This page provides a list of the FHIR artifacts defined as part of this implementation guide.
• You can download a list of CSVs for the profiles here.
• A zip of formatted Excel files for profiles is here.
Extensions
The set of 'extra' elements that have been defined to supplement the capabilities of the base FHIR resources to meet the implementation guide requirements.
- Medication Code is Representative If set to true, indicates that the medication code sent was chosen as a "representative" code of a drug picked at a more general level. I.e. The user didn't actually choose this specific code. The intended constraints around what drug should be supplied are conveyed by the request's substitution rules.
- Medication Dispense Quantity Remaining The total authorized quantity outstanding after the fill issued as part of this dispense record
- Medication Dosage Instruction Sequence Indicates the sequence of a particular dosage line within all dosage lines - equivalent to the repetition number of the dosage instruction element this extension is on.
- Medication Rendered Dosage Instruction Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)
- Medication Order Adapt Reason Provides a textual description of the adapt reason in the medication order
- Medication Order Prescription Reason Provides a textual description of the prescribe reason in the medication order
- Medication Order Based On Identifies the original Medication Order that is being adapted
- Medication Order Category Sub-categorizes medication prescriptions into drugs, devices, compounds, etc. May be used to apply sub-type-specific constraints
- Medication Order Date of Last Dispense Identifies the date of the last dispense
- Medication Order Days Since Last Dispense Identifies the total period of days since the last dispense
- Medication Order Dispense First Fill Instructions Provides instructions specific to how the first fill of a prescription should be processed (if different from other fills)
- Medication Order Dispense Interval Indicates the minimum period of time that must pass between dispensing events
- Medication Order Dosage Instruction Relationship Indicates how the timing of this dosage instruction relates to the preceding dosage instruction. Specifically, is it concurrent (AND) or sequential (THEN).
- Medication Order Indication Priority Indicates the relative priority of a particular indication for a prescription among others. (Lower numbers are higher priority.) Multiple indications may share the same priority
- Medication Order Max Dispense Quantity Identifies the maximum quantity authorized to be dispensed at one time.
- Medication Order Monitored Drug Allows prescribers to indicate that the prescription is for a 'Monitored Drug' (e.g. compound) value in the prescription message to the pharmacies
- Medication Order No Renewals Indicates that the prescriber will not support renewals for this prescription
- Medication Order - Over 25 DUR Indicates that the total number of managed DURs associated with the prescription exceeds the reporting limit of 25
- Medication Order Protocol Identifies the Protocol, Order set, Guideline or other definition that guided the creation of this prescription
- Medication Order Stop Notified Allows pharmacies to indicate that the DIS has been notified of stopped in the prescription message to the EMRs
- Medication Order Supporting Information Additional information that relevant to the order. E.g. observations, allergies, etc.
- Medication Order Total Prescribed Days Supply Identifies the total period of time over which the prescription is expected to last
- Medication Order Total Prescribed Quantity Identifies the total quantity authorized to be dispensed throughout the lifetime of the prescription.
- Medication Order Treatment Type Identifies whether this drug is for acute or chronic use
- Medication Order Trial Dispense Eligibility If true, indicates that the prescription is eligible for performing a partial trial fill (to ensure the medication is tolerated and/or beneficial prior to dispensing a full fill.)
- Medication Strength Description Provides a textual description of the strength of the active ingredient(s) in the medication
- Request-related Coverage (NOT SUPPORTED) Identifies insurance coverage that may be relevant to fulfilling an order
- Request-related Detected Issues A set of managed and relevant detected issues that should be transmitted along with a prescription or order to provide context during the execution of that order.
- Request Dispenser Instructions Provides additional instructions from the prescriber to the pharmacy or other dispenser
- Task Based On Identifies a request, plan or proposal that drove the creation of this task
- Task DIS Notification Indicates that the DIS was notified of the prescription cancel
- Task Do Not Autofill A modifier extension that, if true, indicates that a task that would normally be interpretted as seeking the immediate fulfillment of a request is *not* seeking fulfillment, but is merely sharing the authoritative order. The fulfillment request will arrive by other means
- Task Effective Date/Time Indicates the date and potentially time when the requested action should occur
- Task Group Identifier The group that this particular task was initiated as part of
- Task Message A reference to a message share across one or more tasks
- Task Multiple Response An extension that, if true, indicates that a EMR Prescription has multiple responses.
- Task Drug Name The drug name of the prescription that was created to replace the prescription that was the target of the renewal.
- Task NewRx Reference The reference of the prescription that was created to replace the prescription that was the target of the renewal.
- Task Reason Indicates the reason for the current task's status or existence - used for reasons other than 'failed'
- Task Recorder Indicates who was responsible for recording the task if other than the requester
- Task Request Reason Echoes the reason provided on the Task which this task is fulfilling
- Task Split Prescription An extension, if true, indicates that a PMS Prescription has been split.
- Task Split Prescription Reason Provides a textual description of the split prescription reason.
Data Type Profiles
Constraints and extensions on the FHIR data types used throughout the implementation guide
- PrescribeIT® Prescriber Prescription Identifier Identifier assigned to an individual medication order by a prescribing system
- PrescribeIT® Drug Quantity Profile for representing quantities of medications
- PrescribeIT® Drug Quantity of Administration Profile for representing quantities of medications with an administerable form
- PrescribeIT® Drug Range Profile for representing ranges of medication quantities
- PrescribeIT® Unit Price Quantity Profile for representing unit prices of prescribable items
Abstract Profiles
High-level, shared constraints and extensions on FHIR resources used by the implementation guide. These profiles are not used directly in the specification but serve as a foundation for other profiles that are used within the tasks and interactions.
- PrescribeIT® Bundle for Message Tasks Rules that apply to messages focused on fulfillment of tasks
- PrescribeIT® Task Base StructureDefinition for the Task resource
- PrescribeIT® Request Task Constraints on request Tasks
- PrescribeIT® Response Task Constraints on response Tasks
- PrescribeIT® Deferred Request from EMR Task Tasks for requests originating from EMRs that do not have a specified recipient
- PrescribeIT® EMR Request Task Tasks from for requests originating from an EMR
- PrescribeIT® EMR Response Task Tasks from for responses originating from an EMRs
- PrescribeIT® PMS Request Task Tasks from for requests originating from a PMS
- PrescribeIT® PMS Response Task Tasks from for responses originating from a PMSs
Payload Resource Profiles
General constraints and extensions on FHIR resources used by the implementation guide. These profiles are referenced by Tasks and Interactions or by resources that are referenced by Tasks or Interactions
- PrescribeIT® Communication - Task message Constraints on the Communication resource for task messages
- PrescribeIT® Communication Constraints on the Communication resource for PrescribeIT
- PrescribeIT® Coverage (NOT SUPPORTED) Profile for coverage information related to prescribing and other pharmacy-related activities
- PrescribeIT® Detected Issue - DUR Information about issues detected with a particular prescription
- PrescribeIT® Dispense Constraints on the MedicationDispense resource
- PrescribeIT® Formulary Operation Output Parameters that are the result of the Formulary operation
- PrescribeIT® List - Allergies A simple allergy list expressed as a string
- PrescribeIT® Observation - Pharmacy-related Profile for observations related to ePrescription
- PrescribeIT® Prescribable Item Base StructureDefinition for Medication Resource
- PrescribeIT® Prescription Profile defining how medication prescriptions should be represented
- PrescribeIT® Prescription Adapt Profile defining PMS adapt medication prescriptions
- PrescribeIT® Prescription - Identifiers Profile for medication prescriptions identifiers
- PrescribeIT® New Prescription Profile for brand new medication prescriptions
- PrescribeIT® Original Prescription Profile for original medication prescription
- PrescribeIT® PMS Prescription Profile for PMS medication prescriptions
- PrescribeIT® PMS Rx Dispense Prescription Profile for Rx dispense medication prescriptions
- PrescribeIT® Renewal Prescription Profile for renewal medication prescriptions
Task Profiles - Current
Profiles for all of the Tasks defined as part of this implementation guide and the constraints associated with each
- Task e110-m - New RX Fill Request Request from an EMR to have a new prescription filled by a pharmacy
- Task e120-m - Renewal RX Fill Request Request from an EMR to have a renwal prescription filled by a pharmacy
- Task e140-m - Cancel RX Fill Request Request from an EMR to a PMS to cancel a submitted prescription prior to filling it
- Task e161-m - RX Response - Denied Response from an EMR indicating a refusal to renew a prescription
- Task e162-m - RX Response - Approved Response from an EMR indicating an agreement to renew a prescription and seeking for the renewed prescription to be filled by the requesting pharmacy
- Task e163-m - RX Response - Approved with Changes Response from an EMR indicating an agreement to renew a prescription, with modifications, and seeking for the renewed prescription to be filled by the requesting pharmacy
- Task e164-m - RX Response - Under Review Response from an EMR indicating that additional action is required before a request to renew a prescription can be acted upon
- Task e180-m - Deferred RX Fill Request Request from an EMR to have a new prescription filled by an unspecified pharmacy
- Task p141-m - Cancel RX Request Denied Response from a PMS to an EMR indicating that it cannot cancel a prescription as requested
- Task p142-m - Cancel RX Request Approved Response from a PMS to an EMR indicating that prescription has been cancelled as requested
- Task p143-m - Cancel RX Remaining Fills Revoked Response from a PMS to an EMR indicating that some medication has already been supplied, but all remaining fills have been successfully cancelled
- Task p160-m - RX Renewal Create Request Request from a pharmacy to renew a previously existing prescription
- Task p170-m - Pharmacist Adapt Request from a pharmacy to adapt a previously existing prescription
- Task p190-m - Pharmacist Prescribe Request from a pharmacy to prescribe a new prescription
- Task p200-m - RX Dispense Notification A notification from a PMS system to an EMR system that the initial dispense of a prescription has been processed (though not necessarily yet picked up)
- Task p210-m - RX Dispense Cancel Notification A notification from a PMS system to an EMR system that a previously announced dispense has been reversed (e.g. the customer didn't pick it up)
Interaction Profiles
Profiles used to define communication interactions for this implementation guide. Two types of profiles are defined. The 'Bundle' profiles define the root set of content allowed to be shared. For messaging interactions, the 'MessageHeader' profiles define the messaging events and the focal ''data'' resources for each message.
- Interaction Message Header 101 - Execute tasks from an EMR Message header for the submission of tasks from an EMR.
- Interaction Message Header 201 - Execute tasks from a PMS Message header for the submission of tasks from a pharmacy
- Interaction Message Header 305 - Send Clinician Communication Message header for the transmission of a Clinician Communication from sender to receiver
- Interaction Message Header 401 - Execute Deferred Prescription from an EMR Message header for the submission of tasks from an EMR to an unspecified recipient.
- Interaction Message Header 902 - Jurisidictional RX Identifier Notification Message Header to asynchronously return the Jurisdictional Identifier back to the EMR
- Interaction Bundle 101 - Execute Tasks from an EMR Bundle for the submission of tasks from an EMR.
- Interaction Bundle 201 - Execute Tasks from a PMS Bundle for the submission of tasks from a PMS
- Interaction Bundle 305 - Send Clinician Communication Message Bundle to request transmission of a clinician communication to specified client
- Interaction Bundle 401 - Send Deferred Tasks from an EMR Message Bundle to request execution of tasks sent from an EMR to an unspecified recipient
- Interaction Bundle 902 - Jurisidictional RX Identifier Notification Message Bundle to asynchronously return the Juisdictional Identifier back to the EMR
- Interaction Bundle - Non-authoritative Deferred Message Queue Response The response to a query to retrieve an non-authoritative deferred message queue associated with a particular Group ID.
Operation Definitions
Descriptions of custom operations defined for use in PrescribeIT®.
- Prescribable Product Formulary Lookup Allows checking a jurisdictional formulary to see if it contains a prescribable product and optionally getting a price estimate for the product
Conformance Statements
Descriptions of the types of systems that can participate in PrescribeIT® and what the expectations of each of those systems are.
- PrescribeIT® EMR This role defines the capabilities of electronic medical record systems (EMRs) that participate in PrescribeIT® Switch
- PrescribeIT® PMS This role defines the capabilities of Pharmacy Management Systems (PMSs) that participate in PrescribeIT® Switch
- PrescribeIT® Switch This role defines the capabilities of PrescribeIT® Switch itself
Examples
Examples of the different interactions supported by this specification.
-
A1 - 401 e180 Deferred RX Fill
Feb. 1 - Clinician creates a new prescription for Ventolin
Features:
- e180 New RX Fill Request -
A2 - 201 p200 RX Dispense Notification
Feb. 3 - Pharmacy processes initial Ventolin dispense
Features:
- p200 RX Dispense Notification -
A3 - 201 p210 RX Dispense Cancel Notification
Feb. 4 - Pharmacy cancels initial Ventolin dispense because patient indicates they will not be picking it up
Features:
- p210 RX Dispense CancelNotification -
A5 - 201 p142 Cancel RX Approved
Feb. 4 - Pharmacy confirms the cancelation and indicates they haven't dispensed the medication
Features:
- p142 Cancel RX Accepted -
B1 - 101 e110 New RX Fill
Feb 10 - Clinician creates a new medication prescription for a narcotic (METADOL 10 MG/ML)
Includes:
- e110 New RX Fill Request (medication order flagged as Narcotic; dispense interval declared) - B2 - 101 e140 Cancel Rx Feb 12 - Decides to cancel prescription due to a concern of abuse
- B3 - 201 p141 Cancel RX Denied Feb 13 - Pharmacy indicates that it is unable to cancel as the prescription has been transferred
-
C1 - 101 e110s Multiple New RX Fill
Mar 3 - Clinician creates multiple new prescriptions for various types of items
Includes:
- e110 New RX Fill Request (Prednisone)
- e110 New RX Fill Request (Nicoderm device prescription)
- e110 New RX Fill Request (Custom compound)
- e110 New RX Fill Request (Test strips)
All requests share the same Task Group ID - C2 - 101 e140 Cancel RX Fill Mar 4 - Decides to cancel prescription
- C3 - 201 p200 RX Dispense Notification Mar 5 - Pharmacy indicates that one prescription has been dispensed.
- C4 - 201 p143 Cancel RX Remaining Fills Revoked Mar 5 - Pharmacy indicates that other prescription was successfully cancelled, though only after a dispense had occurred
-
D1 - 101 e110s Multiple New RX Fill
May 10 - Prescriber prescribes an injectable and an antibiotic
Includes:
- e110 New RX Fill Request (Dimenhydrinate - includes body site)
- e110 New RX Fill Request (Cloxacillin) -
E1 - 201 p160s Multiple RX Renewals
Jul 8 - Pharmacy seeks renewal of Prednisone, Nicoderm, Strips and Compound
Includes:
- p160 - RX Renewal Create Request (Prednisone)
- p160 - RX Renewal Create Request (Strips)
- p160 - RX Renewal Create Request (Nicoderm)
- p160 - RX Renewal Create Request (Compund) - E2 - 101 e120 Renewal RX Fill, e161 Denied, 162 RX Approved, e163 RX Approved with Changes, and e164 Under Review Jul 10 - Prescriber refuses to renew Nicoderm, renews Strips, renews Prednisone with changes, and indicates renewal of the Compound is pending.
- E2 - 101 e120 Renewal RX Fill, e162 RX Approved, and e163 RX Approved with Changes Jul 10 - Prescriber renews Strips and renews Prednisone with changes.
- E2 - 101 e161 Denied and e164 Under Review Jul 10 - Non-SAML Prescriber refuses to renew Nicoderm and indicates renewal of the Compound is pending.
- F1- 305 CC - Locum to Organization August 15 - EMR seeks a consult on a past patient medication
- F1 - 305 CC - Organization to Practitioner August 15 - EMR seeks a consult on a past patient medication
- F1 - 305 CC - Practitioner to Organization August 15 - EMR seeks a consult on a past patient medication
- G1 - 201 p170 Pharmacist Adapt Oct 10 - Pharmacist adapts a new medication prescription (Brompheniramine)
- G2 - 201 p190 Pharmacist Prescribe Oct 10 - Pharmacist creates a new medication prescription (Brompheniramine)
- H1 - 902 Jurisidictional RX Identifier Notification Oct 4 - Notification to Prescriber that advise of one or more Jurisdictional RX IDs for a Prescription.
- Formulary Response Sample results of a formulary query
- Undirected retrieval query response Example showing a query response for non-authoritative deferred 401 messages