Athena Core Implementation Guide
4.2.0 - release

Athena Core Implementation Guide - Local Development build (v4.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AthenahealthMedicationRequest - Detailed Descriptions

Active as of 2025-04-17

Definitions for the ah-medicationrequest resource profile.

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

0. MedicationRequest
2. MedicationRequest.meta
4. MedicationRequest.meta.lastUpdated
Comments

This value might be populated. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

6. MedicationRequest.extension
Control1..?
SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. MedicationRequest.extension:ahChartSharingGroup
    Slice NameahChartSharingGroup
    Control0..1
    TypeExtension(athenahealth Chart Sharing Group) (Extension Type: Reference(Organization))
    10. MedicationRequest.extension:ahPractice
    Slice NameahPractice
    Control1..1
    TypeExtension(athenahealth Practice) (Extension Type: Reference(Organization))
    12. MedicationRequest.statusReason
    Control0..0
    14. MedicationRequest.priority
    Control0..0
    16. MedicationRequest.doNotPerform
    Control0..0
    18. MedicationRequest.reported[x]
    Control0..0
    20. MedicationRequest.medication[x]
    TypeReference(Medication), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    22. MedicationRequest.subject
    TypeReference(Patient)
    24. MedicationRequest.supportingInformation
    Control0..0
    26. MedicationRequest.requester
    TypeReference(Practitioner)
    28. MedicationRequest.performer
    Control0..0
    30. MedicationRequest.performerType
    Control0..0
    32. MedicationRequest.recorder
    Control0..0
    34. MedicationRequest.reasonCode
    Control0..0
    36. MedicationRequest.reasonReference
    Control0..0
    38. MedicationRequest.instantiatesCanonical
    Control0..0
    40. MedicationRequest.instantiatesUri
    Control0..0
    42. MedicationRequest.basedOn
    Control0..0
    44. MedicationRequest.groupIdentifier
    Control0..0
    46. MedicationRequest.courseOfTherapyType
    Control0..0
    48. MedicationRequest.insurance
    Control0..0
    50. MedicationRequest.substitution
    52. MedicationRequest.substitution.allowed[x]
    Typeboolean, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    54. MedicationRequest.substitution.reason
    Control0..0
    56. MedicationRequest.priorPrescription
    Control0..0
    58. MedicationRequest.detectedIssue
    Control0..0
    60. MedicationRequest.eventHistory
    Control0..0

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

    0. MedicationRequest
    Definition

    An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

    ShortOrdering of medication for patient or group
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Alternate NamesPrescription, Order
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. MedicationRequest.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. MedicationRequest.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control10..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. MedicationRequest.extension:ahChartSharingGroup
      Slice NameahChartSharingGroup
      Definition

      An Extension used to reference a specific athenahealth chart sharing group Organization.

      Shortathenahealth Chart Sharing Group
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(athenahealth Chart Sharing Group) (Extension Type: Reference(Organization))
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. MedicationRequest.extension:ahPractice
      Slice NameahPractice
      Definition

      An Extension used to reference a specific athenahealth practice Organization.

      Shortathenahealth Practice
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(athenahealth Practice) (Extension Type: Reference(Organization))
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. MedicationRequest.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. MedicationRequest.status
      Definition

      A code specifying the current state of the order. Generally, this will be active or completed state.

      Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

      A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. MedicationRequest.statusReason
      Definition

      Captures the reason for the current state of the MedicationRequest.

      ShortReason for current status
      Comments

      This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

      Control0..01
      BindingFor example codes, see medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason
      (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

      Identifies the reasons for a given status.

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. MedicationRequest.intent
      Definition

      Whether the request is a proposal, plan, or an original order.

      Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
      Comments

      It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

      An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

      This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

      Control1..1
      BindingThe codes SHALL be taken from medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
      (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

      The kind of medication order.

      Typecode
      Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. MedicationRequest.priority
      Definition

      Indicates how quickly the Medication Request should be addressed with respect to other requests.

      Shortroutine | urgent | asap | stat
      Control0..01
      BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

      Identifies the level of importance to be assigned to actioning the request.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. MedicationRequest.doNotPerform
      Definition

      If true indicates that the provider is asking for the medication request not to occur.

      ShortTrue if request is prohibiting action
      Comments

      If do not perform is not specified, the request is a positive request e.g. "do perform".

      Control0..01
      Typeboolean
      Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. MedicationRequest.reported[x]
      Definition

      Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

      ShortReported rather than primary record
      Control0..01
      TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. MedicationRequest.medication[x]
      Definition

      Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

      ShortMedication to be taken
      Comments

      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

      Control1..1
      TypeReference(Medication), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. MedicationRequest.subject
      Definition

      A link to a resource representing the person or set of individuals to whom the medication will be given.

      ShortWho or group medication request is for
      Comments

      The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

      Control1..1
      TypeReference(Patient, Group)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. MedicationRequest.supportingInformation
      Definition

      Include additional information (for example, patient height and weight) that supports the ordering of the medication.

      ShortInformation to support ordering of the medication
      Control0..0*
      TypeReference(Resource)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. MedicationRequest.requester
      Definition

      The individual, organization, or device that initiated the request and has responsibility for its activation.

      ShortWho/What requested the Request
      Control0..1
      TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MedicationRequest.performer
      Definition

      The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

      ShortIntended performer of administration
      Control0..01
      TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationRequest.performerType
      Definition

      Indicates the type of performer of the administration of the medication.

      ShortDesired kind of performer of the medication administration
      Comments

      If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

      Control0..01
      BindingFor example codes, see ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-role
      (example to http://hl7.org/fhir/ValueSet/performer-role)

      Identifies the type of individual that is desired to administer the medication.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MedicationRequest.recorder
      Definition

      The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

      ShortPerson who entered the request
      Control0..01
      TypeReference(Practitioner, PractitionerRole)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. MedicationRequest.reasonCode
      Definition

      The reason or the indication for ordering or not ordering the medication.

      ShortReason or indication for ordering or not ordering the medication
      Comments

      This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

      Control0..0*
      BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
      (example to http://hl7.org/fhir/ValueSet/condition-code)

      A coded concept indicating why the medication was ordered.

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. MedicationRequest.reasonReference
      Definition

      Condition or observation that supports why the medication was ordered.

      ShortCondition or observation that supports why the prescription is being written
      Comments

      This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

      Control0..0*
      TypeReference(Condition, Observation)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. MedicationRequest.instantiatesCanonical
      Definition

      The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

      ShortInstantiates FHIR protocol or definition
      Control0..0*
      Typecanonical
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. MedicationRequest.instantiatesUri
      Definition

      The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

      ShortInstantiates external protocol or definition
      Control0..0*
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. MedicationRequest.basedOn
      Definition

      A plan or request that is fulfilled in whole or in part by this medication request.

      ShortWhat request fulfills
      Control0..0*
      TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. MedicationRequest.groupIdentifier
      Definition

      A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

      ShortComposite request this is part of
      Control0..01
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. MedicationRequest.courseOfTherapyType
      Definition

      The description of the overall patte3rn of the administration of the medication to the patient.

      ShortOverall pattern of medication administration
      Comments

      This attribute should not be confused with the protocol of the medication.

      Control0..01
      BindingFor example codes, see medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
      (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

      Identifies the overall pattern of medication administratio.

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. MedicationRequest.insurance
      Definition

      Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

      ShortAssociated insurance coverage
      Control0..0*
      TypeReference(Coverage, ClaimResponse)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. MedicationRequest.priorPrescription
      Definition

      A link to a resource representing an earlier order related order or prescription.

      ShortAn order/prescription that is being replaced
      Control0..01
      TypeReference(MedicationRequest)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. MedicationRequest.detectedIssue
      Definition

      Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

      ShortClinical Issue with action
      Comments

      This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

      Control0..0*
      TypeReference(DetectedIssue)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. MedicationRequest.eventHistory
      Definition

      Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

      ShortA list of events of interest in the lifecycle
      Comments

      This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

      Control0..0*
      TypeReference(Provenance)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

      0. MedicationRequest
      Definition

      An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

      ShortOrdering of medication for patient or group
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesPrescription, Order
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationRequest.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. MedicationRequest.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MedicationRequest.meta.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      8. MedicationRequest.meta.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationRequest.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. MedicationRequest.meta.versionId
        Definition

        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

        ShortVersion specific identifier
        Comments

        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

        Control0..1
        Typeid
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. MedicationRequest.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        ShortWhen the resource version last changed
        Comments

        This value might be populated. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control0..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. MedicationRequest.meta.source
        Definition

        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

        ShortIdentifies where the resource comes from
        Comments

        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. MedicationRequest.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        ShortProfiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control0..*
        Typecanonical(StructureDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. MedicationRequest.meta.security
        Definition

        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

        ShortSecurity Labels applied to this resource
        Comments

        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
        (extensible to http://hl7.org/fhir/ValueSet/security-labels)

        Security Labels from the Healthcare Privacy and Security Classification System.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. MedicationRequest.meta.tag
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        ShortTags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingFor example codes, see CommonTags
        (example to http://hl7.org/fhir/ValueSet/common-tags)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. MedicationRequest.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationRequest.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MedicationRequest.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. MedicationRequest.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        30. MedicationRequest.extension
        Definition

        An Extension

        ShortExtension
        Control1..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 32. MedicationRequest.extension:ahChartSharingGroup
          Slice NameahChartSharingGroup
          Definition

          An Extension used to reference a specific athenahealth chart sharing group Organization.

          Shortathenahealth Chart Sharing Group
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(athenahealth Chart Sharing Group) (Extension Type: Reference(Organization))
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          34. MedicationRequest.extension:ahPractice
          Slice NameahPractice
          Definition

          An Extension used to reference a specific athenahealth practice Organization.

          Shortathenahealth Practice
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(athenahealth Practice) (Extension Type: Reference(Organization))
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          36. MedicationRequest.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          38. MedicationRequest.identifier
          Definition

          Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

          ShortExternal ids for this request
          Comments

          This is a business identifier, not a resource identifier.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. MedicationRequest.status
          Definition

          A code specifying the current state of the order. Generally, this will be active or completed state.

          Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
          Comments

          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

          Control1..1
          BindingThe codes SHALL be taken from medicationrequest Status
          (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

          A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. MedicationRequest.statusReason
          Definition

          Captures the reason for the current state of the MedicationRequest.

          ShortReason for current status
          Comments

          This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

          Control0..0
          BindingFor example codes, see medicationRequest Status Reason Codes
          (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

          Identifies the reasons for a given status.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. MedicationRequest.intent
          Definition

          Whether the request is a proposal, plan, or an original order.

          Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
          Comments

          It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

          An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

          This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

          Control1..1
          BindingThe codes SHALL be taken from medicationRequest Intent
          (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

          The kind of medication order.

          Typecode
          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. MedicationRequest.category
          Definition

          Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

          ShortType of medication usage
          Comments

          The category can be used to include where the medication is expected to be consumed or other types of requests.

          Control0..*
          BindingFor example codes, see medicationRequest Category Codes
          (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

          A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. MedicationRequest.priority
          Definition

          Indicates how quickly the Medication Request should be addressed with respect to other requests.

          Shortroutine | urgent | asap | stat
          Control0..0
          BindingThe codes SHALL be taken from RequestPriority
          (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

          Identifies the level of importance to be assigned to actioning the request.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. MedicationRequest.doNotPerform
          Definition

          If true indicates that the provider is asking for the medication request not to occur.

          ShortTrue if request is prohibiting action
          Comments

          If do not perform is not specified, the request is a positive request e.g. "do perform".

          Control0..0
          Typeboolean
          Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationRequest.reported[x]
          Definition

          Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

          ShortReported rather than primary record
          Control0..0
          TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. MedicationRequest.medication[x]
          Definition

          Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

          ShortMedication to be taken
          Comments

          If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

          Control1..1
          TypeReference(Medication)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. MedicationRequest.subject
          Definition

          A link to a resource representing the person or set of individuals to whom the medication will be given.

          ShortWho or group medication request is for
          Comments

          The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

          Control1..1
          TypeReference(Patient)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. MedicationRequest.encounter
          Definition

          The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

          ShortEncounter created as part of encounter/admission/stay
          Comments

          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

          Control0..1
          TypeReference(Encounter)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. MedicationRequest.supportingInformation
          Definition

          Include additional information (for example, patient height and weight) that supports the ordering of the medication.

          ShortInformation to support ordering of the medication
          Control0..0
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. MedicationRequest.authoredOn
          Definition

          The date (and perhaps time) when the prescription was initially written or authored on.

          ShortWhen request was initially authored
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. MedicationRequest.requester
          Definition

          The individual, organization, or device that initiated the request and has responsibility for its activation.

          ShortWho/What requested the Request
          Control0..1
          TypeReference(Practitioner)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationRequest.performer
          Definition

          The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

          ShortIntended performer of administration
          Control0..0
          TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. MedicationRequest.performerType
          Definition

          Indicates the type of performer of the administration of the medication.

          ShortDesired kind of performer of the medication administration
          Comments

          If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

          Control0..0
          BindingFor example codes, see ProcedurePerformerRoleCodes
          (example to http://hl7.org/fhir/ValueSet/performer-role)

          Identifies the type of individual that is desired to administer the medication.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. MedicationRequest.recorder
          Definition

          The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

          ShortPerson who entered the request
          Control0..0
          TypeReference(Practitioner, PractitionerRole)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. MedicationRequest.reasonCode
          Definition

          The reason or the indication for ordering or not ordering the medication.

          ShortReason or indication for ordering or not ordering the medication
          Comments

          This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

          Control0..0
          BindingFor example codes, see Condition/Problem/DiagnosisCodes
          (example to http://hl7.org/fhir/ValueSet/condition-code)

          A coded concept indicating why the medication was ordered.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. MedicationRequest.reasonReference
          Definition

          Condition or observation that supports why the medication was ordered.

          ShortCondition or observation that supports why the prescription is being written
          Comments

          This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

          Control0..0
          TypeReference(Condition, Observation)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. MedicationRequest.instantiatesCanonical
          Definition

          The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

          ShortInstantiates FHIR protocol or definition
          Control0..0
          Typecanonical
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. MedicationRequest.instantiatesUri
          Definition

          The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

          ShortInstantiates external protocol or definition
          Control0..0
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. MedicationRequest.basedOn
          Definition

          A plan or request that is fulfilled in whole or in part by this medication request.

          ShortWhat request fulfills
          Control0..0
          TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. MedicationRequest.groupIdentifier
          Definition

          A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

          ShortComposite request this is part of
          Control0..0
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. MedicationRequest.courseOfTherapyType
          Definition

          The description of the overall patte3rn of the administration of the medication to the patient.

          ShortOverall pattern of medication administration
          Comments

          This attribute should not be confused with the protocol of the medication.

          Control0..0
          BindingFor example codes, see medicationRequest Course of Therapy Codes
          (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

          Identifies the overall pattern of medication administratio.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. MedicationRequest.insurance
          Definition

          Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

          ShortAssociated insurance coverage
          Control0..0
          TypeReference(Coverage, ClaimResponse)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. MedicationRequest.note
          Definition

          Extra information about the prescription that could not be conveyed by the other attributes.

          ShortInformation about the prescription
          Control0..*
          TypeAnnotation
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. MedicationRequest.dosageInstruction
          Definition

          Indicates how the medication is to be used by the patient.

          ShortHow the medication should be taken
          Comments

          There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

          Control0..*
          TypeDosage
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. MedicationRequest.dispenseRequest
          Definition

          Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

          ShortMedication supply authorization
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. MedicationRequest.dispenseRequest.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          96. MedicationRequest.dispenseRequest.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          98. MedicationRequest.dispenseRequest.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          100. MedicationRequest.dispenseRequest.initialFill
          Definition

          Indicates the quantity or duration for the first dispense of the medication.

          ShortFirst fill details
          Comments

          If populating this element, either the quantity or the duration must be included.

          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. MedicationRequest.dispenseRequest.initialFill.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          104. MedicationRequest.dispenseRequest.initialFill.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          106. MedicationRequest.dispenseRequest.initialFill.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          108. MedicationRequest.dispenseRequest.initialFill.quantity
          Definition

          The amount or quantity to provide as part of the first dispense.

          ShortFirst fill quantity
          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. MedicationRequest.dispenseRequest.initialFill.duration
          Definition

          The length of time that the first dispense is expected to last.

          ShortFirst fill duration
          Control0..1
          TypeDuration
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          112. MedicationRequest.dispenseRequest.dispenseInterval
          Definition

          The minimum period of time that must occur between dispenses of the medication.

          ShortMinimum period of time between dispenses
          Control0..1
          TypeDuration
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          114. MedicationRequest.dispenseRequest.validityPeriod
          Definition

          This indicates the validity period of a prescription (stale dating the Prescription).

          ShortTime period supply is authorized for
          Comments

          It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

          Control0..1
          TypePeriod
          Is Modifierfalse
          Summaryfalse
          Requirements

          Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
          Definition

          An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

          ShortNumber of refills authorized
          Comments

          If displaying "number of authorized fills", add 1 to this number.

          Control0..1
          TypeunsignedInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. MedicationRequest.dispenseRequest.quantity
          Definition

          The amount that is to be dispensed for one fill.

          ShortAmount of medication to supply per dispense
          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. MedicationRequest.dispenseRequest.expectedSupplyDuration
          Definition

          Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

          ShortNumber of days supply per dispense
          Comments

          In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

          Control0..1
          TypeDuration
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. MedicationRequest.dispenseRequest.performer
          Definition

          Indicates the intended dispensing Organization specified by the prescriber.

          ShortIntended dispenser
          Control0..1
          TypeReference(Organization)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. MedicationRequest.substitution
          Definition

          Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

          ShortAny restrictions on medication substitution
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. MedicationRequest.substitution.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          128. MedicationRequest.substitution.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          130. MedicationRequest.substitution.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          132. MedicationRequest.substitution.allowed[x]
          Definition

          True if the prescriber allows a different drug to be dispensed from what was prescribed.

          ShortWhether substitution is allowed or not
          Comments

          This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

          Control1..1
          Typeboolean
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. MedicationRequest.substitution.reason
          Definition

          Indicates the reason for the substitution, or why substitution must or must not be performed.

          ShortWhy should (not) substitution be made
          Control0..0
          BindingFor example codes, see SubstanceAdminSubstitutionReason
          (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

          A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          136. MedicationRequest.priorPrescription
          Definition

          A link to a resource representing an earlier order related order or prescription.

          ShortAn order/prescription that is being replaced
          Control0..0
          TypeReference(MedicationRequest)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          138. MedicationRequest.detectedIssue
          Definition

          Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

          ShortClinical Issue with action
          Comments

          This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

          Control0..0
          TypeReference(DetectedIssue)
          Is Modifierfalse
          Summaryfalse
          Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          140. MedicationRequest.eventHistory
          Definition

          Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

          ShortA list of events of interest in the lifecycle
          Comments

          This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

          Control0..0
          TypeReference(Provenance)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))