PrescribeIT® PMS Prescription

3.105 StructureDefinition: PrescribeIT® PMS Prescription

The official URL for this profile is:

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

3.105.2 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	over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25 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 p190-m - Pharmacist Prescribe, this conveys the medication order.
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 (category)	0..1	Medication Order Category	Definition: Sub-categorizes medication prescriptions into drugs, devices, compounds, etc. May be used to apply sub-type-specific constraints Comments: Conformance Rule: If no appropriate code exists, provide details using the 'text' component.
extension (prescribeReason)	0..1	Medication Order Prescribe Reason	Definition: Provides a textual description to convey any relevant reasons/rational related to the why the pharmacist’s created the prescription. The pharmacy staff should have the ability to enter any relevant information related to the pharmacist prescribe prescription (e.g. the rationale for prescribing, patient assessment, monitoring plane, details regarding patient consent, etc.) which may be required to be sent as per the jurisdictional regulations. Comments: Conformance Rule: Any relevant information pertaining to the reason/rational that needs to be included as part of this notification, must be populated within this extension. The PMS vendor can determine how best to populate this and what information to populate which adheres to jurisdictional regulations related to the information required to be part of the different prescribe notifications (pharmacist renewal, minor aliment prescribing etc.) that need to be communicated back to the prescriber. Any additional information that needs to be communicated which cannot fit within this extension can be sent within the MedicationOrder.note.text element.
extension (renderedDosageInstruction)	1..1	Medication Rendered Dosage Instruction	Definition: This represents the complete instruction on how the medication is to be taken by the patient as entered by the pharmacy on the dispense or prescription. Comments: Usage Note: This will be populated by the PMS and will reflect the directions as presented to the patient on the label. The rendered dosage instruction will contain all dosage instructions such as dosage quantity, dosage unit, frequency, frequency period administration start/end date, route etc. as well as any additional instructions (e.g. take with food, starting one day before dental appointment) that are provided to the patient on the label. Conformance Rule: This field must contain all the dosage information assembled into one field, this includes any overflow or supplemental directions that do not get included on the label as they are too long but are still are provided to the patient. The dosage information must be in a clear readable format, meaning that codes should not be used (e.g. 'days' should be used instead of 'd', 'oral' should be used instead of 'PO') unless this is how it is presented on the patients label.
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: FUTURE USE ONLY
extension (treatmentType)	0..1	Medication Order Treatment Type	Definition: Identifies whether this drug is for acute or chronic use Comments: Conformance Rule: Must be populated if known
extension (supportingInformation)	0..*	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.
extension (detectedIssue)	0..25	Request-related Detected Issues	Definition: A set of managed and relevant detected issues that should be transmitted along with a prescription or order to provide context during the execution of that order. Comments: Usage Note: This is a reference to the resource which is used to convey Managed Detected Issues (DUR)
extension (pharmacyInstructions)	0..1	Request Dispenser Instructions	Definition: Provides additional instructions from the prescriber to the pharmacy or other dispenser Comments: Usage Note: To convey explicit instructions to the Pharmacist/dispenser related to this medication order. Usage Note: If the PMS solution is unable to display the entire instructions, then it is expected that the current solution has a fail-over process and will create a printout of the prescription. Conformance Rule: PMS solution must be able to print out the entire prescription with ALL dispensing instructions included on the printout. Minimum data elements can be based on the eFax model Conformance Rule: When 'compliance pack' is indicated on the prescription within the EMR, populate the pharmacist instruction/dispenser instructions with 'COMPLIANCE PACK REQUESTED' Usage Note: In the case where the prescriber indicates the concept of ‘do not adapt’ (meaning that the pharmacist should not alter the prescription based on the patient's weight as an example), this direction to the pharmacist should be conveyed in human language in this field. Conformance Rule: If a prescriber wishes to indicate that there is no substitution it must be included as part of the pharmacy instructions. Conformance Rule: LU Codes must be clearly conveyed as part of the Pharmacists Instructions. If vendors are programmitically mapping into this field, they should use a prefix of LU Code before the identifier.
extension (over25dur)	0..1	Medication Order - Over 25 DUR	Definition: Indicates that the total number of managed DURs associated with the prescription exceeds the reporting limit of 25 Comments: Conformance Rule: Set value = true when there are more than 25 warnings returned in the EMR DUR system
extension (monitoredDrug)	0..1	Medication Order - Monitored Drug	Definition: Allows prescribers to indicate that the prescription is for a 'Monitored Drug' (e.g. compound containing a narcotic product). Comments: Conformance Rule: The prescriber should have the ability to set this flag when the medication is a compound. The absence of this extension means (i.e. value=”false”) that this is not a monitored substance. Usage Note: Provinces may require prescribers to enter this value when a compound contains a monitored substance (e.g. narcotic) to support Prescription Drug Monitoring Programs (e.g. the Alberta Triplicate Prescription Program).
extension (noRenewals)	0..1	Medication Order - No Prescription Renewals	Definition: Indicates that the prescriber will not support renewals for this prescription Comments: Conformance Rule: The PMS should present a warning to the dispenser if they create a renewal request for a prescription that has this flag set to indicate 'no renewals'. The PMS should allow the renewal to be submitted along with an explanation as there may be exceptional circumstances.
identifier	1..2	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 PMS 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 Pharmacist Prescribe (p190), this Prescription business identifier is generated by the PMS.
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..1	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: Usage Note: This is the Jurisdictional RX ID associated with the Medication Order that is stored within the PMS.
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.
dateWritten	1..1	dateTime	Definition: The date (and perhaps time) when the prescription was written. Comments: Conformance Rule: Must be either equal to or earlier then the MedicationOrder.dispenseRequest.validityPeriod.start element when integrating with the Alberta PIN system. Conformance Rule: Must be either a full date (i.e. yyyy-mm-dd) or a full date and time with timezone (i.e. yyyy-mm-ddTHH:mm:ss.SSS-ZZZZZ). Conformance Rule: Prescriptions sent within Alberta must support the full date time. EMRs in Alberta that do not have time cannot integrate with Alberta PIN. Note: Vendors should refer to the functional specifications for the rules on how to populate this value as there as some differences based on jurisdiction.
prescriber	1..1	Reference(Shared Health Practitioner) {b }	Definition: A reference from one resource to another. Comments: Conformance Rule: When requesting that a prescription be filled or responding to a renewal request, this SHALL be the practitioner initiating 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: In the case where the prescriber wants to send an Indication for Use that is not included in the value set the prescriber must be able to send a text value without a code.
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: Usage Note: When conveying the reason, this must be populated
note	0..1	Annotation	Definition: Extra information about the prescription that could not be conveyed by the other attributes.
text	1..1	string	Max Length: 2500 Definition: The text of the annotation. Comments: Usage Note: This is used as an additional pharmacy note that is unrelated to the dispensing instructions. Eg. Do not fill immediately, Patient is coming in on July 12th for Booster shot. Conformance Rule: PMS Vendors MUST display this to the pharmacist as it may contain important information. There could be Patient Instructions in here, inadvertently due to current prescribing behaviours.
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, the prescriber wants the patient to start taking the medication on Feb 15, 2019 (i.e. first dose is on day 1) and continue for 10 days. This makes the end date Feb 24, 2019 (i.e. last dose is on day 10). 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.)
dispenseRequest	1..1	BackboneElement	forLife-endOfValidity: IF forLifeFlag = TRUE, then endOfValidity MUST not be specified forLife-totalDaysSupply: IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified forLife-validityPeriodEnd: IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified forLife-numberOfRepeatsAllowed: IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified Definition: Indicates the specific details for the dispense or medication supply part of a medication order (also known as a Medication Prescription). Note that this information is NOT always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Comments: Conformance Rule: Outside of the Quebec jurisdiction, 1) Must have at least one of quantity and expectedSupplyDuration; and 2) Must have at least one of totalPrescribedQuantity and totalDaysSupply
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (forLifeFlag)	0..1	Medication Order Dispense For Life	Definition: If true, indicates that the prescription is eligible for life.
extension (dispenseInterval)	0..1	Medication Order Dispense Interval	Definition: Indicates the minimum period of time that must pass between dispensing events as recorded against the dispense or prescription. Comments: Example: A prescriber instructs a patient to take 3 Tylenol 3 tablets every day as needed for pain for 90 days. However, the prescriber does not wish the patient to have more than 30 days supply at any given time so the prescriber instructs the pharmacist that the dispenseInterval is 30 days. The pharmacist then does 3 partial fills of 90 tablets (or 30 days supply) over the 90 day period.
extension (endOfValidity)	0..1	Medication Order End of Validity	Definition: Identifies the length of time over which the Quebec prescription has an end of validity/treatment.
extension (trialEligibility)	0..1	Medication Order Trial Dispense Eligibility	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: If eligible for trial, this must be set to 'true' and presented to the Pharmacist. Conformance Rule: This is ONLY populated if it is for trial, else it is assumed not to be eligble. Note: Prescribers may include this information in notes.
extension (firstFillInstructions)	0..1	Medication Order Dispense First Fill Instructions	p-mr2: At least one of first fill quantity or first fill expected days supply must be specified Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: If this is supported within the EMR as a discrete data element, this must be populated. (e.g. this could map to 'Must be filled within') Conformance Rule: First fill is only populated if required; if not populated, the general dispenseRequest instructions apply to all fills. You only specify an initial fill quantity if you have refills. Usage Note: There are times when a patient's drug plan limits what can be dispensed (i.e. 7 days initially as a trial). In this situation, the patient is informed that their drug plan only pays for 7 days. The pharmacist will ask the patient to sign the Rx that they have been informed are ok with changing the quantity to 7 days and then dispense the 7 days. The patient's file is updated to note that 7 days was dispensed as a trial period. After the initial 7 days, the patient will still have 353 tablets to be used. (90 tabs x 4 authorized fills = 360 tabs - 7 tabs dispensed as trial.
extension (maxDispense)	0..1	Medication Order Max Dispense	Definition: Identifies the maximum quantity authorized to be dispensed at one time. Comments: Conformance Rule: If this is supported within the EMR as a discrete data element, this must be populated. Example: A prescriber instructs a patient to take 3 Tylenol 3 tablets every day as needed for pain for 90 days. However, the prescriber does not wish the patient to have more than 30 days supply at any given time so the prescriber instructs the pharmacist that the maxDispense is 90 tablets. The pharmacist then does 3 partial fills of 90 tablets (or 30 days supply) over the 90 day period.
extension (totalPrescribedQuantity)	0..1	Medication Order Total Prescribed Quantity	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: The Total Prescribed Quantity is not mandatory but must be supplied if the value is entered by the user or can be calculated by the system.
extension (totalDaysSupply)	0..1	Medication Order Total Prescribed Days Supply	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: Must be populated when the Total Days Supply is entered by the user or when the Total Days Supply can be calculated by the system. Conformance Rule: Code must be 'd' and system must be 'http://unitsofmeasure.org'.
validityPeriod	1..1	Period	Definition: This indicates the validity period of a prescription Comments: Usage Note: The validity period of the prescription refers to when the prescription can be filled by the pharmacy and is not the same as the administration period for which the patient needs to take the medication. Most times the validity start date of the prescription is the same as when the prescription was written. The validity start date can be future dated for prescriptions that need to be dispensed starting on a specific day.
start	1..1	dateTime	Definition: The start of the period. The boundary is inclusive. Comments: Conformance Rule: Must be either equal to or later then the MedicationOrder.dateWritten element when sending prescriptions when integrating with the Alberta PIN system. Conformance Rule: Must be either a full date (i.e. yyyy-mm-dd) or a full date and time with timezone (i.e. yyyy-mm-ddTHH:mm:ss.SSS-ZZZZZ). Note: Vendors should refer to the functional specifications for the rules on how to populate this value as there as some differences based on jurisdiction.
end	0..1	dateTime	Definition: The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments: Usage Note: The validity period end date (MedicationOrder.dispenseRequest.validityPeriod.end) will be used when specifying the end of validity as a date. The end of validity (extension: Medication Order End of Validity) element will be used when specifying the end of validity as a length/duration of time (i.e. 18 months). Note: Vendors should refer to the functional specifications for the rules on how to populate this value as there as some differences based on province.
numberOfRepeatsAllowed	0..1	positiveInt	Definition: An integer indicating the number of additional times (aka refills or repeats) the patient can receive the prescribed medication. Usage Notes: This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. Comments: Conformance Rule: This must be populated when the number of repeats is 1 or more. As this field only allows a positive integer, this is not populated if there are no refills allowed. Guidance: For narcotics, if this is incorrectly populated, the PMS could choose not to reject the message; rather they can adjust for the dispense.
quantity	0..1	PrescribeIT® Drug Quantity	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: If days supply is NOT present, this MUST be populated.
expectedSupplyDuration	0..1	Duration	Definition: Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments: Conformance Rule: This maps to 'duration' in some EMR's. Must be populated when this is a discrete data element in the EMR; else this is sent as part of the textual description. Conformance Rule: If Fill Quantity is NOT populated, this must be present.
value	1..1	decimal	Definition: The value of the measured amount. The value includes an implicit precision in the presentation of the value. Comments: The implicit precision in the value should always be honored.
system	1..1	uri	Fixed Value: http://unitsofmeasure.org Definition: The identification of the system that provides the coded form of the unit. Comments: Fixed value: http://unitsofmeasure.org
code	1..1	code	Fixed Value: d Definition: A computer processable form of the unit in some unit representation system. Comments: Fixed value: d
priorPrescription	0..1	Reference(PrescribeIT® Prescription) {r }	Definition: A link to a resource representing an earlier order or prescription that this order supersedes. Comments: When present the system element will be an OID of the form [Vendor root].[Application instance node].2 expressed as a uri (e.g. urn:oid:1.2.3.4). The branch, “.2” is appended to create a unique namespace for the Medication order PLAC Identifier. The value element will be the unique medication order or prescription number of the order that was used to create this new order.Note that the system value must refer to the namespace of the system that created the original order, which may not always be the system performing the renewal. Conformance Rules: In the context of Task e110: This is not applicable for new prescriptions In the context of Task e120: This is mandatory and MUST be populated with the EMR generated unique identifier of the medication used as the basis of the renewal prescription (this could be for a previous medication that was a non eRx or an eRx). Its purpose is to identify the previous medication order that drove the creation of this Renewal Fill Request. Note: This identifier may not be recognized by the PMS receiving this as it could have been a paper prescription or an ePrescription that was originally sent to another pharmacy. In the context of Task e180: The prior prescription is mandatory for all order that are renewals, and must be populated in the same way as the e120. It is not required or applicable for new prescriptions. In the context of Tasks e140, p160, and p170: This is not required but may be provided. In the context Tasks e162 and e163: This is mandatory and MUST be populated in the same way as the e120 or with the subject MedicationOrder.identifier as specified in the p160 being responded to. In the context of Tasks e161 and e164: This is not required but may be provided. In the context of Task p190: This is not required but may be provided. This will reference a previous prescription if the prescription being communicated is a continuation of an existing therapy.
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (identifier)	0..1	Referenced Business identifier	Definition: Allows a reference to identify the target prescription, dispense or task by business identifier rather than URL Comments: When this is present, the reference is typically omitted. Usage Note: This provides the medication order identifier that the cancel response is associated with Usage Note: In the context of p141, p142, and p143, this provides the medication order identifier that the cancel response is associated with 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.
url	1..1	uri	"http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier"
value[x]	1..1	PrescribeIT® Prescriber Prescription Identifier	Slice: Unordered, Closed by type:$this Definition: A technical identifier - identifies some entity uniquely and unambiguously.
display	0..1	string	Definition: Plain text narrative that identifies the resource in addition to the resource reference. Comments: This can be populated with the prescription identifier as a human-readable hint for downstream systems that don't recognize the extension. However, there is no known need for this element at present.

This structure is derived from MedicationOrder

Summary

Mandatory: 13 elements (12 nested mandatory elements)
Must-Support: 85 elements
Fixed Value: 3 elements
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	SI	0..*	MedicationOrder	Prescription of medication to for patient over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25
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-medicationorder-category	S	0..1	CodeableConcept	Medication Order Category URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.category profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category
ext-medicationorder-prescribe-reason	S	0..1	string	Medication Order Prescription Reason URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-prescribe-reason
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..*	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
ext-request-detectedissue	SI	0..25	Reference(PrescribeIT® DUR) {b }	Managed DUR and other issues URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue
ext-request-dispenser-instructions	S	0..1	string	Dispenser Instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-dispenser-instructions
ext-medicationorder-over-25-dur	SI	0..1	boolean	More than 25 DURs? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-over-25-dur
ext-medicationorder-monitored-drug	S	0..1	boolean	Monitored Drug? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-monitored-drug
ext-medicationorder-no-renewals	S	0..1	boolean	No Prescription Renewals? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-no-renewals
identifier	S	1..2	(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..1	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
dateWritten	S	1..1	dateTime	When prescription was authorized
prescriber	S	1..1	Reference(Shared Health Practitioner) {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	SI	1..1	BackboneElement	Medication supply authorization forLife-endOfValidity: IF forLifeFlag = TRUE, then endOfValidity MUST not be specified forLife-totalDaysSupply: IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified forLife-validityPeriodEnd: IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified forLife-numberOfRepeatsAllowed: IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medicationorder-dispense-for-life	SI	0..1	boolean	For Life? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life
ext-medicationorder-dispense-interval	S	0..1	Duration	Dispense interval URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval
ext-medicationorder-end-of-validity	SI	0..1	Duration	Extension URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-end-of-validity
ext-medicationorder-dispense-trial	S	0..1	boolean	Trial fill authorized? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-trial
ext-medicationorder-dispense-first-fill	SI	0..1	(Complex)	First fill instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill p-mr2: At least one of first fill quantity or first fill expected days supply must be specified
ext-medicationorder-dispense-max	S	0..1	PrescribeIT® Drug Quantity	Maximum prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-max Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-quantity	S	0..1	PrescribeIT® Drug Quantity	Total prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-quantity Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-days-supply	SI	0..1	Duration	Total prescribed days supply URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-days-supply
medicationCodeableConcept		0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionMedicinalProduct (extensible)
validityPeriod	S	1..1	Period	Time period supply is authorized for
start	S	1..1	dateTime	Starting time with inclusive boundary
end	SI	0..1	dateTime	End time with inclusive boundary, if not ongoing
numberOfRepeatsAllowed	SI	0..1	positiveInt	Number of refills authorized
quantity	S	0..1	PrescribeIT® Drug Quantity	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
value	S	1..1	decimal	Numerical value (with implicit precision)
comparator		0..0
unit		0..1	string	Unit representation
system	S	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	Coded form of the unit Fixed Value: d
priorPrescription	S	0..1	Reference(PrescribeIT® Prescription) {r }	An order/prescription that this supersedes
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-reference-identifier	S	0..1	Identifier	Referenced identifier URL: http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier profiled by http://sharedhealth.exchange/fhir/StructureDefinition/ext-reference-identifier
value[x]	S	1..1	PrescribeIT® Prescriber Prescription Identifier	An identifier intended for computation
reference		0..1	string	Relative, internal or absolute URL reference
display	S	0..1	string	Text alternative for the resource
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationOrder	SΣI	0..*	MedicationOrder	Prescription of medication to for patient over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25
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-medicationorder-category	S	0..1	CodeableConcept	Medication Order Category URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.category profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category
ext-medicationorder-prescribe-reason	S	0..1	string	Medication Order Prescription Reason URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-prescribe-reason
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..*	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
ext-request-detectedissue	SI	0..25	Reference(PrescribeIT® DUR) {b }	Managed DUR and other issues URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue
ext-request-dispenser-instructions	S	0..1	string	Dispenser Instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-dispenser-instructions
ext-medicationorder-over-25-dur	SI	0..1	boolean	More than 25 DURs? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-over-25-dur
ext-medicationorder-monitored-drug	S	0..1	boolean	Monitored Drug? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-monitored-drug
ext-medicationorder-no-renewals	S	0..1	boolean	No Prescription Renewals? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-no-renewals
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..2	(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..1	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	SΣ	1..1	dateTime	When prescription was authorized
prescriber	SΣ	1..1	Reference(Shared Health Practitioner) {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)
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
dispenseRequest	SΣI	1..1	BackboneElement	Medication supply authorization forLife-endOfValidity: IF forLifeFlag = TRUE, then endOfValidity MUST not be specified forLife-totalDaysSupply: IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified forLife-validityPeriodEnd: IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified forLife-numberOfRepeatsAllowed: IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified
id		0..1	id	xml:id (or equivalent in JSON)
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medicationorder-dispense-for-life	SI	0..1	boolean	For Life? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life
ext-medicationorder-dispense-interval	S	0..1	Duration	Dispense interval URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval
ext-medicationorder-end-of-validity	SI	0..1	Duration	Extension URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-end-of-validity
ext-medicationorder-dispense-trial	S	0..1	boolean	Trial fill authorized? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-trial
ext-medicationorder-dispense-first-fill	SI	0..1	(Complex)	First fill instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill p-mr2: At least one of first fill quantity or first fill expected days supply must be specified
ext-medicationorder-dispense-max	S	0..1	PrescribeIT® Drug Quantity	Maximum prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-max Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-quantity	S	0..1	PrescribeIT® Drug Quantity	Total prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-quantity Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-days-supply	SI	0..1	Duration	Total prescribed days supply URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-days-supply
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
medication[x]	Σ	0..1	(Slice Definition)	Product to be supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept		0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionMedicinalProduct (extensible)
validityPeriod	SΣ	1..1	Period	Time period supply is authorized for
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
start	SΣI	1..1	dateTime	Starting time with inclusive boundary
end	SΣI	0..1	dateTime	End time with inclusive boundary, if not ongoing
numberOfRepeatsAllowed	SΣI	0..1	positiveInt	Number of refills authorized
quantity	SI	0..1	PrescribeIT® Drug Quantity	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
expectedSupplyDuration	SΣ	0..1	Duration	Number of days supply per dispense
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	SΣI	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit Fixed Value: d
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	SΣ	0..1	Reference(PrescribeIT® Prescription) {r }	An order/prescription that this supersedes
id		0..1	id	xml:id (or equivalent in JSON)
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-reference-identifier	S	0..1	Identifier	Referenced identifier URL: http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier profiled by http://sharedhealth.exchange/fhir/StructureDefinition/ext-reference-identifier
id		0..1	id	xml:id (or equivalent in JSON)
url	S	1..1	uri	"http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier"
value[x]	S	1..1	(Slice Definition)	An identifier intended for computation Slice: Unordered, Closed by type:$this
value[x]:valueIdentifier		1..1	Identifier	Value of extension
reference	ΣI	0..1	string	Relative, internal or absolute URL reference
display	SΣ	0..1	string	Text alternative for the resource
Documentation for this format

Grid View

This structure is derived from MedicationOrder

Name	Card.	Type	Constraints and Usage
MedicationOrder	0..*	MedicationOrder	over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25 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 p190-m - Pharmacist Prescribe, this conveys the medication order.
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 (category)	0..1	Medication Order Category	Definition: Sub-categorizes medication prescriptions into drugs, devices, compounds, etc. May be used to apply sub-type-specific constraints Comments: Conformance Rule: If no appropriate code exists, provide details using the 'text' component.
extension (prescribeReason)	0..1	Medication Order Prescribe Reason	Definition: Provides a textual description to convey any relevant reasons/rational related to the why the pharmacist’s created the prescription. The pharmacy staff should have the ability to enter any relevant information related to the pharmacist prescribe prescription (e.g. the rationale for prescribing, patient assessment, monitoring plane, details regarding patient consent, etc.) which may be required to be sent as per the jurisdictional regulations. Comments: Conformance Rule: Any relevant information pertaining to the reason/rational that needs to be included as part of this notification, must be populated within this extension. The PMS vendor can determine how best to populate this and what information to populate which adheres to jurisdictional regulations related to the information required to be part of the different prescribe notifications (pharmacist renewal, minor aliment prescribing etc.) that need to be communicated back to the prescriber. Any additional information that needs to be communicated which cannot fit within this extension can be sent within the MedicationOrder.note.text element.
extension (renderedDosageInstruction)	1..1	Medication Rendered Dosage Instruction	Definition: This represents the complete instruction on how the medication is to be taken by the patient as entered by the pharmacy on the dispense or prescription. Comments: Usage Note: This will be populated by the PMS and will reflect the directions as presented to the patient on the label. The rendered dosage instruction will contain all dosage instructions such as dosage quantity, dosage unit, frequency, frequency period administration start/end date, route etc. as well as any additional instructions (e.g. take with food, starting one day before dental appointment) that are provided to the patient on the label. Conformance Rule: This field must contain all the dosage information assembled into one field, this includes any overflow or supplemental directions that do not get included on the label as they are too long but are still are provided to the patient. The dosage information must be in a clear readable format, meaning that codes should not be used (e.g. 'days' should be used instead of 'd', 'oral' should be used instead of 'PO') unless this is how it is presented on the patients label.
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: FUTURE USE ONLY
extension (treatmentType)	0..1	Medication Order Treatment Type	Definition: Identifies whether this drug is for acute or chronic use Comments: Conformance Rule: Must be populated if known
extension (supportingInformation)	0..*	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.
extension (detectedIssue)	0..25	Request-related Detected Issues	Definition: A set of managed and relevant detected issues that should be transmitted along with a prescription or order to provide context during the execution of that order. Comments: Usage Note: This is a reference to the resource which is used to convey Managed Detected Issues (DUR)
extension (pharmacyInstructions)	0..1	Request Dispenser Instructions	Definition: Provides additional instructions from the prescriber to the pharmacy or other dispenser Comments: Usage Note: To convey explicit instructions to the Pharmacist/dispenser related to this medication order. Usage Note: If the PMS solution is unable to display the entire instructions, then it is expected that the current solution has a fail-over process and will create a printout of the prescription. Conformance Rule: PMS solution must be able to print out the entire prescription with ALL dispensing instructions included on the printout. Minimum data elements can be based on the eFax model Conformance Rule: When 'compliance pack' is indicated on the prescription within the EMR, populate the pharmacist instruction/dispenser instructions with 'COMPLIANCE PACK REQUESTED' Usage Note: In the case where the prescriber indicates the concept of ‘do not adapt’ (meaning that the pharmacist should not alter the prescription based on the patient's weight as an example), this direction to the pharmacist should be conveyed in human language in this field. Conformance Rule: If a prescriber wishes to indicate that there is no substitution it must be included as part of the pharmacy instructions. Conformance Rule: LU Codes must be clearly conveyed as part of the Pharmacists Instructions. If vendors are programmitically mapping into this field, they should use a prefix of LU Code before the identifier.
extension (over25dur)	0..1	Medication Order - Over 25 DUR	Definition: Indicates that the total number of managed DURs associated with the prescription exceeds the reporting limit of 25 Comments: Conformance Rule: Set value = true when there are more than 25 warnings returned in the EMR DUR system
extension (monitoredDrug)	0..1	Medication Order - Monitored Drug	Definition: Allows prescribers to indicate that the prescription is for a 'Monitored Drug' (e.g. compound containing a narcotic product). Comments: Conformance Rule: The prescriber should have the ability to set this flag when the medication is a compound. The absence of this extension means (i.e. value=”false”) that this is not a monitored substance. Usage Note: Provinces may require prescribers to enter this value when a compound contains a monitored substance (e.g. narcotic) to support Prescription Drug Monitoring Programs (e.g. the Alberta Triplicate Prescription Program).
extension (noRenewals)	0..1	Medication Order - No Prescription Renewals	Definition: Indicates that the prescriber will not support renewals for this prescription Comments: Conformance Rule: The PMS should present a warning to the dispenser if they create a renewal request for a prescription that has this flag set to indicate 'no renewals'. The PMS should allow the renewal to be submitted along with an explanation as there may be exceptional circumstances.
identifier	1..2	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 PMS 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 Pharmacist Prescribe (p190), this Prescription business identifier is generated by the PMS.
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..1	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: Usage Note: This is the Jurisdictional RX ID associated with the Medication Order that is stored within the PMS.
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.
dateWritten	1..1	dateTime	Definition: The date (and perhaps time) when the prescription was written. Comments: Conformance Rule: Must be either equal to or earlier then the MedicationOrder.dispenseRequest.validityPeriod.start element when integrating with the Alberta PIN system. Conformance Rule: Must be either a full date (i.e. yyyy-mm-dd) or a full date and time with timezone (i.e. yyyy-mm-ddTHH:mm:ss.SSS-ZZZZZ). Conformance Rule: Prescriptions sent within Alberta must support the full date time. EMRs in Alberta that do not have time cannot integrate with Alberta PIN. Note: Vendors should refer to the functional specifications for the rules on how to populate this value as there as some differences based on jurisdiction.
prescriber	1..1	Reference(Shared Health Practitioner) {b }	Definition: A reference from one resource to another. Comments: Conformance Rule: When requesting that a prescription be filled or responding to a renewal request, this SHALL be the practitioner initiating 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: In the case where the prescriber wants to send an Indication for Use that is not included in the value set the prescriber must be able to send a text value without a code.
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: Usage Note: When conveying the reason, this must be populated
note	0..1	Annotation	Definition: Extra information about the prescription that could not be conveyed by the other attributes.
text	1..1	string	Max Length: 2500 Definition: The text of the annotation. Comments: Usage Note: This is used as an additional pharmacy note that is unrelated to the dispensing instructions. Eg. Do not fill immediately, Patient is coming in on July 12th for Booster shot. Conformance Rule: PMS Vendors MUST display this to the pharmacist as it may contain important information. There could be Patient Instructions in here, inadvertently due to current prescribing behaviours.
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, the prescriber wants the patient to start taking the medication on Feb 15, 2019 (i.e. first dose is on day 1) and continue for 10 days. This makes the end date Feb 24, 2019 (i.e. last dose is on day 10). 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.)
dispenseRequest	1..1	BackboneElement	forLife-endOfValidity: IF forLifeFlag = TRUE, then endOfValidity MUST not be specified forLife-totalDaysSupply: IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified forLife-validityPeriodEnd: IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified forLife-numberOfRepeatsAllowed: IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified Definition: Indicates the specific details for the dispense or medication supply part of a medication order (also known as a Medication Prescription). Note that this information is NOT always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Comments: Conformance Rule: Outside of the Quebec jurisdiction, 1) Must have at least one of quantity and expectedSupplyDuration; and 2) Must have at least one of totalPrescribedQuantity and totalDaysSupply
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (forLifeFlag)	0..1	Medication Order Dispense For Life	Definition: If true, indicates that the prescription is eligible for life.
extension (dispenseInterval)	0..1	Medication Order Dispense Interval	Definition: Indicates the minimum period of time that must pass between dispensing events as recorded against the dispense or prescription. Comments: Example: A prescriber instructs a patient to take 3 Tylenol 3 tablets every day as needed for pain for 90 days. However, the prescriber does not wish the patient to have more than 30 days supply at any given time so the prescriber instructs the pharmacist that the dispenseInterval is 30 days. The pharmacist then does 3 partial fills of 90 tablets (or 30 days supply) over the 90 day period.
extension (endOfValidity)	0..1	Medication Order End of Validity	Definition: Identifies the length of time over which the Quebec prescription has an end of validity/treatment.
extension (trialEligibility)	0..1	Medication Order Trial Dispense Eligibility	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: If eligible for trial, this must be set to 'true' and presented to the Pharmacist. Conformance Rule: This is ONLY populated if it is for trial, else it is assumed not to be eligble. Note: Prescribers may include this information in notes.
extension (firstFillInstructions)	0..1	Medication Order Dispense First Fill Instructions	p-mr2: At least one of first fill quantity or first fill expected days supply must be specified Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: If this is supported within the EMR as a discrete data element, this must be populated. (e.g. this could map to 'Must be filled within') Conformance Rule: First fill is only populated if required; if not populated, the general dispenseRequest instructions apply to all fills. You only specify an initial fill quantity if you have refills. Usage Note: There are times when a patient's drug plan limits what can be dispensed (i.e. 7 days initially as a trial). In this situation, the patient is informed that their drug plan only pays for 7 days. The pharmacist will ask the patient to sign the Rx that they have been informed are ok with changing the quantity to 7 days and then dispense the 7 days. The patient's file is updated to note that 7 days was dispensed as a trial period. After the initial 7 days, the patient will still have 353 tablets to be used. (90 tabs x 4 authorized fills = 360 tabs - 7 tabs dispensed as trial.
extension (maxDispense)	0..1	Medication Order Max Dispense	Definition: Identifies the maximum quantity authorized to be dispensed at one time. Comments: Conformance Rule: If this is supported within the EMR as a discrete data element, this must be populated. Example: A prescriber instructs a patient to take 3 Tylenol 3 tablets every day as needed for pain for 90 days. However, the prescriber does not wish the patient to have more than 30 days supply at any given time so the prescriber instructs the pharmacist that the maxDispense is 90 tablets. The pharmacist then does 3 partial fills of 90 tablets (or 30 days supply) over the 90 day period.
extension (totalPrescribedQuantity)	0..1	Medication Order Total Prescribed Quantity	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: The Total Prescribed Quantity is not mandatory but must be supplied if the value is entered by the user or can be calculated by the system.
extension (totalDaysSupply)	0..1	Medication Order Total Prescribed Days Supply	Definition: Optional Extensions Element - found in all resources. Comments: Conformance Rule: Must be populated when the Total Days Supply is entered by the user or when the Total Days Supply can be calculated by the system. Conformance Rule: Code must be 'd' and system must be 'http://unitsofmeasure.org'.
validityPeriod	1..1	Period	Definition: This indicates the validity period of a prescription Comments: Usage Note: The validity period of the prescription refers to when the prescription can be filled by the pharmacy and is not the same as the administration period for which the patient needs to take the medication. Most times the validity start date of the prescription is the same as when the prescription was written. The validity start date can be future dated for prescriptions that need to be dispensed starting on a specific day.
start	1..1	dateTime	Definition: The start of the period. The boundary is inclusive. Comments: Conformance Rule: Must be either equal to or later then the MedicationOrder.dateWritten element when sending prescriptions when integrating with the Alberta PIN system. Conformance Rule: Must be either a full date (i.e. yyyy-mm-dd) or a full date and time with timezone (i.e. yyyy-mm-ddTHH:mm:ss.SSS-ZZZZZ). Note: Vendors should refer to the functional specifications for the rules on how to populate this value as there as some differences based on jurisdiction.
end	0..1	dateTime	Definition: The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments: Usage Note: The validity period end date (MedicationOrder.dispenseRequest.validityPeriod.end) will be used when specifying the end of validity as a date. The end of validity (extension: Medication Order End of Validity) element will be used when specifying the end of validity as a length/duration of time (i.e. 18 months). Note: Vendors should refer to the functional specifications for the rules on how to populate this value as there as some differences based on province.
numberOfRepeatsAllowed	0..1	positiveInt	Definition: An integer indicating the number of additional times (aka refills or repeats) the patient can receive the prescribed medication. Usage Notes: This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. Comments: Conformance Rule: This must be populated when the number of repeats is 1 or more. As this field only allows a positive integer, this is not populated if there are no refills allowed. Guidance: For narcotics, if this is incorrectly populated, the PMS could choose not to reject the message; rather they can adjust for the dispense.
quantity	0..1	PrescribeIT® Drug Quantity	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: If days supply is NOT present, this MUST be populated.
expectedSupplyDuration	0..1	Duration	Definition: Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments: Conformance Rule: This maps to 'duration' in some EMR's. Must be populated when this is a discrete data element in the EMR; else this is sent as part of the textual description. Conformance Rule: If Fill Quantity is NOT populated, this must be present.
value	1..1	decimal	Definition: The value of the measured amount. The value includes an implicit precision in the presentation of the value. Comments: The implicit precision in the value should always be honored.
system	1..1	uri	Fixed Value: http://unitsofmeasure.org Definition: The identification of the system that provides the coded form of the unit. Comments: Fixed value: http://unitsofmeasure.org
code	1..1	code	Fixed Value: d Definition: A computer processable form of the unit in some unit representation system. Comments: Fixed value: d
priorPrescription	0..1	Reference(PrescribeIT® Prescription) {r }	Definition: A link to a resource representing an earlier order or prescription that this order supersedes. Comments: When present the system element will be an OID of the form [Vendor root].[Application instance node].2 expressed as a uri (e.g. urn:oid:1.2.3.4). The branch, “.2” is appended to create a unique namespace for the Medication order PLAC Identifier. The value element will be the unique medication order or prescription number of the order that was used to create this new order.Note that the system value must refer to the namespace of the system that created the original order, which may not always be the system performing the renewal. Conformance Rules: In the context of Task e110: This is not applicable for new prescriptions In the context of Task e120: This is mandatory and MUST be populated with the EMR generated unique identifier of the medication used as the basis of the renewal prescription (this could be for a previous medication that was a non eRx or an eRx). Its purpose is to identify the previous medication order that drove the creation of this Renewal Fill Request. Note: This identifier may not be recognized by the PMS receiving this as it could have been a paper prescription or an ePrescription that was originally sent to another pharmacy. In the context of Task e180: The prior prescription is mandatory for all order that are renewals, and must be populated in the same way as the e120. It is not required or applicable for new prescriptions. In the context of Tasks e140, p160, and p170: This is not required but may be provided. In the context Tasks e162 and e163: This is mandatory and MUST be populated in the same way as the e120 or with the subject MedicationOrder.identifier as specified in the p160 being responded to. In the context of Tasks e161 and e164: This is not required but may be provided. In the context of Task p190: This is not required but may be provided. This will reference a previous prescription if the prescription being communicated is a continuation of an existing therapy.
extension	0..*	Extension	Slice: Unordered, Open by value:url Definition: An Extension
extension (identifier)	0..1	Referenced Business identifier	Definition: Allows a reference to identify the target prescription, dispense or task by business identifier rather than URL Comments: When this is present, the reference is typically omitted. Usage Note: This provides the medication order identifier that the cancel response is associated with Usage Note: In the context of p141, p142, and p143, this provides the medication order identifier that the cancel response is associated with 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.
url	1..1	uri	"http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier"
value[x]	1..1	PrescribeIT® Prescriber Prescription Identifier	Slice: Unordered, Closed by type:$this Definition: A technical identifier - identifies some entity uniquely and unambiguously.
display	0..1	string	Definition: Plain text narrative that identifies the resource in addition to the resource reference. Comments: This can be populated with the prescription identifier as a human-readable hint for downstream systems that don't recognize the extension. However, there is no known need for this element at present.

This structure is derived from MedicationOrder

Summary

Mandatory: 13 elements (12 nested mandatory elements)
Must-Support: 85 elements
Fixed Value: 3 elements
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	SI	0..*	MedicationOrder	Prescription of medication to for patient over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25
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-medicationorder-category	S	0..1	CodeableConcept	Medication Order Category URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.category profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category
ext-medicationorder-prescribe-reason	S	0..1	string	Medication Order Prescription Reason URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-prescribe-reason
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..*	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
ext-request-detectedissue	SI	0..25	Reference(PrescribeIT® DUR) {b }	Managed DUR and other issues URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue
ext-request-dispenser-instructions	S	0..1	string	Dispenser Instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-dispenser-instructions
ext-medicationorder-over-25-dur	SI	0..1	boolean	More than 25 DURs? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-over-25-dur
ext-medicationorder-monitored-drug	S	0..1	boolean	Monitored Drug? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-monitored-drug
ext-medicationorder-no-renewals	S	0..1	boolean	No Prescription Renewals? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-no-renewals
identifier	S	1..2	(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..1	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
dateWritten	S	1..1	dateTime	When prescription was authorized
prescriber	S	1..1	Reference(Shared Health Practitioner) {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	SI	1..1	BackboneElement	Medication supply authorization forLife-endOfValidity: IF forLifeFlag = TRUE, then endOfValidity MUST not be specified forLife-totalDaysSupply: IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified forLife-validityPeriodEnd: IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified forLife-numberOfRepeatsAllowed: IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medicationorder-dispense-for-life	SI	0..1	boolean	For Life? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life
ext-medicationorder-dispense-interval	S	0..1	Duration	Dispense interval URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval
ext-medicationorder-end-of-validity	SI	0..1	Duration	Extension URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-end-of-validity
ext-medicationorder-dispense-trial	S	0..1	boolean	Trial fill authorized? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-trial
ext-medicationorder-dispense-first-fill	SI	0..1	(Complex)	First fill instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill p-mr2: At least one of first fill quantity or first fill expected days supply must be specified
ext-medicationorder-dispense-max	S	0..1	PrescribeIT® Drug Quantity	Maximum prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-max Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-quantity	S	0..1	PrescribeIT® Drug Quantity	Total prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-quantity Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-days-supply	SI	0..1	Duration	Total prescribed days supply URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-days-supply
medicationCodeableConcept		0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionMedicinalProduct (extensible)
validityPeriod	S	1..1	Period	Time period supply is authorized for
start	S	1..1	dateTime	Starting time with inclusive boundary
end	SI	0..1	dateTime	End time with inclusive boundary, if not ongoing
numberOfRepeatsAllowed	SI	0..1	positiveInt	Number of refills authorized
quantity	S	0..1	PrescribeIT® Drug Quantity	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
expectedSupplyDuration	S	0..1	Duration	Number of days supply per dispense
value	S	1..1	decimal	Numerical value (with implicit precision)
comparator		0..0
unit		0..1	string	Unit representation
system	S	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	S	1..1	code	Coded form of the unit Fixed Value: d
priorPrescription	S	0..1	Reference(PrescribeIT® Prescription) {r }	An order/prescription that this supersedes
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-reference-identifier	S	0..1	Identifier	Referenced identifier URL: http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier profiled by http://sharedhealth.exchange/fhir/StructureDefinition/ext-reference-identifier
value[x]	S	1..1	PrescribeIT® Prescriber Prescription Identifier	An identifier intended for computation
reference		0..1	string	Relative, internal or absolute URL reference
display	S	0..1	string	Text alternative for the resource
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationOrder	SΣI	0..*	MedicationOrder	Prescription of medication to for patient over25dur-true: IF over25dur = TRUE, total number of detectedissue must be 25
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-medicationorder-category	S	0..1	CodeableConcept	Medication Order Category URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.category profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-category
ext-medicationorder-prescribe-reason	S	0..1	string	Medication Order Prescription Reason URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-prescribe-reason
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..*	Reference()	Allergies, height, weight, etc. URL: http://hl7.org/fhir/StructureDefinition/extension-MedicationRequest.supportingInfo profiled by http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-supportinginfo
ext-request-detectedissue	SI	0..25	Reference(PrescribeIT® DUR) {b }	Managed DUR and other issues URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue
ext-request-dispenser-instructions	S	0..1	string	Dispenser Instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-request-dispenser-instructions
ext-medicationorder-over-25-dur	SI	0..1	boolean	More than 25 DURs? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-over-25-dur
ext-medicationorder-monitored-drug	S	0..1	boolean	Monitored Drug? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-monitored-drug
ext-medicationorder-no-renewals	S	0..1	boolean	No Prescription Renewals? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-no-renewals
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..2	(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..1	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	SΣ	1..1	dateTime	When prescription was authorized
prescriber	SΣ	1..1	Reference(Shared Health Practitioner) {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)
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
dispenseRequest	SΣI	1..1	BackboneElement	Medication supply authorization forLife-endOfValidity: IF forLifeFlag = TRUE, then endOfValidity MUST not be specified forLife-totalDaysSupply: IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified forLife-validityPeriodEnd: IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified forLife-numberOfRepeatsAllowed: IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified
id		0..1	id	xml:id (or equivalent in JSON)
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-medicationorder-dispense-for-life	SI	0..1	boolean	For Life? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life
ext-medicationorder-dispense-interval	S	0..1	Duration	Dispense interval URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-interval
ext-medicationorder-end-of-validity	SI	0..1	Duration	Extension URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-end-of-validity
ext-medicationorder-dispense-trial	S	0..1	boolean	Trial fill authorized? URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-trial
ext-medicationorder-dispense-first-fill	SI	0..1	(Complex)	First fill instructions URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill p-mr2: At least one of first fill quantity or first fill expected days supply must be specified
ext-medicationorder-dispense-max	S	0..1	PrescribeIT® Drug Quantity	Maximum prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-max Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-quantity	S	0..1	PrescribeIT® Drug Quantity	Total prescribed quantity URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-quantity Binding: PrescribedQuantityUnit (20220331) (extensible)
ext-medicationorder-total-days-supply	SI	0..1	Duration	Total prescribed days supply URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-days-supply
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
medication[x]	Σ	0..1	(Slice Definition)	Product to be supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept		0..1	Shared Health CodeableConcept Required Text with optional code	Concept - reference to a terminology or just text Binding: PrescriptionMedicinalProduct (extensible)
validityPeriod	SΣ	1..1	Period	Time period supply is authorized for
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
start	SΣI	1..1	dateTime	Starting time with inclusive boundary
end	SΣI	0..1	dateTime	End time with inclusive boundary, if not ongoing
numberOfRepeatsAllowed	SΣI	0..1	positiveInt	Number of refills authorized
quantity	SI	0..1	PrescribeIT® Drug Quantity	Quantity of a medication Binding: PrescribedQuantityUnit (20220331) (extensible)
expectedSupplyDuration	SΣ	0..1	Duration	Number of days supply per dispense
id		0..1	id	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	SΣI	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit Fixed Value: d
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	SΣ	0..1	Reference(PrescribeIT® Prescription) {r }	An order/prescription that this supersedes
id		0..1	id	xml:id (or equivalent in JSON)
extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
ext-reference-identifier	S	0..1	Identifier	Referenced identifier URL: http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier profiled by http://sharedhealth.exchange/fhir/StructureDefinition/ext-reference-identifier
id		0..1	id	xml:id (or equivalent in JSON)
url	S	1..1	uri	"http://hl7.org/fhir/StructureDefinition/extension-Reference.identifier"
value[x]	S	1..1	(Slice Definition)	An identifier intended for computation Slice: Unordered, Closed by type:$this
value[x]:valueIdentifier		1..1	Identifier	Value of extension
reference	ΣI	0..1	string	Relative, internal or absolute URL reference
display	SΣ	0..1	string	Text alternative for the resource
Documentation for this format

Other representations of profile: Schematron

3.105.3 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.dispenseRequest.medication[x]:medicationCodeableConcept	extensible	PrescriptionMedicinalProduct
MedicationOrder.dispenseRequest.quantity	extensible	PrescribedQuantityUnit
MedicationOrder.substitution.type	example	ActSubstanceAdminSubstitutionCode
MedicationOrder.substitution.reason	example	SubstanceAdminSubstitutionReason

3.105.4 Constraints

Constraints

Id	Path	Details	Requirements
over25dur-true	MedicationOrder	IF over25dur = TRUE, total number of detectedissue must be 25 : (extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-over-25-dur').exists() and extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-over-25-dur').value=true) implies extension('http://prescribeit.ca/fhir/StructureDefinition/ext-request-detectedissue').count() = 25
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()
forLife-endOfValidity	MedicationOrder.dispenseRequest	IF forLifeFlag = TRUE, then endOfValidity MUST not be specified : (extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').exists() and extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').value=true) implies extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-end-of-validity').count() = 0
forLife-totalDaysSupply	MedicationOrder.dispenseRequest	IF forLifeFlag = TRUE, then totalDaysSupply MUST not be specified : (extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').exists() and extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').value=true) implies extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-total-days-supply').count() = 0
forLife-validityPeriodEnd	MedicationOrder.dispenseRequest	IF forLifeFlag = TRUE, then validityPeriod.end MUST not be specified : (extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').exists() and extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').value=true) implies $this.validityPeriod.end.count() = 0
forLife-numberOfRepeatsAllowed	MedicationOrder.dispenseRequest	IF forLifeFlag = TRUE, then numberOfRepeatsAllowed MUST not be specified : (extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').exists() and extension('http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-for-life').value=true) implies $this.numberOfRepeatsAllowed.count() = 0
p-mr2	MedicationOrder.dispenseRequest.extension:firstFillInstructions	At least one of first fill quantity or first fill expected days supply must be specified : extension.where(url='quantity').exists() or extension.where(url='expectedSupplyDuration').exists()
qty-3	MedicationOrder.dispenseRequest.quantity	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	MedicationOrder.dispenseRequest.quantity	The comparator is not used on a SimpleQuantity : comparator.empty()