| Package | ForgePatientChart.0830 |
| Type | StructureDefinition |
| Id | Id |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=ForgePatientChart.0830@0.1.0&canonical=http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-order |
| Url | http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-order |
| Status | draft |
| Name | MedicationOrder |
| Experimental | False |
| Authority | hl7 |
| Type | MedicationRequest |
| Kind | resource |
No resources found
FHIR
{
"resourceType" : "StructureDefinition",
"id" : "profile-medication-request-order-patient-chart",
"url" : "http://telus.com/fhir/patientChart/StructureDefinition/profile-medication-order",
"name" : "MedicationOrder",
"status" : "draft",
"fhirVersion" : "4.0.1",
"mapping" : [
{
"identity" : "workflow",
"uri" : "http://hl7.org/fhir/workflow",
"name" : "Workflow Pattern"
},
{
"identity" : "script10.6",
"uri" : "http://ncpdp.org/SCRIPT10_6",
"name" : "Mapping to NCPDP SCRIPT 10.6"
},
{
"identity" : "rim",
"uri" : "http://hl7.org/v3",
"name" : "RIM Mapping"
},
{
"identity" : "w5",
"uri" : "http://hl7.org/fhir/fivews",
"name" : "FiveWs Pattern Mapping"
},
{
"identity" : "v2",
"uri" : "http://hl7.org/v2",
"name" : "HL7 v2 Mapping"
},
{
"identity" : "PrescribeIT",
"name" : "PrescribeIT"
}
],
"kind" : "resource",
"abstract" : false,
"type" : "MedicationRequest",
"baseDefinition" : "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"derivation" : "constraint",
"differential" : {
"element" : [
{
"id" : "MedicationRequest",
"path" : "MedicationRequest",
"comment" : "START REVIEW - ON INFORMATION SOURCE Review Requestor, Dose&Rate - Datatype\r\n\r\nReview - MELVA - patient instructions\r\n**Add Dispenser Instructions as extension - see PrescribeIT\r\nExtensions - TreatmentType, Observations (height/weight/creatine), ManagedIssues (0..*) PharmacyInstructions, MonitoredDrug, NoRenewals, + dispense Trial, MaxDispense, TotalPrescribedQuantity,\r\n\r\n*Add - rendered dosage instruction ext ... 0..1 Conformance Rule: Must be present where dosage was specified. This is not mandatory as there may be orders for tests or products where dosage does not apply such as lancets or pregnancy tests.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.id",
"path" : "MedicationRequest.id",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.meta",
"path" : "MedicationRequest.meta",
"mustSupport" : true
},
{
"id" : "MedicationRequest.meta.versionId",
"path" : "MedicationRequest.meta.versionId",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.meta.lastUpdated",
"path" : "MedicationRequest.meta.lastUpdated",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.meta.source",
"path" : "MedicationRequest.meta.source",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.meta.profile",
"path" : "MedicationRequest.meta.profile",
"comment" : "Usage: Each implementation project will determine if this will be supported. It may be useful for validating message instances against this specific profile.\r\n\r\nIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.text",
"path" : "MedicationRequest.text",
"mustSupport" : true
},
{
"id" : "MedicationRequest.contained",
"path" : "MedicationRequest.contained",
"comment" : "Usage Rule: The medication resource will be contained and present in most situations.\r\n\r\nThis 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.",
"type" : [
{
"code" : "Resource",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/medication"
]
}
],
"mustSupport" : true
},
{
"id" : "MedicationRequest.extension",
"path" : "MedicationRequest.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"rules" : "open"
},
"min" : 0
},
{
"id" : "MedicationRequest.extension:RenderedDosageInstruction",
"path" : "MedicationRequest.extension",
"sliceName" : "RenderedDosageInstruction",
"comment" : "Usage Note: This is intended to provide all dosage instructions in a clear human-readable format. This field may be presented to users when viewing the prescription. This must be as clear as possible and must include all instructions. \r\nAlignment: This is a pre-adoption of an R5 element; this is also prsent in PrescribeIT\r\n\r\nIt is recognized that very complex instructions may be conveyed as text only (not as structured data). Example: take 500 mg twice a day at breakfast and at lunch AND 250 mg once a day at bedtime - THEN (new dosage line)). If the EMR submits structured dosage instructions, this must be consistent with the textual instructions provided here. Example: the EMR may enter frequency (multiplier of the dose) in their system like this (2 qam and 3 qhs ), in the structured frequency. The textual instructions could say Take 2 tablets in the morning and 3 at bedtime.\r\n\r\nConformance Rule: The rendered dosage instruction MUST contain ALL dosage instructions. This includes ALL child elements of dosage instruction, such as dosage quantity, dosage unit, frequency, etc) in human readable form and must be able to stand on its own. This field will include all of the information contained in the structured dosage as well as patient instructions (eg take with food, starting one day before dental appointment), assembled into one field and formatted as human-readable. Coded values codes should not be used (e.g. 'days' should be used instead of 'd', the code of PO as 'oral' )\r\n\r\nConformance Rule: MUST allow all printable characters and carriage return/line feeds.\r\n\r\nAlignment - PrescribeIT - Rendered Dosage Instruction",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-rendered-dosage-instruction"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.extension:DispenserInstructions",
"path" : "MedicationRequest.extension",
"sliceName" : "DispenserInstructions",
"comment" : "Alignment: MedicationOrder.extension:pharmacyInstructions\r\nUsage Note: If available, this should be included\r\n\r\nThere 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.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-request-dispenser-instructions"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.extension:MonitoredDrug",
"path" : "MedicationRequest.extension",
"sliceName" : "MonitoredDrug",
"comment" : "Alignment: PrescribeIT - MedicationOrder.extension:monitoredDrug\r\n\r\nthere 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.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-medicationorder-monitored-drug"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.extension:NoRenewalsFlag",
"path" : "MedicationRequest.extension",
"sliceName" : "NoRenewalsFlag",
"comment" : "Alignment: PrescribeIT: MedicationOrder.extension:noRenewals\r\n\r\nThere 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.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-medicationorder-no-renewals"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.extension:InformationSource",
"path" : "MedicationRequest.extension",
"sliceName" : "InformationSource",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-information-source"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.extension:StatusChanged",
"path" : "MedicationRequest.extension",
"sliceName" : "StatusChanged",
"definition" : "The date (and perhaps time) when the status was changed.",
"comment" : "Usage Note: This is a pre-adoption of an R5 data element, \r\nhttps://build.fhir.org/medicationrequest-definitions.html#MedicationRequest.statusChanged",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-status-changed"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.identifier",
"path" : "MedicationRequest.identifier",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "type.coding.code"
}
],
"rules" : "open"
},
"comment" : "Conformance Rule: The Placer ID (identifier.type=PLAC) must be populated with the prescription identifier issued by the source system for each medication. This aligns with PrescribeIT. Note: An EMR may view a \"prescription\" as having multiple medications whereas in FHIR, a medication request represents a single medication. \r\n\r\nConformance Rule: If the provincial DIS ID is available, this should be included\r\n\r\nMapping: PrescribeIT MedicationOrder.identifier\r\n\r\nThis is a business identifier, not a resource identifier.",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier.type",
"path" : "MedicationRequest.identifier.type",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier.system",
"path" : "MedicationRequest.identifier.system",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier.value",
"path" : "MedicationRequest.identifier.value",
"min" : 1,
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "MedicationOrder.identifier:EMR-id.value"
}
]
},
{
"id" : "MedicationRequest.identifier:Placer",
"path" : "MedicationRequest.identifier",
"sliceName" : "Placer",
"max" : "1"
},
{
"id" : "MedicationRequest.identifier:Placer.type",
"path" : "MedicationRequest.identifier.type",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:Placer.type.coding",
"path" : "MedicationRequest.identifier.type.coding",
"min" : 1,
"max" : "1",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:Placer.type.coding.code",
"path" : "MedicationRequest.identifier.type.coding.code",
"min" : 1,
"fixedCode" : "PLAC",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:Placer.system",
"path" : "MedicationRequest.identifier.system",
"comment" : "Conformance Rule: Follow the same rule as PrescribeIT for consistency ********** more to come on this\r\n\r\nPrescribeIT Conformance Rule: This must be an OID of the URI form [Vendor root].[Application instance node].2 (e.g. urn:oid:1.2.3.4). The branch, “.2†is appended to create a unique namespace for the Prescription Identifer\r\n\r\n\r\nIdentifier.system is always case sensitive.",
"min" : 1,
"fixedUri" : "http://hl7.org/fhir/identifier-type",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:Placer.value",
"path" : "MedicationRequest.identifier.value",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:DISID",
"path" : "MedicationRequest.identifier",
"sliceName" : "DISID",
"comment" : "Conformance Rule: If this is available to the sending system, this must be sent.\r\n\r\nThis is a business identifier, not a resource identifier.",
"max" : "2"
},
{
"id" : "MedicationRequest.identifier:DISID.type",
"path" : "MedicationRequest.identifier.type",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:DISID.type.coding",
"path" : "MedicationRequest.identifier.type.coding",
"min" : 1,
"max" : "1",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:DISID.type.coding.system",
"path" : "MedicationRequest.identifier.type.coding.system",
"min" : 1,
"fixedUri" : "http://hl7.org/fhir/v2/0203",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:DISID.type.coding.code",
"path" : "MedicationRequest.identifier.type.coding.code",
"min" : 1,
"fixedCode" : "RRI",
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:DISID.system",
"path" : "MedicationRequest.identifier.system",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.identifier:DISID.value",
"path" : "MedicationRequest.identifier.value",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.status",
"path" : "MedicationRequest.status",
"comment" : "Conformance Rule: Sending systems should set all orders should be set to completed. Rationale: The status of an order should not change and therefore all internal prescriptions may be set to completed. Note: this is not the medication status, it is the order status which is complete as soon as the order immediately when the prescription is written.\r\n\r\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.statusReason",
"path" : "MedicationRequest.statusReason",
"comment" : "Usage Note: When radio buttons are used, the status reason is be captured discretely.\r\n\r\nThis 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.intent",
"path" : "MedicationRequest.intent",
"fixedCode" : "order",
"mustSupport" : true
},
{
"id" : "MedicationRequest.category",
"path" : "MedicationRequest.category",
"comment" : "Conformance Rule: This should be populated if known\r\nPrescribeIT Mapping: May2016 extension \r\n\r\nThe category can be used to include where the medication is expected to be consumed or other types of requests.",
"max" : "1",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontype"
},
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category"
}
]
},
{
"id" : "MedicationRequest.category.coding",
"path" : "MedicationRequest.category.coding",
"min" : 1,
"max" : "1",
"mustSupport" : true
},
{
"id" : "MedicationRequest.category.coding.system",
"path" : "MedicationRequest.category.coding.system",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.category.coding.code",
"path" : "MedicationRequest.category.coding.code",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.reported[x]",
"path" : "MedicationRequest.reported[x]",
"comment" : "Conformance Rule: The boolean is mandatory where known, the source resource must be included in the extension:InformationSource. \r\nConformance Rule: In EMR's this may be derived from the \"external\" prescription indicator consider it reported and set value = true. \r\n\r\nUsage Note: The presence of the boolean = true is set only when the exporting system can be set with certainty. By example, the value would be set to \"true\" when a record was imported or when the physician has input the prescription data into the EMR from a bottle, prescription, discharge summary or consult report. In these cases the EMR can detect that the prescription being exported was an external prescription. It is recognized that there are other more complex scenarios where this flag cannot be set with certainty and should therefore not be populated.\r\n\r\nUsage Rule: For migration from EMR-EMR, it is important to ensure that not all records are marked as reported; rather the rules in the source EMR should be respected.\r\n\r\nCore-CA - supported\r\n \r\nNote R5 - does not support a reference in this field (in R5 it is an information source) and therefore it will not be supported by extension",
"type" : [
{
"code" : "boolean"
}
],
"mustSupport" : true
},
{
"id" : "MedicationRequest.medication[x]",
"path" : "MedicationRequest.medication[x]",
"mustSupport" : true
},
{
"id" : "MedicationRequest.subject",
"path" : "MedicationRequest.subject",
"mustSupport" : true
},
{
"id" : "MedicationRequest.subject.reference",
"path" : "MedicationRequest.subject.reference",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.subject.display",
"path" : "MedicationRequest.subject.display",
"comment" : "Usage Note: This should contain the name of the Patient, which can then be used in narrative\r\n\r\nThis 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.encounter",
"path" : "MedicationRequest.encounter",
"comment" : "Usage Note: This should be included if there is a definitive link to an encounter in the EMR and when it is deemed to be important for the implmementation.\r\n\r\nThis 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.supportingInformation",
"path" : "MedicationRequest.supportingInformation",
"comment" : "Usage Rules: This will be used to support the observations for weight, height, creatinine, eGFR. \r\nUsage Rule: Consider use of the vitals and lab profiles\r\n\r\nPrescribeIT mapping: extension, supporting information\r\n\r\n** **For MedicationOrders, create a value set that is scoped to weight, height, creatinine, eGFR (extensible) -- LOINC\r\n\r\nReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"type" : [
{
"code" : "Reference",
"aggregation" : [
"bundled"
]
}
],
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo"
}
]
},
{
"id" : "MedicationRequest.supportingInformation.reference",
"path" : "MedicationRequest.supportingInformation.reference",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.supportingInformation.display",
"path" : "MedicationRequest.supportingInformation.display",
"mustSupport" : true
},
{
"id" : "MedicationRequest.authoredOn",
"path" : "MedicationRequest.authoredOn",
"comment" : "Alignment: PrescribeIT Mapping: DateWritten\r\nConformance Rule: In the context of \"order\" this is often the date when the prescription was originally written. If this is an external prescription the date may not be known. In some cases this date will be an estimate by the physician who entered the record. \r\n\r\nConformance Rule: Must be either a full date (i.e. yyyy-mm-dd) or a full date and time with timezone (i.e. yyyy-mm-dd-HH:mm:ss.SSS-ZZZZZ). Prescriptions sent within Alberta will support the full date time.\r\n\r\nAlignment - PS-ON - TELUS asked: Are there any rules around this? Is this always the \"initial\" prescription date or latest renewal? Eg 7 years ago, rather than the date of the latest renewal? Please update the specification with this level of detail. Answer: They will seek clinical guidance in the future and advise.\r\r\n\r\nCA-Core: supported\r\nPrescribeIT: Date written\r\nPrescribeIT Conformance Rule: Must be either equal to or earlier then the MedicationOrder.dispenseRequest.valididityPeriod.start element.",
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "MedicationOrder.dateWritten"
}
]
},
{
"id" : "MedicationRequest.requester",
"path" : "MedicationRequest.requester",
"comment" : "Developer Guidance: This is not mandatory as the EMR may not always know the prescriber when creating an external prescription. If the role is known, the practitionerRole can be specified which has minimal information.\r\n\r\nCA - this element is supported\r\n\r\nReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"type" : [
{
"code" : "Reference",
"targetProfile" : [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization"
],
"aggregation" : [
"bundled"
]
}
],
"mustSupport" : true
},
{
"id" : "MedicationRequest.requester.reference",
"path" : "MedicationRequest.requester.reference",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.requester.display",
"path" : "MedicationRequest.requester.display",
"mustSupport" : true
},
{
"id" : "MedicationRequest.reasonCode",
"path" : "MedicationRequest.reasonCode",
"comment" : "Conformance Rule: In the case where the prescriber wants to send an Indication for Use that is not included in the value set the prescriber must be able to send a text value without a code.\r\n\r\n\r\nThis could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
},
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "MedicationOrder.reasonCode"
}
]
},
{
"id" : "MedicationRequest.reasonCode.coding",
"path" : "MedicationRequest.reasonCode.coding",
"mustSupport" : true
},
{
"id" : "MedicationRequest.reasonCode.coding.system",
"path" : "MedicationRequest.reasonCode.coding.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.reasonCode.coding.code",
"path" : "MedicationRequest.reasonCode.coding.code",
"mustSupport" : true
},
{
"id" : "MedicationRequest.reasonCode.text",
"path" : "MedicationRequest.reasonCode.text",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.basedOn",
"path" : "MedicationRequest.basedOn",
"comment" : "Conformance Rule: This must reference the MedicationRequest (Plan). This is the only supported resource at this time and is expected to be mandatory.\r\n\r\nReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"max" : "1",
"type" : [
{
"code" : "Reference",
"aggregation" : [
"bundled"
]
}
],
"mustSupport" : true
},
{
"id" : "MedicationRequest.basedOn.reference",
"path" : "MedicationRequest.basedOn.reference",
"mustSupport" : true
},
{
"id" : "MedicationRequest.courseOfTherapyType",
"path" : "MedicationRequest.courseOfTherapyType",
"comment" : "Usage Note: This should be included where known\r\nAlignment: PrescribeIT Mapping - Extension - TreatmentType\r\n\r\n\r\nThis attribute should not be confused with the protocol of the medication.",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiontreatmentcategory"
},
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type"
}
]
},
{
"id" : "MedicationRequest.courseOfTherapyType.coding",
"path" : "MedicationRequest.courseOfTherapyType.coding",
"min" : 1,
"max" : "1",
"mustSupport" : true
},
{
"id" : "MedicationRequest.courseOfTherapyType.coding.system",
"path" : "MedicationRequest.courseOfTherapyType.coding.system",
"min" : 1,
"fixedUri" : "http://hl7.org/fhir/v3/ActCode",
"mustSupport" : true
},
{
"id" : "MedicationRequest.courseOfTherapyType.coding.code",
"path" : "MedicationRequest.courseOfTherapyType.coding.code",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.courseOfTherapyType.text",
"path" : "MedicationRequest.courseOfTherapyType.text",
"mustSupport" : true
},
{
"id" : "MedicationRequest.note",
"path" : "MedicationRequest.note",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction",
"path" : "MedicationRequest.dosageInstruction",
"comment" : "Conformance Rules - if this is available in discrete form, this should be sent. This represents a single dosage line/instruction.\r\n\r\nAlignment Note: For sending systems, this will follow the same rules as PrescribeIT with one difference; the sequence data element is an extension in PrescribeIt. \r\nAlignment Note: Please refer to the SIG Table that is published in PrescribeIT for a full breakdown and guidance on populating these data elements.\r\n\r\nThere 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.sequence",
"path" : "MedicationRequest.dosageInstruction.sequence",
"comment" : "Usage Rule: This indicates the relationship between instruction line. If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. This carries the meaning of AND. If the sequence number is different, then the Dosages are intended to be sequential. and carries a meaning of \"THEN\". \r\n\r\nPrescribeIT Mapping: MedicationOrder.dosageInstruction.extension:instructionRelationship",
"min" : 1,
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence"
}
]
},
{
"id" : "MedicationRequest.dosageInstruction.text",
"path" : "MedicationRequest.dosageInstruction.text",
"comment" : "Alignment Note: This follows the same conformance rules as PrescribeIT and represents a textual version of the discrete data.\r\nCA core - must support\r\n\r\nConformance Rule: When providing multiple dosage lines this can be expressed individually. All dosage lines (full text content) must be concatenated into MedicationOrder.extension(renderedDosageInstruction).\r\n\r\nUsage Note: This is a string composed of any available discrete MedicationOrder.dosageInstruction child elements such as timing, asNeeded[x], siteCodeableConcept, route, dose[x], rate[x], and maxDosePerPeriod for each repetition sequence line.\r\n\r\nExample: Prednisone; variable dosage instruction, or concurrent instructions (1 pill morning and 1 pill before bed) or sequential dosages (1 pill for 2 days, then 2 pills). Note that FHIR strings SHALL NOT exceed 1MB in size",
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "MedicationOrder.dosageInstruction.text"
}
]
},
{
"id" : "MedicationRequest.dosageInstruction.additionalInstruction",
"path" : "MedicationRequest.dosageInstruction.additionalInstruction",
"comment" : "Usage Note: This follows the same conformance rules as PrescribeIT \r\n\r\nMapping: CHR - OMD requires that additional instructions are captured separately in the EMR\r\nPSS - two text fields; pharmacy instrucitons and \"other\" \r\n\r\nConformance Rule: When providing an additional instruction at the dosage line level (complex), this should be populated when appropriate.\r\n\r\nUsage Note: It may be necessary for the EMR to parse instructions such as QHS (take at bedtime), into two data elements DOSAGE_TIMING_FREQUENCY = once a day and 'at bedtime' would be placed into this field.\r\n\r\nInformation 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"path" : "MedicationRequest.dosageInstruction.additionalInstruction.coding",
"max" : "1",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"path" : "MedicationRequest.dosageInstruction.additionalInstruction.coding.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"path" : "MedicationRequest.dosageInstruction.additionalInstruction.coding.code",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.additionalInstruction.text",
"path" : "MedicationRequest.dosageInstruction.additionalInstruction.text",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.patientInstruction",
"path" : "MedicationRequest.dosageInstruction.patientInstruction",
"comment" : "This will not be used as EMRs do not have a patient-facing field - \r\nMELVA\r\nCHR -- Marc will double check but does not have a \"Patient Instruction field\"\r\nPSS - conversion is happening on frequency, but not guaranteed for other shortforms; recipient is pharmacist.\r\n\r\n\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size"
},
{
"id" : "MedicationRequest.dosageInstruction.timing",
"path" : "MedicationRequest.dosageInstruction.timing",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat",
"path" : "MedicationRequest.dosageInstruction.timing.repeat",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.bounds[x]",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.bounds[x]",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.count",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.count",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.countMax",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.countMax",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.duration",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.duration",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.durationMax",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.durationMax",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.durationUnit",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.frequency",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.frequencyMax",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.frequencyMax",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.period",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.period",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.periodMax",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.periodMax",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.timing.repeat.periodUnit",
"path" : "MedicationRequest.dosageInstruction.timing.repeat.periodUnit",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.asNeeded[x]",
"path" : "MedicationRequest.dosageInstruction.asNeeded[x]",
"comment" : "Usage Note: This will follow the same conformance rules as PrescribeIT:\r\nConformance Rule: This is ONLY populated when the medication is prescribed on an as needed (i.e. PRN) basis.\r\nConformance Rule: Set value = true\r\nConformance Rule: When this is specified, it is not acceptable to express the quantity exclusively as a duration/DAYS_SUPPLY. The DOSAGE_QUANTITY must be provided.\r\n\r\nConformance Rule: The CodeableConcept should not be used at this time. If it is present, treat it as though the boolean value is set to true.\r\n\r\nCan 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\".",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.site",
"path" : "MedicationRequest.dosageInstruction.site",
"comment" : "This follows the same conformance rule as PrescribeIT:\r\n\r\nConformance Rule: When providing a structured SIG, this should be populated when appropriate. If not structured, this should be part of the SIG (RENDERED_DOSAGE_INSTRUCTION)\r\n\r\nIf the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both.",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionadministrationsitees"
}
},
{
"id" : "MedicationRequest.dosageInstruction.site.coding",
"path" : "MedicationRequest.dosageInstruction.site.coding",
"max" : "1",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.site.coding.system",
"path" : "MedicationRequest.dosageInstruction.site.coding.system",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.site.coding.code",
"path" : "MedicationRequest.dosageInstruction.site.coding.code",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.site.text",
"path" : "MedicationRequest.dosageInstruction.site.text",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.route",
"path" : "MedicationRequest.dosageInstruction.route",
"comment" : "Conformance Rule: Coding should be populated if a code is available. However, text is always required.\r\n\r\nNot all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration"
}
},
{
"id" : "MedicationRequest.dosageInstruction.route.coding",
"path" : "MedicationRequest.dosageInstruction.route.coding",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.route.coding.system",
"path" : "MedicationRequest.dosageInstruction.route.coding.system",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.route.coding.code",
"path" : "MedicationRequest.dosageInstruction.route.coding.code",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.route.text",
"path" : "MedicationRequest.dosageInstruction.route.text",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.doseAndRate",
"path" : "MedicationRequest.dosageInstruction.doseAndRate",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"path" : "MedicationRequest.dosageInstruction.doseAndRate.dose[x]",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.doseAndRate.rate[x]",
"path" : "MedicationRequest.dosageInstruction.doseAndRate.rate[x]",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit"
}
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system",
"fixedUri" : "http://unitsofmeasure.org",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code",
"path" : "MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest",
"path" : "MedicationRequest.dispenseRequest",
"comment" : "Usage Rule: This will be mandatory for internally created prescriptions (source system is the reported source). This is not expected for external prescriptions that have been manually entered into the EMR by the physician; by exmaple, from a prescription bottle or a discharge summary.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.extension",
"path" : "MedicationRequest.dispenseRequest.extension",
"slicing" : {
"discriminator" : [
{
"type" : "value",
"path" : "url"
}
],
"rules" : "open"
},
"min" : 0
},
{
"id" : "MedicationRequest.dispenseRequest.extension:MaxDispensed",
"path" : "MedicationRequest.dispenseRequest.extension",
"sliceName" : "MaxDispensed",
"comment" : "Alignment PrescribeIT: MedicationOrder.dispenseRequest.extension:maxDispense\r\n\r\nConformance Rule: If this is supported within the EMR as a discrete data element, this must be populated.\r\n\r\nExample: A prescriber instructs a patient to take 3 Tylenol 3 tablets every day as needed for pain for 90 days. However, the prescriber does not wish the patient to have more than 30 days supply at any given time so the prescriber instructs the pharmacist that the maxDispense is 90 tablets. The pharmacist then does 3 partial fills of 90 tablets (or 30 days supply) over the 90 day period.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-medicationorder-max-dispense"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.dispenseRequest.extension:TotalQuantity",
"path" : "MedicationRequest.dispenseRequest.extension",
"sliceName" : "TotalQuantity",
"comment" : "Alignment Note: PrescribeIT - MedicationOrder.dispenseRequest.extension:totalPrescribedQuantity\r\n\r\nConformance Rule: The Total Prescribed Quantity is not mandatory but must be supplied if the value is entered by the user or can be calculated by the system.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-medicationorder-total-quantity"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.dispenseRequest.extension:MedicationForLife",
"path" : "MedicationRequest.dispenseRequest.extension",
"sliceName" : "MedicationForLife",
"definition" : "Flag to indicate that the prescription will cover the lifetime of a patient",
"comment" : "Alignment - PrescribeIT - MedicationOrder.dispenseRequest.extension:forLifeFlag\r\nConformance Rule: This is only used in Quebec\r\nConformance Rule: This must be set to \"true\" when the prescriber has indicated that the medication is authorized for the patient's lifetime (eg ephipens)\r\nConformance Rule: When flag = \"true\", there will be no end date on the validity period; there will be no total days supply or numberOfRepeats specified.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"https://telus.com/fhir/patientChart/StructureDefinition/ext-medication-for-life"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.dispenseRequest.extension:TotalDaysSupply",
"path" : "MedicationRequest.dispenseRequest.extension",
"sliceName" : "TotalDaysSupply",
"comment" : "Alignment - PrescribeIT Mapping - MedicationOrder.dispenseRequest.extension:totalDaysSupply\r\nConformance Rule: Must be populated when the Total Days Supply is entered by the user or when the Total Days Supply can be calculated by the system. Note: In Quebec this cannot be calculated; it is only provided if entered by the prescriber.\r\n\r\nConformance Rule: Code must be 'd' and system must be 'http://unitsofmeasure.org'.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-medicationorder-total-days-supply"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.dispenseRequest.extension:DispenseTrial",
"path" : "MedicationRequest.dispenseRequest.extension",
"sliceName" : "DispenseTrial",
"comment" : "Alignment: PrescribeIT: Maps to extension MedicationOrder.dispenseRequest.extension:trialEligibility\r\nConformance Rule: If eligible for trial, this must be set to 'true' and presented to the Pharmacist.\r\nConformance Rule: This is ONLY populated if it is for trial, else it is assumed not to be eligble.\r\nNote: Prescribers may include this information in notes.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Extension",
"profile" : [
"http://telus.com/fhir/patientChart/StructureDefinition/ext-medicationorder-dispense-trial"
]
}
],
"isModifier" : false
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill",
"path" : "MedicationRequest.dispenseRequest.initialFill",
"comment" : "Mapping: PrescribeIT first fill instructions - \r\nJN ******** need to add an extension for \"date\", as per PrescribeIT\r\nConformance Rule: If entry of the first fill information is supported within the EMR as discrete information, this must be populated. For the first fill instructions to be meaningful, the first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these must be provided.\r\n\r\nIf populating this element, either the quantity or the duration must be included.",
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill"
}
]
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.quantity",
"path" : "MedicationRequest.dispenseRequest.initialFill.quantity",
"comment" : "PrescribeIT mapping: \r\n\r\nThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"mustSupport" : true,
"binding" : {
"strength" : "preferred",
"valueSet" : "https://fhir.infoway-inforoute.ca/ValueSet/prescribedquantityunit"
},
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/dtprofile-quantity-drug"
}
]
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.quantity.value",
"path" : "MedicationRequest.dispenseRequest.initialFill.quantity.value",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.quantity.unit",
"path" : "MedicationRequest.dispenseRequest.initialFill.quantity.unit",
"min" : 1,
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.quantity.system",
"path" : "MedicationRequest.dispenseRequest.initialFill.quantity.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.quantity.code",
"path" : "MedicationRequest.dispenseRequest.initialFill.quantity.code",
"comment" : "Conformance Rule: A Code must be supplied if one is available from the PrescribedQuantityUnit subset. If the user picks a prescribed quantity unit that does not have a code in the PrescribedQuantityUnit subset, only then can unit be supplied without a code. If a receiving system receives a code that it doesn't recognize, the system must just display the unit.\r\n\r\nThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.duration",
"path" : "MedicationRequest.dispenseRequest.initialFill.duration",
"comment" : "Conformance Rule: The duration must be expressed as a ‘day(s)’ value and must be coded in the following way; code must be 'd' and system must be 'http://unitsofmeasure.org'.\r\n\r\nThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.duration.value",
"path" : "MedicationRequest.dispenseRequest.initialFill.duration.value",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.duration.system",
"path" : "MedicationRequest.dispenseRequest.initialFill.duration.system",
"fixedUri" : "http://unitsofmeasure.org",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.initialFill.duration.code",
"path" : "MedicationRequest.dispenseRequest.initialFill.duration.code",
"fixedCode" : "d",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.dispenseInterval",
"path" : "MedicationRequest.dispenseRequest.dispenseInterval",
"comment" : "Mapping: PrescribeIT extension\r\nConformance Rule: Only days are currently support as a measurement of dispenseInterval.\r\n\r\n\r\nThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval"
}
]
},
{
"id" : "MedicationRequest.dispenseRequest.dispenseInterval.value",
"path" : "MedicationRequest.dispenseRequest.dispenseInterval.value",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.dispenseInterval.system",
"path" : "MedicationRequest.dispenseRequest.dispenseInterval.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.dispenseInterval.code",
"path" : "MedicationRequest.dispenseRequest.dispenseInterval.code",
"comment" : "Conformance Rule: Only days are currently support as a measurement of dispenseInterval.\r\n\r\nThe preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.validityPeriod",
"path" : "MedicationRequest.dispenseRequest.validityPeriod",
"comment" : "Usage Rule: If status = on hold//stopped - the date it was put on hold conveyed as the end date. Start Date of Med + Hold/End Date\r\nIf status = intended - convey future estimated start date\r\nIf status = not taken - single date - ??? confirm this woudl be a date/time\r\n\r\nExample: Patient on med from Jan 1-Jan31 - put on hold on Jan 31. Patient never started the med but was formally discontinued on Feb 15th. \r\n\r\nOption 1** On Hold status - effective Jan 1-Jan 31. Second Med Statement - Feb 15th - Stopped. (single date conveys that the patient was NOT on the drug during the period statement- action by Prescriber) \r\n\r\nOption 2 - 3 med statements? First: Complete: Jan 1-Jan 31, second:On Hold Jan 31, single date Third: Stopped Feb 15, single date\r\n\r\nConformance Rule: Active, Intended, On-Hold will have an effective date that reflects a period of time. ??? Example: For an active and intended med statement, this will be the same as the Prescription Period. For On-Hold, this will reflect the start date of the Prescription and the Hold date will be the end date.\r\n\r\n***NOTE; QUEBEC HAS A NOTION OF A QC VALIDITY PERIOD, EXPRESSED AS A PERIOD OF TIME (EG 30 DAYS), BUT THIS IS NOT THE TOTAL DAYS SUPPLY (MEETING 08/31)\r\n\r\nMappings for Effective Date: \r\nCore-CA - supported\r\nEMRAPI: effectiveDate\r\nPSS: Available but not supported in the API. Derived from dose, frequency and quantity. End date Is calculated if discrete fields dose, frequency, duration OR dose, frequency and quantity if captured discretely. CPP->Rx->More details->Start Date beside label instructions\r\nMA: Patient--> Meds --> new --> start date, No API support\r\nMS: start date\r\n\r\nIt 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.validityPeriod.start",
"path" : "MedicationRequest.dispenseRequest.validityPeriod.start",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.validityPeriod.end",
"path" : "MedicationRequest.dispenseRequest.validityPeriod.end",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"path" : "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
"comment" : "Conformance Rule: This must be populated when the number of repeats is 1 or more. As this field only allows a positive integer, this is not populated if there are no refills allowed.\r\n\r\nGuidance: For narcotics, if this is incorrectly populated, the PMS could choose not to reject the message; rather they can adjust for the dispense.If displaying \"number of authorized fills\", add 1 to this number.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.quantity",
"path" : "MedicationRequest.dispenseRequest.quantity",
"comment" : "Alignment Mapping: PrescribeIT - total quantity\r\n\r\nThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.quantity.value",
"path" : "MedicationRequest.dispenseRequest.quantity.value",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.quantity.unit",
"path" : "MedicationRequest.dispenseRequest.quantity.unit",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.quantity.system",
"path" : "MedicationRequest.dispenseRequest.quantity.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.quantity.code",
"path" : "MedicationRequest.dispenseRequest.quantity.code",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"path" : "MedicationRequest.dispenseRequest.expectedSupplyDuration",
"definition" : "Identifies the period time over which the supplied product is expected to be used, \r\nor the length of time the dispense is expected to last.",
"comment" : "Alignment PrescribeIT = ExpectedSupplyDuration\r\n\r\n\r\nIn 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.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"path" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.value",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.unit",
"path" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.unit",
"fixedString" : "days",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"path" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.system",
"min" : 1,
"fixedUri" : "http://unitsofmeasure.org",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"path" : "MedicationRequest.dispenseRequest.expectedSupplyDuration.code",
"min" : 1,
"fixedCode" : "d",
"mustSupport" : true
},
{
"id" : "MedicationRequest.dispenseRequest.performer",
"path" : "MedicationRequest.dispenseRequest.performer",
"comment" : "Usage Note: The pharmacy should be included when known; \r\n***AB - create org resource with name (1..1) fax number, address, telephone\r\n\r\nReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution",
"path" : "MedicationRequest.substitution",
"comment" : "Conformance Rule: This MUST be included when the prescriber specifies \"no substitution\" (boolean = false)\r\nConformance Rule: must be specified when available as a discrete data element in the EMR\r\nMS: support\r\nPSS: no sub flag is present; there is no reason\r\nMA: supported\r\nCHR: no sub flag is present\r\n\r\nNote: This is not supported in PrescribeIT as a discrete data element; it is included in Pharmacist Instructions",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution.allowed[x]",
"path" : "MedicationRequest.substitution.allowed[x]",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution.reason",
"path" : "MedicationRequest.substitution.reason",
"comment" : "Conformance Rule: If available this must be sent. A local code may be used or if no code is available then text may be sent\r\n\r\n* Create our own value set (CT exists) \r\n\r\nMS: Reasons supported are: Allergy, Intolerence, ExactDosage, CT-ContininingTherapy, Brand Names not good enough, etc\r\nPSS: no reason\r\nMA: \r\nCHR: no reason\r\n\r\nNot all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution.reason.coding",
"path" : "MedicationRequest.substitution.reason.coding",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution.reason.coding.system",
"path" : "MedicationRequest.substitution.reason.coding.system",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution.reason.coding.code",
"path" : "MedicationRequest.substitution.reason.coding.code",
"mustSupport" : true
},
{
"id" : "MedicationRequest.substitution.reason.text",
"path" : "MedicationRequest.substitution.reason.text",
"mustSupport" : true
},
{
"id" : "MedicationRequest.priorPrescription",
"path" : "MedicationRequest.priorPrescription",
"comment" : "Mapping: This is supported by OMD in the CDS specification\r\n\r\nReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"mustSupport" : true
},
{
"id" : "MedicationRequest.priorPrescription.reference",
"path" : "MedicationRequest.priorPrescription.reference",
"mustSupport" : true
},
{
"id" : "MedicationRequest.detectedIssue",
"path" : "MedicationRequest.detectedIssue",
"comment" : "Conformance Rule: Detected Issue will be used to convey managed drug interactions. If available, this must be sent.\r\n\r\nPrescribeIT mapping - extension, detected issues\r\n\r\nThis 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.",
"mustSupport" : true,
"mapping" : [
{
"identity" : "PrescribeIT",
"map" : "http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue"
}
]
},
{
"id" : "MedicationRequest.detectedIssue.reference",
"path" : "MedicationRequest.detectedIssue.reference",
"mustSupport" : true
},
{
"id" : "MedicationRequest.detectedIssue.display",
"path" : "MedicationRequest.detectedIssue.display",
"mustSupport" : true
}
]
},
"text" : {
}
}
XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.