PrescribeIT® Prescription Discontinue

3.100 StructureDefinition: PrescribeIT® Prescription - Discontinue

The official URL for this profile is:

http://prescribeit.ca/fhir/StructureDefinition/profile-medicationorder-discontinue

3.100.2 Formal Views of Profile Content

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

This structure is derived from MedicationOrder

Name	Card.	Type	Constraints and Usage
MedicationOrder	0..*	MedicationOrder	Definition: An order for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationOrder" rather than "MedicationPrescription" to generalize the use across inpatient and outpatient settings as well as for care plans, etc. Comments: For Task e110-m - New RX Fill Request, this conveys the details of a single medication order. For Task e120-m - Renewal RX Fill Request, this conveys the medication order for which a fill is being requested. For Task p160-m - RX Renewal Create Request, this conveys the details of a single medication order for which the renewal is being requested.
id	1..1	id	Definition: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments: Usage Note: This will usually be a GUID and is assigned by the sending application.
contained	1..1	Resource	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. Comments: Conformance Rule: This will be used to contain the Medication resource. No other resources should be 'contained'.
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (renderedDosageInstruction)	1..1	Medication Rendered Dosage Instruction	Definition: This represents the complete instruction on how the discontinued medication was to be taken by the patient. This is made up of 'Ad-hoc instructions' and/or the 'textual rendition of the elements within the structured dosage lines' Comments: Usage Note: This will be populated by the EMR and will reflect the instructions of the discontinued medication as it was provided on the original prescription or or as entered by the prescriber on a standalone discontinue order. Conformance Rule: The rendered dosage instruction element in the message must contain ALL dosage instructions that are supported. This field must include ALL the information contained in the structured dosage instructions fields that are supported and populated, (such as dosage quantity, dosage unit, frequency, frequency period administration start/end date, route, site of admin etc.) as well as any additional patient instructions fields that may be supported and populated (e.g. take with food, starting one day before dental appointment). Conformance Rule: If an EMR has discrete field for Pharmacy Notes (Dispenser Instructions), they should not be included here. If EMR's have both concepts combined into one instruction field, then those instructions must be included as part of the rendered dosage instructions.
extension (protocol)	0..10	Medication Order Protocol	Definition: Identifies the Protocol, Order set, Guideline or other definition that guided the creation of this prescription Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
extension (treatmentType)	0..1	Medication Order Treatment Type	Definition: Identifies whether this drug is for acute or chronic use Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
extension (supportingInformation)	0..3	Medication Order Supporting Information	Definition: Additional information that relevant (e.g. observations, allergies, etc.) Comments: Conformance Rule: Cardinality must be 0..1 for Shared Health List-Allergies and 0..2 for Shared Health Pharmacy-related Observation (i.e. 1 for height and 1 for weight) as per bundle Conformance Rule: When sending this is the current list of allergies and observation for the patient from the sending system and should not include or replay back any information that is received in an incoming message. Conformance Rule: Only 1 allergy list, 1 weight and 1 height observation can be sent per bundle. If different values need to be sent that are specific to one medication order that must be sent as part of the pharmacist instructions or note data elements instead. Usage Note: See the functional specifications document for further requirements related to sending the allergy and observations information. Usage Note: The URL for this extension does not refer to an existing web-page as is a pre-adoption extension. Refer to the Shared Health implementation Guide for more information.
identifier	1..3	Shared Health Identifier	Slice: Unordered, Open by pattern:type Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: These are the identifiers assigned by the EMR and, in some cases, by the DIS.
identifier (EMR-id)	1..1	PrescribeIT® Prescriber Prescription Identifier	Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: In the context of a new prescription (e110, e120, e162, or e163), this Prescription business identifier is generated by the EMR. In the context of a Cancel Rx Fill Request (e140), this Prescription Identifier should be populated with the same Rx that was included in the original new prescription message (e110, e120, e162, or e163). In the context of a Discontinue Rx Fill Request (e150), this Prescription Identifier should be populated with the same Rx that was included in the original new prescription message (e110, e120, e162, e163, or e180). In the context of a Renewal Request (p160), this Prescription business Identifier is for the prescription that is being requested to be renewed. In most cases, this will be a value that was originally generated by the EMR. However, in some cases (e.g. the renewal of a paper/fax prescription), there will be no EMR generated prescription identifier, and in this case, the PMS should generate its own Prescription business identifier. In the context of an Rx Response - Denied (e161), or an Rx Response - Under Review (e164), this Prescription Identifier should be populated with the MedicationOrder.identifier(EMR-id) provided in the Renewal Request (p160).
type	1..1	Shared Health CodeableConcept Code	Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/identifier-type","code":"PLAC"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments:
coding	1..*	Coding	Slice: Unordered, Open by value:system, value:code Definition: A reference to a 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 labelled as UserSelected = true.
system	1..1	uri	Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: This is the URI that represents the coding system as defined within the binding.
code	1..1	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). Comments: This is the code as defined within the binding.
display	0..1	string	Definition: A representation of the meaning of the code in the system, following the rules of the system.
coding (placer)	0..*	Coding	Definition: A reference to a 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 labelled as UserSelected = true.
system	1..1	uri	Fixed Value: http://hl7.org/fhir/identifier-type Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: Fixed value: http://hl7.org/fhir/identifier-type
code	1..1	code	Fixed Value: PLAC 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). Comments: Fixed value: PLAC
display	0..1	string	Definition: A representation of the meaning of the code in the system, following the rules of the system.
system	1..1	uri	EMR-id-branch-2: This must be an OID ending in .2 Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique. Comments: 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
value	1..1	string	Example' General': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: Usage Rule: The business identifier that uniquely identifies a prescription.
identifier (DIS-id)	0..2	Identifier	Definition: External identifier - one that would be used by another non-FHIR system - for example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records have to be tracked through an entire system. Comments: In the context of Tasks e110, e120, e162, e163, and e180, this identifier will not be present in the message transmitted from the EMR to the PrescribeIT® Switch. As the message passes through the PrescribeIT® Switch in a jurisdiction which has a Drug Information System (DIS), the PrescribeIT® Switch will add the DIS's identifier to the MedicationOrder. PMS is to use this identifier to record the dispense event against the correct DIS Prescription identifier, if possible. In the context of Tasks e140 and p160, this is not applicable.
type	1..1	Shared Health CodeableConcept Code	Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"RRI"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments:
system	0..1	uri	Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique.
value	1..1	string	Example' General': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
status	1..1	code	Binding: MedicationOrderStatus (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Fixed Value: active Definition: A code specifying the state of the order. Generally this will be active or completed state. Comments: Fixed value: active
medication[x] (medicationReference)	1..1	Reference(PrescribeIT® Medication) {c }	Definition: A reference from one resource to another. Comments: Usage Note: this is populated with the reference to the Medication resource pertaining to this Medication Order. It will point to the 'contained' Medication resource. This will reference the medication id value without the '#'
patient	1..1	Reference(Shared Health Patient) {b }	Definition: A reference from one resource to another. Comments: Usage Note: This must point to the patient associated with the message.
reasonCode	0..5	Shared Health CodeableConcept Required Text with optional code	Binding: PrescriptionIndicationForUse (20220331) (extensible) Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
coding	0..1	Coding	Definition: A reference to a 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 labelled as UserSelected = true.
system	1..1	uri	Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: This is the URI that represents the coding system as defined within the binding.
code	1..1	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). Comments: This is the code as defined within the binding.
display	0..1	string	Definition: A representation of the meaning of the code in the system, following the rules of the system.
text	1..1	string	Max Length: 2500 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. Comments: Conformance Rule: This is the text used to convey the exact word that was displayed to the practitioner
note	0..1	Annotation	Definition: Extra information about the prescription that could not be conveyed by the other attributes. Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
text	1..1	string	Max Length: 2500 Definition: The text of the annotation.
dosageInstruction	0..*	BackboneElement	Definition: Indicates how the medication is to be used by the patient. Comments: Conformance Rule: For EMRs that can support structured dosage instruction, this element must be populated when the prescriber specifies any of structured dosage information. Anything that is populated as part of the structured dosage information must also be part of the RENDERED_DOSAGE_INSTRUCTION element. Usage Note: An Excel spreadsheet providing guidance on how to populate dosage instructions can be found under 'Scope and Usage'. When the dose or rate is intended to change over the entire administration period, e.g. Tapering dose prescriptions, multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. Another common example in institutional settings is 'titration' of an IV medication dose to maintain a specific stated hemodynamic value or range e.g. drug x to be administered to maintain AM (arterial mean) greater than 65.
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (sequence)	1..1	Medication Dosage Line Sequence	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: This must match the positional sequence of the dosageInstruction repetition. I.e. The first dosageInstruction repetition must have a 'sequence' value of 1, the second a 'sequence' value of 2, etc.
extension (instructionRelationship)	0..1	Medication Order Dosage Instruction Relationship	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: As this will establish the relationship to the previous dosage lines (example: first and second dosage line, the second and thrid dosage line, etc.) this must be present for all dosage lines except for the FIRST dosage line. Usage Note: ANDs are instructions lines that are done together and THENs are instructions that are sequential and are done following the previous line. ANDs and THENs can be used individually or mixed together depending on the specific instructions. Example using just AND: Take 1 tablet every morning and 2 tablets every evening. Example using just THEN: Take 1 tablet every morning for 1 week THEN take 2 tablets every morning for 1 week. Example using both: Take 1 tablet every morning AND 2 tablets every evening for 1 week THEN take 2 tablets every morning AND 3 tablets every evening for 1 week.
text	0..1	string	Definition: 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. Comments: Conformance Rule: When providing multiple dosage lines can be expressed individually. All dosage lines (full text content) must be concatenated into MedicationOrder.extension(renderedDosageInstruction) as PMS will not be forced to support the receipt of individual lines. Usage 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. Example: 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).
additionalInstructions	0..1	Shared Health CodeableConcept Text Required	Binding: (unbound) (example): Codes identifying additional instructions such as "take with water" or "avoid operating heavy machinery". Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance Rule: When providing an additional instruction at the dosage line level (complex), this should be populated when appropriate. Usage 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.
text	1..1	string	Max Length: 2500 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. Comments: Conformance Rule: This is the text used to convey the exact word that was displayed to the practitioner
timing	0..1	Timing	Definition: The timing schedule on how the patient is to take the medication. The timing schedules allows many different expressions to be expressed. For example: Every 8 hours, Three times a day, 1/2 an hour before breakfast for 10 days from 17 Oct 2017 to 27 Oct 2017 Comments: Conformance Rule: For EMRs that can support structured dosage instruction, this must be populated if prescriber specifies any of structured timing information. Anything that is populated as part of the structured timing information must also be part of the RENDERED_DOSAGE_INSTRUCTION. Usage Note: An Excel spreadsheet providing guidance on how to populate dosage instructions can be found under 'Scope and Usage'.
event	0..1	dateTime	Definition: Identifies specific times when the event occurs.
repeat	0..1	Element	tim-3: Either frequency or when can exist, not both tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-9: If there's an offset, there must be a when tim-6: If there's a periodMax, there must be a period tim-8: If there's a countMax, there must be a count tim-7: If there's a durationMax, there must be a duration tim-4: duration SHALL be a non-negative value Definition: A set of rules that describe when the event should occur. Comments: Conformance Rule: If an EMR cannot send discrete elements in all cases for timing.repeat element, this is acceptable as long as RENDERED_DOSAGE_INSTRUCTION captures the timing.
bounds[x]	0..1	Period, Shared Health Duration, Range	Definition: boundsPeriod defines the start and/or end date of the period over which the specified instruction should take place for a given dosage line. For example, if the prescriber wants a patient to start taking the medication starting the day before surgery, and the surgery is scheduled for Feb 16th 2019, the start date within bounds period would be Feb 15 2019. The end date can be included if the prescriber wants the patient to stop medication after a certain number of days. In the example above lets say the prescriber wants to the patient to stop the medication after 10 days the end date would Feb 26 2019. boundsDuration defines the amount of time that the patient should be taking the specified instruction for a given dosage line. As an example, a prescription may call for taking 1-2 pills per day for 10 days. The boundsDuration would be 10 days. boundsRange defines a minimum and maximum amount of time that the patient should be taking the specified instruction for a given dosage line. As an example, a prescriber may indicate that a patient should apply a cream 2 times per day for a minimum of 10 days but if the rash persists, continue applying for up to 14 days. In this case the minimum for boundsRange would be 10 days and the maximum for boundsRange would be 14 days.
count	0..1	integer	Definition: count defines how many time the dosing activities should be repeated across all periods. For example, if a prescriber wants a patient to take 1 pill morning and night every day for 10 days, the dose is 1 pill, the frequency is 2 per day, the period is one day, and the count is 20 doses (corresponding to 10 days times 2 doses per day). Comments: If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
countMax	0..1	integer	Definition: countMax defines the max number of doses that should be taken across all periods within a dosage line. countMax is only used when the count is expressed as a range of values. For example, if a prescriber wants a patient to take a dose of 2 pills per day for 7-10 days, the dose is 2 pills, the frequency is 1 dose per day, the period is 1 days, the count is 7 doses, and the countMax is 10 doses.
duration	0..1	decimal	Definition: duration defines the amount of time it takes to provide a SINGLE dose of a medication to a patient. For most medications, duration is not relevant. However, one example that uses duration would be the application of a patch. The prescriber may instruct the patient to apply a patch for 10 hours each day for 10 days. In this case, the dose would be 1 patch, the duration would be 10 hours, the period would be 1 day, and the count would be 10 doses. Comments: For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
durationMax	0..1	decimal	Definition: durationMax defines the maximum amount of time CAN/SHOULD take to provide a SINGLE dose of a medication to a patient. durationMax implies the usage of a range of values for the duration. For most medications, duration and durationMax is not relevant. However, one example that uses duration and durationMax would be the application of a patch for a range of time each day. The prescriber may instruct the patient to apply a patch for 10-12 hours each day for 10 days. In this case, the dose would be 1 patch, the duration would be 10 hours, the durationMax would be 12 hours, the period would be 1 day, and the count would be 10 doses. Comments: For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
durationUnit	0..1	code	Binding: x_TimeUnitsOfMeasure (20230710) (required) Definition: The units of time for the duration, in UCUM units.
frequency	0..1	integer	Definition: frequency defines the number of times to apply a single dose of a medication within a particular period. For example, the prescriber may instruct the patient to take 1 tablet 3 times per day for 10 days. In this cases, the dose would be 1 tablet, the frequency would be 3 times, the period would be 1 day, and the count would be 30 doses.
frequencyMax	0..1	integer	Definition: frequencyMax defines the maximum number of times to apply a single dose of a medication within a particular period. Using frequencyMax implies that the frequency is a range of values. For example, the prescriber may instruct the patient to take 1 tablet 3-4 times per day for 10 days. In this cases, the dose would be 1 tablet, the frequency would be 3 times, the frequencyMax would be 4 times, the period would be 1 day, and the count would be 30 doses.
period	0..1	decimal	Definition: The period defines the amount of time over which the frequency of doses should occur. For example, the prescriber may instruct the patient to take 1 tablet every day for 10 days. In this case, the period is 1 day.
periodMax	0..1	decimal	Definition: The periodMax defines the maximum amount of time over which the frequency of doses should occur. For example, the prescriber may instruct the patient to apply one patch every 48 to 72 hours and leave the patch on for 12 hour and do this for 1 month. In this case, the dose would be one patch, the frequency would be 1, the duration would be 12 hours, the period would be 48 hours, the periodMax would be 72 hours, and the boundPeriod would be a start day of today and an end date of 2 months from now.
periodUnit	0..1	code	Binding: x_TimeUnitsOfMeasure (20230710) (required) Definition: The units of time for the period in UCUM units.
asNeeded[x]	0..1	boolean, CodeableConcept	Binding: (unbound) (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. 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). Comments: Conformance Rule: This is ONLY populated when the medication is prescribed on an as needed (i.e. PRN) basis. Conformance Rule: Set value = true Conformance 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. The CodeableConcept should not be used at this time. If it is present, treat it as though the boolean value is set to true.
site[x] (siteCodeableConcept)	0..1	Shared Health CodeableConcept Required Text with optional code	Binding: PrescriptionAdministrationSite (20220331) (extensible) Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance 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)
route	0..1	Shared Health CodeableConcept Required Text with optional code	Binding: PrescriptionRouteOfAdministration (20190415) (extensible) Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance Rule: Coding should be populated if a code is available. However, text is always required.
dose[x]	0..1	PrescribeIT® Drug Quantity for Administration, PrescribeIT® Drug Range	Binding: PrescriptionDoseQuantityUnit (20220331) (extensible) Definition: The amount of therapeutic or other substance given at one administration event. Comments: Conformance Rule: Could be sent as part of the dosage instruction. OR for those EMRs that can support it, this should be specified.
rate[x] (rateRatio)	0..1	Ratio	Definition: 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. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. 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 MedicationOrder with an updated rate, or captured with a new MedicationOrder with the new rate.
numerator	1..1	PrescribeIT® Drug Quantity for Administration	Binding: PrescribedQuantityUnit (20220331) (extensible) qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity Definition: A measured or counted amount of a medication expressed as a value and human-readable string with optional coded units expressed in a local coding system Comments: Usage Note: Quantity is used throughout the messages. It may be a drug form (e.g. TAB) an administrable drug (e.g. PUFF) form or a unit of measure (e.g. mg).
denominator	1..1	Shared Health Quantity	qty-3: If a code for the unit is present, the system SHALL also be present Definition: A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. Comments: This indicates the unit of time (e.g. per day, every 4 weeks, etc.)
maxDosePerPeriod	0..1	Ratio	Definition: 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. Comments: Conformance Rule: When providing a structured SIG, this should be populated when appropriate.
numerator	1..1	PrescribeIT® Drug Quantity for Administration	Binding: PrescribedQuantityUnit (20220331) (extensible) qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity Definition: A measured or counted amount of a medication expressed as a value and human-readable string with optional coded units expressed in a local coding system Comments: Conformance Rule: Quantity is used throughout the messages. It may be a drug form (e.g. TAB) an adminstratable drug (e.g. PUFF) for or a unit of measure (e.g. mg). If this is provided it is mandatory to send a value from the PrescribeIT® Drug Quantity.
denominator	1..1	Shared Health Quantity	qty-3: If a code for the unit is present, the system SHALL also be present Definition: A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. Comments: This indicates the unit of time (e.g. per day, every 4 weeks, etc.)

This structure is derived from MedicationOrder

Summary

Mandatory: 8 elements (9 nested mandatory elements)
Must-Support: 52 elements
Fixed Value: 1 element
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

The element MedicationOrder.identifier is sliced based on the value of pattern:type

This structure is derived from MedicationOrder

Name	Flags	Card.	Type	Description & Constraints
MedicationOrder	S	0..*	MedicationOrder	Prescription of medication to for patient
id	S	1..1	id	Logical id of this artifact
contained	S	1..1	Resource	Contained, inline Resources
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-rendered-dosage	S	1..1	string	Rendered Dosage Instruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
ext-medicationorder-protocol	S	0..10	string, uri, Shared Health Identifier	Protocol, order set, guideline, etc. URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-protocol
ext-medicationorder-treatment-type	S	0..1	code	ACU \| CHRON URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type Binding: PrescriptionTreatmentCategory (20190415) (required)
ext-medicationorder-supportinginfo	S	0..3	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
identifier	S	1..3	(Slice Definition)	An identifier intended for computation Slice: Unordered, Open by pattern:type
identifier:EMR-id	S	1..1	PrescribeIT® Prescriber Prescription Identifier	EMR Prescription Identifier
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/identifier-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
identifier:DIS-id	S	0..2	Identifier	DIS Order identifier
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/v2/0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RRI
system	S	0..1	uri	The namespace for the identifier
value	S	1..1	string	The value that is unique
status	S	1..1	code	active \| on-hold \| completed \| entered-in-error \| stopped \| draft Fixed Value: active
medicationReference	S	1..1	Reference(PrescribeIT® Medication) {c }	A reference from one resource to another
patient	S	1..1	Reference(Shared Health Patient) {b }	A reference from one resource to another
reasonCode	S	0..5	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionIndicationForUse (20220331) (extensible)
text	S	1..1	string	Plain text representation of the concept
note	S	0..1	Annotation	Information about the prescription
text	S	1..1	string	The annotation - text content Max Length: 2500
dosageInstruction	S	0..*	BackboneElement	How medication should be taken
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-dosageinstruction-sequence	S	1..1	integer	Sequence of dosage instruction URL: http://hl7.org/fhir/StructureDefinition/extension-Dosage.sequence profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence
ext-medicationorder-dosageinstruction-relationship	S	0..1	code	AND \| THEN URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship Binding: PrescriptionDosageInstructionLineRelationship (20170626) (required)
text	S	0..1	string	Free text dosage instructions e.g. SIG
additionalInstructions	S	0..1	Shared Health CodeableConcept Text Required	Concept - reference to a terminology or just text
text	S	1..1	string	Plain text representation of the concept
timing	S	0..1	Timing	When medication should be administered
event	S	0..1	dateTime	When the event occurs
repeat	S	0..1	Element	When the event is to occur
bounds[x]	S	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsPeriod			Period
boundsQuantity			Quantity(Shared Health Duration)
boundsRange			Range
count	S	0..1	integer	Number of times to repeat
countMax	S	0..1	integer	Maximum number of times to repeat
duration	S	0..1	decimal	How long when it happens
durationMax	S	0..1	decimal	How long when it happens (Max)
durationUnit	S	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
frequency	S	0..1	integer	Event occurs frequency times per period
frequencyMax	S	0..1	integer	Event occurs up to frequencyMax times per period
period	S	0..1	decimal	Event occurs frequency times per period
periodMax	S	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	S	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
when		0..0
offset		0..0
asNeeded[x]	S	0..1	boolean, CodeableConcept	Take "as needed" (for x)
siteCodeableConcept	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionAdministrationSite (20220331) (extensible)
route	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionRouteOfAdministration (20190415) (extensible)
dose[x]	S	0..1		Amount of medication per dose Binding: PrescriptionDoseQuantityUnit (20220331) (extensible)
doseQuantity			Quantity(PrescribeIT® Drug Quantity for Administration)
doseRange			Range(PrescribeIT® Drug Range)
rateRatio	S	0..1	Ratio	Amount of medication per unit of time
numerator	S	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	S	1..1	Shared Health Quantity	A measured or measurable amount
maxDosePerPeriod	S	0..1	Ratio	Upper limit on medication per unit of time
numerator	S	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	S	1..1	Shared Health Quantity	A measured or measurable amount
dispenseRequest		0..0
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationOrder	SΣ	0..*	MedicationOrder	Prescription of medication to for patient
id	SΣ	1..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: http://tools.ietf.org/html/bcp47 (required): A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained	S	1..1	Resource	Contained, inline Resources
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-rendered-dosage	S	1..1	string	Rendered Dosage Instruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
ext-medicationorder-protocol	S	0..10	string, uri, Shared Health Identifier	Protocol, order set, guideline, etc. URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-protocol
ext-medicationorder-treatment-type	S	0..1	code	ACU \| CHRON URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type Binding: PrescriptionTreatmentCategory (20190415) (required)
ext-medicationorder-supportinginfo	S	0..3	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..3	(Slice Definition)	An identifier intended for computation Slice: Unordered, Open by pattern:type
identifier:EMR-id	S	1..1	PrescribeIT® Prescriber Prescription Identifier	EMR Prescription Identifier
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
use	?!Σ	0..1	code	usual \| official \| temp \| secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/identifier-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding	SΣ	1..*	(Slice Definition)	Code defined by a terminology system Slice: Unordered, Open by value:system, value:code
coding:All Slices				Content/Rules for all slices
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:placer	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/identifier-type
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	SΣI	1..1	uri	The namespace for the identifier EMR-id-branch-2: This must be an OID ending in .2 Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:DIS-id	SΣ	0..2	Identifier	DIS Order identifier
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
use	?!Σ	0..1	code	usual \| official \| temp \| secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/v2/0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RRI
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	SΣ	0..1	uri	The namespace for the identifier Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	active \| on-hold \| completed \| entered-in-error \| stopped \| draft Binding: MedicationOrderStatus (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Fixed Value: active
medication[x]	Σ	1..1	(Slice Definition)	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	SΣ	1..1	Reference(PrescribeIT® Medication) {c }	A reference from one resource to another
patient	SΣ	1..1	Reference(Shared Health Patient) {b }	A reference from one resource to another
encounter	Σ	0..1	Reference(Encounter)	Created during encounter/admission/stay
dateWritten	Σ	0..1	dateTime	When prescription was authorized
prescriber	Σ	0..1	Reference(Practitioner)	Who ordered the medication(s)
reasonCode	S	0..5	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionIndicationForUse (20220331) (extensible)
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding	SΣ	0..1	Coding	Code defined by a terminology system
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣ	1..1	string	Plain text representation of the concept Max Length: 2500
reasonReference	Σ	0..*	Reference(Condition)	Condition that supports why the prescription is being written
dateEnded	Σ	0..1	dateTime	When prescription was stopped
reasonEnded	Σ	0..1	CodeableConcept	Why prescription was stopped Binding: (unbound) (example): Codes indicating why the medication was terminated; e.g. Adverse reaction, medication change, issue resolved, etc.
note	SΣ	0..1	Annotation	Information about the prescription
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(Practitioner \| Patient \| RelatedPerson)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text	S	1..1	string	The annotation - text content Max Length: 2500
dosageInstruction	SΣ	0..*	BackboneElement	How medication should be taken
id		0..1	id	xml:id (or equivalent in JSON)
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-dosageinstruction-sequence	S	1..1	integer	Sequence of dosage instruction URL: http://hl7.org/fhir/StructureDefinition/extension-Dosage.sequence profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence
ext-medicationorder-dosageinstruction-relationship	S	0..1	code	AND \| THEN URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship Binding: PrescriptionDosageInstructionLineRelationship (20170626) (required)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstructions	S	0..1	Shared Health CodeableConcept Text Required	Concept - reference to a terminology or just text Binding: (unbound) (example): Codes identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SΣ	1..1	string	Plain text representation of the concept Max Length: 2500
timing	SΣ	0..1	Timing	When medication should be administered
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
event	SΣ	0..1	dateTime	When the event occurs
repeat	SΣI	0..1	Element	When the event is to occur
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
bounds[x]	SΣ	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsPeriod			Period
boundsQuantity			Quantity(Shared Health Duration)
boundsRange			Range
count	SΣ	0..1	integer	Number of times to repeat
countMax	SΣ	0..1	integer	Maximum number of times to repeat
duration	SΣ	0..1	decimal	How long when it happens
durationMax	SΣ	0..1	decimal	How long when it happens (Max)
durationUnit	SΣ	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
frequency	SΣ	0..1	integer	Event occurs frequency times per period
frequencyMax	SΣ	0..1	integer	Event occurs up to frequencyMax times per period
period	SΣ	0..1	decimal	Event occurs frequency times per period
periodMax	SΣ	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	SΣ	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
code	Σ	0..1	CodeableConcept	QD \| QOD \| Q4H \| Q6H \| BID \| TID \| QID \| AM \| PM + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x]	SΣ	0..1		Take "as needed" (for x) Binding: (unbound) (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site[x]	Σ	0..1	(Slice Definition)	Body site to administer to Slice: Unordered, Closed by type:$this Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
site[x]:siteCodeableConcept	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionAdministrationSite (20220331) (extensible)
route	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionRouteOfAdministration (20190415) (extensible)
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: (unbound) (example): A coded concept describing the technique by which the medicine is administered.
dose[x]	SΣ	0..1		Amount of medication per dose Binding: PrescriptionDoseQuantityUnit (20220331) (extensible)
doseQuantity			Quantity(PrescribeIT® Drug Quantity for Administration)
doseRange			Range(PrescribeIT® Drug Range)
rate[x]	Σ	0..1	(Slice Definition)	Amount of medication per unit of time Slice: Unordered, Closed by type:$this
rate[x]:rateRatio	SΣ	0..1	Ratio	Amount of medication per unit of time
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
numerator	SI	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	SI	1..1	Shared Health Quantity	A measured or measurable amount
maxDosePerPeriod	SΣ	0..1	Ratio	Upper limit on medication per unit of time
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
numerator	SI	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	SI	1..1	Shared Health Quantity	A measured or measurable amount
substitution	Σ	0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	CodeableConcept	generic \| formulary + Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason	Σ	0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription	Σ	0..1	Reference(MedicationOrder)	An order/prescription that this supersedes
Documentation for this format

Grid View

This structure is derived from MedicationOrder

Name	Card.	Type	Constraints and Usage
MedicationOrder	0..*	MedicationOrder	Definition: An order for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationOrder" rather than "MedicationPrescription" to generalize the use across inpatient and outpatient settings as well as for care plans, etc. Comments: For Task e110-m - New RX Fill Request, this conveys the details of a single medication order. For Task e120-m - Renewal RX Fill Request, this conveys the medication order for which a fill is being requested. For Task p160-m - RX Renewal Create Request, this conveys the details of a single medication order for which the renewal is being requested.
id	1..1	id	Definition: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments: Usage Note: This will usually be a GUID and is assigned by the sending application.
contained	1..1	Resource	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. Comments: Conformance Rule: This will be used to contain the Medication resource. No other resources should be 'contained'.
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (renderedDosageInstruction)	1..1	Medication Rendered Dosage Instruction	Definition: This represents the complete instruction on how the discontinued medication was to be taken by the patient. This is made up of 'Ad-hoc instructions' and/or the 'textual rendition of the elements within the structured dosage lines' Comments: Usage Note: This will be populated by the EMR and will reflect the instructions of the discontinued medication as it was provided on the original prescription or or as entered by the prescriber on a standalone discontinue order. Conformance Rule: The rendered dosage instruction element in the message must contain ALL dosage instructions that are supported. This field must include ALL the information contained in the structured dosage instructions fields that are supported and populated, (such as dosage quantity, dosage unit, frequency, frequency period administration start/end date, route, site of admin etc.) as well as any additional patient instructions fields that may be supported and populated (e.g. take with food, starting one day before dental appointment). Conformance Rule: If an EMR has discrete field for Pharmacy Notes (Dispenser Instructions), they should not be included here. If EMR's have both concepts combined into one instruction field, then those instructions must be included as part of the rendered dosage instructions.
extension (protocol)	0..10	Medication Order Protocol	Definition: Identifies the Protocol, Order set, Guideline or other definition that guided the creation of this prescription Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
extension (treatmentType)	0..1	Medication Order Treatment Type	Definition: Identifies whether this drug is for acute or chronic use Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
extension (supportingInformation)	0..3	Medication Order Supporting Information	Definition: Additional information that relevant (e.g. observations, allergies, etc.) Comments: Conformance Rule: Cardinality must be 0..1 for Shared Health List-Allergies and 0..2 for Shared Health Pharmacy-related Observation (i.e. 1 for height and 1 for weight) as per bundle Conformance Rule: When sending this is the current list of allergies and observation for the patient from the sending system and should not include or replay back any information that is received in an incoming message. Conformance Rule: Only 1 allergy list, 1 weight and 1 height observation can be sent per bundle. If different values need to be sent that are specific to one medication order that must be sent as part of the pharmacist instructions or note data elements instead. Usage Note: See the functional specifications document for further requirements related to sending the allergy and observations information. Usage Note: The URL for this extension does not refer to an existing web-page as is a pre-adoption extension. Refer to the Shared Health implementation Guide for more information.
identifier	1..3	Shared Health Identifier	Slice: Unordered, Open by pattern:type Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: These are the identifiers assigned by the EMR and, in some cases, by the DIS.
identifier (EMR-id)	1..1	PrescribeIT® Prescriber Prescription Identifier	Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: In the context of a new prescription (e110, e120, e162, or e163), this Prescription business identifier is generated by the EMR. In the context of a Cancel Rx Fill Request (e140), this Prescription Identifier should be populated with the same Rx that was included in the original new prescription message (e110, e120, e162, or e163). In the context of a Discontinue Rx Fill Request (e150), this Prescription Identifier should be populated with the same Rx that was included in the original new prescription message (e110, e120, e162, e163, or e180). In the context of a Renewal Request (p160), this Prescription business Identifier is for the prescription that is being requested to be renewed. In most cases, this will be a value that was originally generated by the EMR. However, in some cases (e.g. the renewal of a paper/fax prescription), there will be no EMR generated prescription identifier, and in this case, the PMS should generate its own Prescription business identifier. In the context of an Rx Response - Denied (e161), or an Rx Response - Under Review (e164), this Prescription Identifier should be populated with the MedicationOrder.identifier(EMR-id) provided in the Renewal Request (p160).
type	1..1	Shared Health CodeableConcept Code	Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/identifier-type","code":"PLAC"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments:
coding	1..*	Coding	Slice: Unordered, Open by value:system, value:code Definition: A reference to a 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 labelled as UserSelected = true.
system	1..1	uri	Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: This is the URI that represents the coding system as defined within the binding.
code	1..1	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). Comments: This is the code as defined within the binding.
display	0..1	string	Definition: A representation of the meaning of the code in the system, following the rules of the system.
coding (placer)	0..*	Coding	Definition: A reference to a 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 labelled as UserSelected = true.
system	1..1	uri	Fixed Value: http://hl7.org/fhir/identifier-type Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: Fixed value: http://hl7.org/fhir/identifier-type
code	1..1	code	Fixed Value: PLAC 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). Comments: Fixed value: PLAC
display	0..1	string	Definition: A representation of the meaning of the code in the system, following the rules of the system.
system	1..1	uri	EMR-id-branch-2: This must be an OID ending in .2 Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique. Comments: 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
value	1..1	string	Example' General': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: Usage Rule: The business identifier that uniquely identifies a prescription.
identifier (DIS-id)	0..2	Identifier	Definition: External identifier - one that would be used by another non-FHIR system - for example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records have to be tracked through an entire system. Comments: In the context of Tasks e110, e120, e162, e163, and e180, this identifier will not be present in the message transmitted from the EMR to the PrescribeIT® Switch. As the message passes through the PrescribeIT® Switch in a jurisdiction which has a Drug Information System (DIS), the PrescribeIT® Switch will add the DIS's identifier to the MedicationOrder. PMS is to use this identifier to record the dispense event against the correct DIS Prescription identifier, if possible. In the context of Tasks e140 and p160, this is not applicable.
type	1..1	Shared Health CodeableConcept Code	Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"RRI"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments:
system	0..1	uri	Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique.
value	1..1	string	Example' General': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
status	1..1	code	Binding: MedicationOrderStatus (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Fixed Value: active Definition: A code specifying the state of the order. Generally this will be active or completed state. Comments: Fixed value: active
medication[x] (medicationReference)	1..1	Reference(PrescribeIT® Medication) {c }	Definition: A reference from one resource to another. Comments: Usage Note: this is populated with the reference to the Medication resource pertaining to this Medication Order. It will point to the 'contained' Medication resource. This will reference the medication id value without the '#'
patient	1..1	Reference(Shared Health Patient) {b }	Definition: A reference from one resource to another. Comments: Usage Note: This must point to the patient associated with the message.
reasonCode	0..5	Shared Health CodeableConcept Required Text with optional code	Binding: PrescriptionIndicationForUse (20220331) (extensible) Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
coding	0..1	Coding	Definition: A reference to a 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 labelled as UserSelected = true.
system	1..1	uri	Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: This is the URI that represents the coding system as defined within the binding.
code	1..1	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). Comments: This is the code as defined within the binding.
display	0..1	string	Definition: A representation of the meaning of the code in the system, following the rules of the system.
text	1..1	string	Max Length: 2500 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. Comments: Conformance Rule: This is the text used to convey the exact word that was displayed to the practitioner
note	0..1	Annotation	Definition: Extra information about the prescription that could not be conveyed by the other attributes. Comments: Conformance Rule: This element is not supported and must not be populated or included when the sender is sending the discontinue, therefore the receiver will never need to display this value.
text	1..1	string	Max Length: 2500 Definition: The text of the annotation.
dosageInstruction	0..*	BackboneElement	Definition: Indicates how the medication is to be used by the patient. Comments: Conformance Rule: For EMRs that can support structured dosage instruction, this element must be populated when the prescriber specifies any of structured dosage information. Anything that is populated as part of the structured dosage information must also be part of the RENDERED_DOSAGE_INSTRUCTION element. Usage Note: An Excel spreadsheet providing guidance on how to populate dosage instructions can be found under 'Scope and Usage'. When the dose or rate is intended to change over the entire administration period, e.g. Tapering dose prescriptions, multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. Another common example in institutional settings is 'titration' of an IV medication dose to maintain a specific stated hemodynamic value or range e.g. drug x to be administered to maintain AM (arterial mean) greater than 65.
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (sequence)	1..1	Medication Dosage Line Sequence	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: This must match the positional sequence of the dosageInstruction repetition. I.e. The first dosageInstruction repetition must have a 'sequence' value of 1, the second a 'sequence' value of 2, etc.
extension (instructionRelationship)	0..1	Medication Order Dosage Instruction Relationship	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: As this will establish the relationship to the previous dosage lines (example: first and second dosage line, the second and thrid dosage line, etc.) this must be present for all dosage lines except for the FIRST dosage line. Usage Note: ANDs are instructions lines that are done together and THENs are instructions that are sequential and are done following the previous line. ANDs and THENs can be used individually or mixed together depending on the specific instructions. Example using just AND: Take 1 tablet every morning and 2 tablets every evening. Example using just THEN: Take 1 tablet every morning for 1 week THEN take 2 tablets every morning for 1 week. Example using both: Take 1 tablet every morning AND 2 tablets every evening for 1 week THEN take 2 tablets every morning AND 3 tablets every evening for 1 week.
text	0..1	string	Definition: 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. Comments: Conformance Rule: When providing multiple dosage lines can be expressed individually. All dosage lines (full text content) must be concatenated into MedicationOrder.extension(renderedDosageInstruction) as PMS will not be forced to support the receipt of individual lines. Usage 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. Example: 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).
additionalInstructions	0..1	Shared Health CodeableConcept Text Required	Binding: (unbound) (example): Codes identifying additional instructions such as "take with water" or "avoid operating heavy machinery". Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance Rule: When providing an additional instruction at the dosage line level (complex), this should be populated when appropriate. Usage 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.
text	1..1	string	Max Length: 2500 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. Comments: Conformance Rule: This is the text used to convey the exact word that was displayed to the practitioner
timing	0..1	Timing	Definition: The timing schedule on how the patient is to take the medication. The timing schedules allows many different expressions to be expressed. For example: Every 8 hours, Three times a day, 1/2 an hour before breakfast for 10 days from 17 Oct 2017 to 27 Oct 2017 Comments: Conformance Rule: For EMRs that can support structured dosage instruction, this must be populated if prescriber specifies any of structured timing information. Anything that is populated as part of the structured timing information must also be part of the RENDERED_DOSAGE_INSTRUCTION. Usage Note: An Excel spreadsheet providing guidance on how to populate dosage instructions can be found under 'Scope and Usage'.
event	0..1	dateTime	Definition: Identifies specific times when the event occurs.
repeat	0..1	Element	tim-3: Either frequency or when can exist, not both tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-9: If there's an offset, there must be a when tim-6: If there's a periodMax, there must be a period tim-8: If there's a countMax, there must be a count tim-7: If there's a durationMax, there must be a duration tim-4: duration SHALL be a non-negative value Definition: A set of rules that describe when the event should occur. Comments: Conformance Rule: If an EMR cannot send discrete elements in all cases for timing.repeat element, this is acceptable as long as RENDERED_DOSAGE_INSTRUCTION captures the timing.
bounds[x]	0..1	Period, Shared Health Duration, Range	Definition: boundsPeriod defines the start and/or end date of the period over which the specified instruction should take place for a given dosage line. For example, if the prescriber wants a patient to start taking the medication starting the day before surgery, and the surgery is scheduled for Feb 16th 2019, the start date within bounds period would be Feb 15 2019. The end date can be included if the prescriber wants the patient to stop medication after a certain number of days. In the example above lets say the prescriber wants to the patient to stop the medication after 10 days the end date would Feb 26 2019. boundsDuration defines the amount of time that the patient should be taking the specified instruction for a given dosage line. As an example, a prescription may call for taking 1-2 pills per day for 10 days. The boundsDuration would be 10 days. boundsRange defines a minimum and maximum amount of time that the patient should be taking the specified instruction for a given dosage line. As an example, a prescriber may indicate that a patient should apply a cream 2 times per day for a minimum of 10 days but if the rash persists, continue applying for up to 14 days. In this case the minimum for boundsRange would be 10 days and the maximum for boundsRange would be 14 days.
count	0..1	integer	Definition: count defines how many time the dosing activities should be repeated across all periods. For example, if a prescriber wants a patient to take 1 pill morning and night every day for 10 days, the dose is 1 pill, the frequency is 2 per day, the period is one day, and the count is 20 doses (corresponding to 10 days times 2 doses per day). Comments: If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
countMax	0..1	integer	Definition: countMax defines the max number of doses that should be taken across all periods within a dosage line. countMax is only used when the count is expressed as a range of values. For example, if a prescriber wants a patient to take a dose of 2 pills per day for 7-10 days, the dose is 2 pills, the frequency is 1 dose per day, the period is 1 days, the count is 7 doses, and the countMax is 10 doses.
duration	0..1	decimal	Definition: duration defines the amount of time it takes to provide a SINGLE dose of a medication to a patient. For most medications, duration is not relevant. However, one example that uses duration would be the application of a patch. The prescriber may instruct the patient to apply a patch for 10 hours each day for 10 days. In this case, the dose would be 1 patch, the duration would be 10 hours, the period would be 1 day, and the count would be 10 doses. Comments: For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
durationMax	0..1	decimal	Definition: durationMax defines the maximum amount of time CAN/SHOULD take to provide a SINGLE dose of a medication to a patient. durationMax implies the usage of a range of values for the duration. For most medications, duration and durationMax is not relevant. However, one example that uses duration and durationMax would be the application of a patch for a range of time each day. The prescriber may instruct the patient to apply a patch for 10-12 hours each day for 10 days. In this case, the dose would be 1 patch, the duration would be 10 hours, the durationMax would be 12 hours, the period would be 1 day, and the count would be 10 doses. Comments: For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
durationUnit	0..1	code	Binding: x_TimeUnitsOfMeasure (20230710) (required) Definition: The units of time for the duration, in UCUM units.
frequency	0..1	integer	Definition: frequency defines the number of times to apply a single dose of a medication within a particular period. For example, the prescriber may instruct the patient to take 1 tablet 3 times per day for 10 days. In this cases, the dose would be 1 tablet, the frequency would be 3 times, the period would be 1 day, and the count would be 30 doses.
frequencyMax	0..1	integer	Definition: frequencyMax defines the maximum number of times to apply a single dose of a medication within a particular period. Using frequencyMax implies that the frequency is a range of values. For example, the prescriber may instruct the patient to take 1 tablet 3-4 times per day for 10 days. In this cases, the dose would be 1 tablet, the frequency would be 3 times, the frequencyMax would be 4 times, the period would be 1 day, and the count would be 30 doses.
period	0..1	decimal	Definition: The period defines the amount of time over which the frequency of doses should occur. For example, the prescriber may instruct the patient to take 1 tablet every day for 10 days. In this case, the period is 1 day.
periodMax	0..1	decimal	Definition: The periodMax defines the maximum amount of time over which the frequency of doses should occur. For example, the prescriber may instruct the patient to apply one patch every 48 to 72 hours and leave the patch on for 12 hour and do this for 1 month. In this case, the dose would be one patch, the frequency would be 1, the duration would be 12 hours, the period would be 48 hours, the periodMax would be 72 hours, and the boundPeriod would be a start day of today and an end date of 2 months from now.
periodUnit	0..1	code	Binding: x_TimeUnitsOfMeasure (20230710) (required) Definition: The units of time for the period in UCUM units.
asNeeded[x]	0..1	boolean, CodeableConcept	Binding: (unbound) (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. 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). Comments: Conformance Rule: This is ONLY populated when the medication is prescribed on an as needed (i.e. PRN) basis. Conformance Rule: Set value = true Conformance 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. The CodeableConcept should not be used at this time. If it is present, treat it as though the boolean value is set to true.
site[x] (siteCodeableConcept)	0..1	Shared Health CodeableConcept Required Text with optional code	Binding: PrescriptionAdministrationSite (20220331) (extensible) Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance 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)
route	0..1	Shared Health CodeableConcept Required Text with optional code	Binding: PrescriptionRouteOfAdministration (20190415) (extensible) Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: Conformance Rule: Coding should be populated if a code is available. However, text is always required.
dose[x]	0..1	PrescribeIT® Drug Quantity for Administration, PrescribeIT® Drug Range	Binding: PrescriptionDoseQuantityUnit (20220331) (extensible) Definition: The amount of therapeutic or other substance given at one administration event. Comments: Conformance Rule: Could be sent as part of the dosage instruction. OR for those EMRs that can support it, this should be specified.
rate[x] (rateRatio)	0..1	Ratio	Definition: 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. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. 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 MedicationOrder with an updated rate, or captured with a new MedicationOrder with the new rate.
numerator	1..1	PrescribeIT® Drug Quantity for Administration	Binding: PrescribedQuantityUnit (20220331) (extensible) qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity Definition: A measured or counted amount of a medication expressed as a value and human-readable string with optional coded units expressed in a local coding system Comments: Usage Note: Quantity is used throughout the messages. It may be a drug form (e.g. TAB) an administrable drug (e.g. PUFF) form or a unit of measure (e.g. mg).
denominator	1..1	Shared Health Quantity	qty-3: If a code for the unit is present, the system SHALL also be present Definition: A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. Comments: This indicates the unit of time (e.g. per day, every 4 weeks, etc.)
maxDosePerPeriod	0..1	Ratio	Definition: 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. Comments: Conformance Rule: When providing a structured SIG, this should be populated when appropriate.
numerator	1..1	PrescribeIT® Drug Quantity for Administration	Binding: PrescribedQuantityUnit (20220331) (extensible) qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity Definition: A measured or counted amount of a medication expressed as a value and human-readable string with optional coded units expressed in a local coding system Comments: Conformance Rule: Quantity is used throughout the messages. It may be a drug form (e.g. TAB) an adminstratable drug (e.g. PUFF) for or a unit of measure (e.g. mg). If this is provided it is mandatory to send a value from the PrescribeIT® Drug Quantity.
denominator	1..1	Shared Health Quantity	qty-3: If a code for the unit is present, the system SHALL also be present Definition: A measured amount (or an amount that can potentially be measured). Note that measured amounts include amounts that are not precisely quantified, including amounts involving arbitrary units and floating currencies. Comments: This indicates the unit of time (e.g. per day, every 4 weeks, etc.)

This structure is derived from MedicationOrder

Summary

Mandatory: 8 elements (9 nested mandatory elements)
Must-Support: 52 elements
Fixed Value: 1 element
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

The element MedicationOrder.identifier is sliced based on the value of pattern:type

Differential View

This structure is derived from MedicationOrder

Name	Flags	Card.	Type	Description & Constraints
MedicationOrder	S	0..*	MedicationOrder	Prescription of medication to for patient
id	S	1..1	id	Logical id of this artifact
contained	S	1..1	Resource	Contained, inline Resources
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-rendered-dosage	S	1..1	string	Rendered Dosage Instruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
ext-medicationorder-protocol	S	0..10	string, uri, Shared Health Identifier	Protocol, order set, guideline, etc. URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-protocol
ext-medicationorder-treatment-type	S	0..1	code	ACU \| CHRON URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type Binding: PrescriptionTreatmentCategory (20190415) (required)
ext-medicationorder-supportinginfo	S	0..3	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
identifier	S	1..3	(Slice Definition)	An identifier intended for computation Slice: Unordered, Open by pattern:type
identifier:EMR-id	S	1..1	PrescribeIT® Prescriber Prescription Identifier	EMR Prescription Identifier
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/identifier-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
identifier:DIS-id	S	0..2	Identifier	DIS Order identifier
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/v2/0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RRI
system	S	0..1	uri	The namespace for the identifier
value	S	1..1	string	The value that is unique
status	S	1..1	code	active \| on-hold \| completed \| entered-in-error \| stopped \| draft Fixed Value: active
medicationReference	S	1..1	Reference(PrescribeIT® Medication) {c }	A reference from one resource to another
patient	S	1..1	Reference(Shared Health Patient) {b }	A reference from one resource to another
reasonCode	S	0..5	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionIndicationForUse (20220331) (extensible)
text	S	1..1	string	Plain text representation of the concept
note	S	0..1	Annotation	Information about the prescription
text	S	1..1	string	The annotation - text content Max Length: 2500
dosageInstruction	S	0..*	BackboneElement	How medication should be taken
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-dosageinstruction-sequence	S	1..1	integer	Sequence of dosage instruction URL: http://hl7.org/fhir/StructureDefinition/extension-Dosage.sequence profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence
ext-medicationorder-dosageinstruction-relationship	S	0..1	code	AND \| THEN URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship Binding: PrescriptionDosageInstructionLineRelationship (20170626) (required)
text	S	0..1	string	Free text dosage instructions e.g. SIG
additionalInstructions	S	0..1	Shared Health CodeableConcept Text Required	Concept - reference to a terminology or just text
text	S	1..1	string	Plain text representation of the concept
timing	S	0..1	Timing	When medication should be administered
event	S	0..1	dateTime	When the event occurs
repeat	S	0..1	Element	When the event is to occur
bounds[x]	S	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsPeriod			Period
boundsQuantity			Quantity(Shared Health Duration)
boundsRange			Range
count	S	0..1	integer	Number of times to repeat
countMax	S	0..1	integer	Maximum number of times to repeat
duration	S	0..1	decimal	How long when it happens
durationMax	S	0..1	decimal	How long when it happens (Max)
durationUnit	S	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
frequency	S	0..1	integer	Event occurs frequency times per period
frequencyMax	S	0..1	integer	Event occurs up to frequencyMax times per period
period	S	0..1	decimal	Event occurs frequency times per period
periodMax	S	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	S	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
when		0..0
offset		0..0
asNeeded[x]	S	0..1	boolean, CodeableConcept	Take "as needed" (for x)
siteCodeableConcept	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionAdministrationSite (20220331) (extensible)
route	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionRouteOfAdministration (20190415) (extensible)
dose[x]	S	0..1		Amount of medication per dose Binding: PrescriptionDoseQuantityUnit (20220331) (extensible)
doseQuantity			Quantity(PrescribeIT® Drug Quantity for Administration)
doseRange			Range(PrescribeIT® Drug Range)
rateRatio	S	0..1	Ratio	Amount of medication per unit of time
numerator	S	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	S	1..1	Shared Health Quantity	A measured or measurable amount
maxDosePerPeriod	S	0..1	Ratio	Upper limit on medication per unit of time
numerator	S	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	S	1..1	Shared Health Quantity	A measured or measurable amount
dispenseRequest		0..0
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationOrder	SΣ	0..*	MedicationOrder	Prescription of medication to for patient
id	SΣ	1..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: http://tools.ietf.org/html/bcp47 (required): A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained	S	1..1	Resource	Contained, inline Resources
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-rendered-dosage	S	1..1	string	Rendered Dosage Instruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
ext-medicationorder-protocol	S	0..10	string, uri, Shared Health Identifier	Protocol, order set, guideline, etc. URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-protocol
ext-medicationorder-treatment-type	S	0..1	code	ACU \| CHRON URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-treatment-type Binding: PrescriptionTreatmentCategory (20190415) (required)
ext-medicationorder-supportinginfo	S	0..3	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..3	(Slice Definition)	An identifier intended for computation Slice: Unordered, Open by pattern:type
identifier:EMR-id	S	1..1	PrescribeIT® Prescriber Prescription Identifier	EMR Prescription Identifier
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
use	?!Σ	0..1	code	usual \| official \| temp \| secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/identifier-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding	SΣ	1..*	(Slice Definition)	Code defined by a terminology system Slice: Unordered, Open by value:system, value:code
coding:All Slices				Content/Rules for all slices
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:placer	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/identifier-type
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	SΣI	1..1	uri	The namespace for the identifier EMR-id-branch-2: This must be an OID ending in .2 Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:DIS-id	SΣ	0..2	Identifier	DIS Order identifier
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
use	?!Σ	0..1	code	usual \| official \| temp \| secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	S	1..1	Shared Health CodeableConcept Code	Concept - reference to a terminology or just text Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/v2/0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RRI
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	SΣ	0..1	uri	The namespace for the identifier Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	active \| on-hold \| completed \| entered-in-error \| stopped \| draft Binding: MedicationOrderStatus (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Fixed Value: active
medication[x]	Σ	1..1	(Slice Definition)	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	SΣ	1..1	Reference(PrescribeIT® Medication) {c }	A reference from one resource to another
patient	SΣ	1..1	Reference(Shared Health Patient) {b }	A reference from one resource to another
encounter	Σ	0..1	Reference(Encounter)	Created during encounter/admission/stay
dateWritten	Σ	0..1	dateTime	When prescription was authorized
prescriber	Σ	0..1	Reference(Practitioner)	Who ordered the medication(s)
reasonCode	S	0..5	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionIndicationForUse (20220331) (extensible)
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding	SΣ	0..1	Coding	Code defined by a terminology system
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣ	1..1	string	Plain text representation of the concept Max Length: 2500
reasonReference	Σ	0..*	Reference(Condition)	Condition that supports why the prescription is being written
dateEnded	Σ	0..1	dateTime	When prescription was stopped
reasonEnded	Σ	0..1	CodeableConcept	Why prescription was stopped Binding: (unbound) (example): Codes indicating why the medication was terminated; e.g. Adverse reaction, medication change, issue resolved, etc.
note	SΣ	0..1	Annotation	Information about the prescription
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(Practitioner \| Patient \| RelatedPerson)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text	S	1..1	string	The annotation - text content Max Length: 2500
dosageInstruction	SΣ	0..*	BackboneElement	How medication should be taken
id		0..1	id	xml:id (or equivalent in JSON)
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medication-dosageinstruction-sequence	S	1..1	integer	Sequence of dosage instruction URL: http://hl7.org/fhir/StructureDefinition/extension-Dosage.sequence profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medication-dosageinstruction-sequence
ext-medicationorder-dosageinstruction-relationship	S	0..1	code	AND \| THEN URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship Binding: PrescriptionDosageInstructionLineRelationship (20170626) (required)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstructions	S	0..1	Shared Health CodeableConcept Text Required	Concept - reference to a terminology or just text Binding: (unbound) (example): Codes identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SΣ	1..1	string	Plain text representation of the concept Max Length: 2500
timing	SΣ	0..1	Timing	When medication should be administered
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
event	SΣ	0..1	dateTime	When the event occurs
repeat	SΣI	0..1	Element	When the event is to occur
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
bounds[x]	SΣ	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsPeriod			Period
boundsQuantity			Quantity(Shared Health Duration)
boundsRange			Range
count	SΣ	0..1	integer	Number of times to repeat
countMax	SΣ	0..1	integer	Maximum number of times to repeat
duration	SΣ	0..1	decimal	How long when it happens
durationMax	SΣ	0..1	decimal	How long when it happens (Max)
durationUnit	SΣ	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
frequency	SΣ	0..1	integer	Event occurs frequency times per period
frequencyMax	SΣ	0..1	integer	Event occurs up to frequencyMax times per period
period	SΣ	0..1	decimal	Event occurs frequency times per period
periodMax	SΣ	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	SΣ	0..1	code	s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Binding: x_TimeUnitsOfMeasure (20230710) (required)
code	Σ	0..1	CodeableConcept	QD \| QOD \| Q4H \| Q6H \| BID \| TID \| QID \| AM \| PM + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x]	SΣ	0..1		Take "as needed" (for x) Binding: (unbound) (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site[x]	Σ	0..1	(Slice Definition)	Body site to administer to Slice: Unordered, Closed by type:$this Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
site[x]:siteCodeableConcept	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionAdministrationSite (20220331) (extensible)
route	S	0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionRouteOfAdministration (20190415) (extensible)
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: (unbound) (example): A coded concept describing the technique by which the medicine is administered.
dose[x]	SΣ	0..1		Amount of medication per dose Binding: PrescriptionDoseQuantityUnit (20220331) (extensible)
doseQuantity			Quantity(PrescribeIT® Drug Quantity for Administration)
doseRange			Range(PrescribeIT® Drug Range)
rate[x]	Σ	0..1	(Slice Definition)	Amount of medication per unit of time Slice: Unordered, Closed by type:$this
rate[x]:rateRatio	SΣ	0..1	Ratio	Amount of medication per unit of time
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
numerator	SI	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	SI	1..1	Shared Health Quantity	A measured or measurable amount
maxDosePerPeriod	SΣ	0..1	Ratio	Upper limit on medication per unit of time
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
numerator	SI	1..1	PrescribeIT® Drug Quantity for Administration	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
denominator	SI	1..1	Shared Health Quantity	A measured or measurable amount
substitution	Σ	0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	CodeableConcept	generic \| formulary + Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason	Σ	0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription	Σ	0..1	Reference(MedicationOrder)	An order/prescription that this supersedes
Documentation for this format

Other representations of profile: Schematron

3.100.3 Terminology Bindings

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationOrder.language	required	http://tools.ietf.org/html/bcp47
MedicationOrder.identifier:EMR-id.use	required	IdentifierUse
MedicationOrder.identifier:EMR-id.type	extensible	Pattern: PLAC
MedicationOrder.identifier:DIS-id.use	required	IdentifierUse
MedicationOrder.identifier:DIS-id.type	extensible	Pattern: RRI
MedicationOrder.status	required	Fixed Value: active
MedicationOrder.reasonCode	extensible	PrescriptionIndicationForUse
MedicationOrder.reasonEnded	example
MedicationOrder.dosageInstruction.additionalInstructions	example
MedicationOrder.dosageInstruction.timing.repeat.durationUnit	required	x_TimeUnitsOfMeasure
MedicationOrder.dosageInstruction.timing.repeat.periodUnit	required	x_TimeUnitsOfMeasure
MedicationOrder.dosageInstruction.timing.code	preferred	TimingAbbreviation
MedicationOrder.dosageInstruction.asNeeded[x]	example
MedicationOrder.dosageInstruction.site[x]	example	SNOMED CT Anatomical Structure for Administration Site Codes
MedicationOrder.dosageInstruction.site[x]:siteCodeableConcept	extensible	PrescriptionAdministrationSite
MedicationOrder.dosageInstruction.route	extensible	PrescriptionRouteOfAdministration
MedicationOrder.dosageInstruction.method	example
MedicationOrder.dosageInstruction.dose[x]	extensible	PrescriptionDoseQuantityUnit
MedicationOrder.dosageInstruction.rate[x]:rateRatio.numerator	extensible	PrescribedQuantityUnit
MedicationOrder.dosageInstruction.maxDosePerPeriod.numerator	extensible	PrescribedQuantityUnit
MedicationOrder.substitution.type	example	ActSubstanceAdminSubstitutionCode
MedicationOrder.substitution.reason	example	SubstanceAdminSubstitutionReason

3.100.4 Constraints

Constraints

Id	Path	Details	Requirements
EMR-id-branch-2	MedicationOrder.identifier:EMR-id.system	This must be an OID ending in .2 : $this.matches('^urn\\:oid\\:(\\d+\\.)+2$')
tim-3	MedicationOrder.dosageInstruction.timing.repeat	Either frequency or when can exist, not both : ((period.exists() or frequency.exists()) and when.exists()).not()
tim-1	MedicationOrder.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	MedicationOrder.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-9	MedicationOrder.dosageInstruction.timing.repeat	If there's an offset, there must be a when : offset.empty() or when.exists()
tim-6	MedicationOrder.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-8	MedicationOrder.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-7	MedicationOrder.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-4	MedicationOrder.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
qty-3	MedicationOrder.dosageInstruction.rate[x]:rateRatio.numerator	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	MedicationOrder.dosageInstruction.rate[x]:rateRatio.numerator	The comparator is not used on a SimpleQuantity : comparator.empty()
qty-3	MedicationOrder.dosageInstruction.rate[x]:rateRatio.denominator	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
qty-3	MedicationOrder.dosageInstruction.maxDosePerPeriod.numerator	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	MedicationOrder.dosageInstruction.maxDosePerPeriod.numerator	The comparator is not used on a SimpleQuantity : comparator.empty()
qty-3	MedicationOrder.dosageInstruction.maxDosePerPeriod.denominator	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()