter
Type | Reference(AU PS Encounter)
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
24. MedicationRequest.authoredOn
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
26. MedicationRequest.requester
Type | Reference(AU PS Practitioner, AU PS PractitionerRole, AU PS Organization, AU PS Patient, AU PS RelatedPerson)
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
28. MedicationRequest.reasonCode
Type | CodeableConcept(Codeable Concept (IPS))
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
30. MedicationRequest.reasonReference
Type | Reference(AU PS Condition, Observation)
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
32. MedicationRequest.dosageInstruction
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
34. MedicationRequest.dosageInstruction.text
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer
36. MedicationRequest.dosageInstruction.timing
Must Support | true
Obligations |
Obligations | Actor
SHALL:populate-if-known | AU PS Producer
SHALL:handle | AU PS Consumer
SHOULD:display | AU PS Consumer

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

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