CIBMTR Reporting Implementation Guide
0.1.8 - Trial Use 1

This page is part of the CIBMTR Reporting Implementation Guide (v0.1.8: Release Draft) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: CIBMTR Medication Request (mcode)

Official URL: http://fhir.nmdp.org/ig/cibmtr-reporting/StructureDefinition/cibmtr-medication-request Version: 0.1.8
Draft as of 2025-02-18 Computable Name: CIBMTR_MedicationRequest

CIBMTR Medication Request (mcode)

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* CancerRelatedMedicationRequest Ordering of medication for patient or group
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
mcode-reason-required: One of reasonCode or reasonReference SHALL be present
... meta Σ 0..1 Meta Metadata about the resource
ele-1: All FHIR elements must have a @value or children
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code ΣC 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
sec-rc: Use transplant center identifier for security tag
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... treatmentIntent S 0..1 CodeableConcept Procedure Intent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
Binding: Procedure Intent Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... terminationReason S 0..* CodeableConcept Treatment Termination Reason Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason
Binding: Treatment Termination Reason Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.


ele-1: All FHIR elements must have a @value or children
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.


ele-1: All FHIR elements must have a @value or children
... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (preferred): The type of medication order.


ele-1: All FHIR elements must have a @value or children
... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
ele-1: All FHIR elements must have a @value or children
... reported[x] SΣ 0..1 Reported rather than primary record
ele-1: All FHIR elements must have a @value or children
.... reportedBoolean boolean
.... reportedReference Reference(US Core Practitioner Profile(7.0.0))
... medication[x] SΣ 1..1 Medication to be taken
Binding: Medication Clinical Drug . (extensible)
ele-1: All FHIR elements must have a @value or children
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile(7.0.0))
... subject SΣ 1..1 Reference(Cancer Patient Profile) Who or group medication request is for
ele-1: All FHIR elements must have a @value or children
... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
ele-1: All FHIR elements must have a @value or children
... authoredOn SΣ 0..1 dateTime When request was initially authored
ele-1: All FHIR elements must have a @value or children
... requester SΣ 1..1 Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | Cancer Patient Profile) Who/What requested the Request
ele-1: All FHIR elements must have a @value or children
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Cancer Disorder Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... reasonReference S 0..* Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile) Condition or observation that supports why the prescription is being written
ele-1: All FHIR elements must have a @value or children
... dosageInstruction S 0..* Dosage How the medication should be taken
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.security:TransplantCenterextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categorypreferredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedication Clinical Drug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs

Constraints

IdGradePath(s)DetailsRequirements
sec-rcerrorMedicationRequest.meta.security:TransplantCenter.codeUse transplant center identifier for security tag
: matches('^rc_[0-9]{5}$')

This structure is derived from CancerRelatedMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* CancerRelatedMedicationRequest Ordering of medication for patient or group
... meta
.... Slices for security 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
..... security:TransplantCenter S 1..1 Coding Security Labels applied to this resource
...... system 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code C 1..1 code Symbol in syntax defined by the system
sec-rc: Use transplant center identifier for security tag

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
sec-rcerrorMedicationRequest.meta.security:TransplantCenter.codeUse transplant center identifier for security tag
: matches('^rc_[0-9]{5}$')
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* CancerRelatedMedicationRequest Ordering of medication for patient or group
mcode-reason-required: One of reasonCode or reasonReference SHALL be present
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... version Σ 0..1 string Version of the system - if relevant
...... code ΣC 1..1 code Symbol in syntax defined by the system
sec-rc: Use transplant center identifier for security tag
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... 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: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
.... treatmentIntent S 0..1 CodeableConcept Procedure Intent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
Binding: Procedure Intent Value Set (required)
.... terminationReason S 0..* CodeableConcept Treatment Termination Reason Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason
Binding: Treatment Termination Reason Value Set (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (preferred): The type of medication order.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] SΣ 0..1 Reported rather than primary record
.... reportedBoolean boolean S
.... reportedReference Reference S(US Core Practitioner Profile(7.0.0) S | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | RelatedPerson)
... medication[x] SΣ 1..1 Medication to be taken
Binding: Medication Clinical Drug . (extensible)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile(7.0.0))
... subject SΣ 1..1 Reference(Cancer Patient Profile) Who or group medication request is for
... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 1..1 Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | Cancer Patient Profile) Who/What requested the Request
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Cancer Disorder Value Set (extensible)
... reasonReference S 0..* Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile) Condition or observation that supports why the prescription is being written
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.

... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing Σ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (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 Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 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 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.security:TransplantCenterextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categorypreferredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedication Clinical Drug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
sec-rcerrorMedicationRequest.meta.security:TransplantCenter.codeUse transplant center identifier for security tag
: matches('^rc_[0-9]{5}$')

This structure is derived from CancerRelatedMedicationRequest

Summary

Mandatory: 0 element(4 nested mandatory elements)
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of MedicationRequest.meta.security

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* CancerRelatedMedicationRequest Ordering of medication for patient or group
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
mcode-reason-required: One of reasonCode or reasonReference SHALL be present
... meta Σ 0..1 Meta Metadata about the resource
ele-1: All FHIR elements must have a @value or children
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code ΣC 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
sec-rc: Use transplant center identifier for security tag
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... treatmentIntent S 0..1 CodeableConcept Procedure Intent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
Binding: Procedure Intent Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... terminationReason S 0..* CodeableConcept Treatment Termination Reason Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason
Binding: Treatment Termination Reason Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.


ele-1: All FHIR elements must have a @value or children
... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.


ele-1: All FHIR elements must have a @value or children
... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (preferred): The type of medication order.


ele-1: All FHIR elements must have a @value or children
... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
ele-1: All FHIR elements must have a @value or children
... reported[x] SΣ 0..1 Reported rather than primary record
ele-1: All FHIR elements must have a @value or children
.... reportedBoolean boolean
.... reportedReference Reference(US Core Practitioner Profile(7.0.0))
... medication[x] SΣ 1..1 Medication to be taken
Binding: Medication Clinical Drug . (extensible)
ele-1: All FHIR elements must have a @value or children
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile(7.0.0))
... subject SΣ 1..1 Reference(Cancer Patient Profile) Who or group medication request is for
ele-1: All FHIR elements must have a @value or children
... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
ele-1: All FHIR elements must have a @value or children
... authoredOn SΣ 0..1 dateTime When request was initially authored
ele-1: All FHIR elements must have a @value or children
... requester SΣ 1..1 Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | Cancer Patient Profile) Who/What requested the Request
ele-1: All FHIR elements must have a @value or children
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Cancer Disorder Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... reasonReference S 0..* Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile) Condition or observation that supports why the prescription is being written
ele-1: All FHIR elements must have a @value or children
... dosageInstruction S 0..* Dosage How the medication should be taken
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.security:TransplantCenterextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categorypreferredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedication Clinical Drug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs

Constraints

IdGradePath(s)DetailsRequirements
sec-rcerrorMedicationRequest.meta.security:TransplantCenter.codeUse transplant center identifier for security tag
: matches('^rc_[0-9]{5}$')

Differential View

This structure is derived from CancerRelatedMedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..* CancerRelatedMedicationRequest Ordering of medication for patient or group
... meta
.... Slices for security 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
..... security:TransplantCenter S 1..1 Coding Security Labels applied to this resource
...... system 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code C 1..1 code Symbol in syntax defined by the system
sec-rc: Use transplant center identifier for security tag

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
sec-rcerrorMedicationRequest.meta.security:TransplantCenter.codeUse transplant center identifier for security tag
: matches('^rc_[0-9]{5}$')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C 0..* CancerRelatedMedicationRequest Ordering of medication for patient or group
mcode-reason-required: One of reasonCode or reasonReference SHALL be present
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... version Σ 0..1 string Version of the system - if relevant
...... code ΣC 1..1 code Symbol in syntax defined by the system
sec-rc: Use transplant center identifier for security tag
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... 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: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension S 0..* Extension Extension
Slice: Unordered, Open by value:url
.... treatmentIntent S 0..1 CodeableConcept Procedure Intent Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
Binding: Procedure Intent Value Set (required)
.... terminationReason S 0..* CodeableConcept Treatment Termination Reason Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason
Binding: Treatment Termination Reason Value Set (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... statusReason 0..1 CodeableConcept Reason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣ 1..1 code proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category S 0..* CodeableConcept Type of medication usage
Binding: medicationRequest Category Codes (preferred): The type of medication order.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... reported[x] SΣ 0..1 Reported rather than primary record
.... reportedBoolean boolean S
.... reportedReference Reference S(US Core Practitioner Profile(7.0.0) S | US Core Organization Profile(7.0.0) | US Core Patient Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | RelatedPerson)
... medication[x] SΣ 1..1 Medication to be taken
Binding: Medication Clinical Drug . (extensible)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Core Medication Profile(7.0.0))
... subject SΣ 1..1 Reference(Cancer Patient Profile) Who or group medication request is for
... encounter S 0..1 Reference(US Core Encounter Profile(7.0.0)) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 0..1 dateTime When request was initially authored
... requester SΣ 1..1 Reference(US Core Practitioner Profile(7.0.0) | US Core Organization Profile(7.0.0) | Cancer Patient Profile) Who/What requested the Request
... performer 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) Intended performer of administration
... performerType Σ 0..1 CodeableConcept Desired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1 Reference(Practitioner | PractitionerRole) Person who entered the request
... reasonCode S 0..* CodeableConcept Reason or indication for ordering or not ordering the medication
Binding: Cancer Disorder Value Set (extensible)
... reasonReference S 0..* Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile) Condition or observation that supports why the prescription is being written
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) What request fulfills
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... courseOfTherapyType 0..1 CodeableConcept Overall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.

... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Information about the prescription
... dosageInstruction S 0..* Dosage How the medication should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing Σ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (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 Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... dispenseRequest 0..1 BackboneElement Medication supply authorization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... initialFill 0..1 BackboneElement First fill details
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... quantity 0..1 SimpleQuantity First fill quantity
..... duration 0..1 Duration First fill duration
.... dispenseInterval 0..1 Duration Minimum period of time between dispenses
.... validityPeriod 0..1 Period Time period supply is authorized for
.... numberOfRepeatsAllowed 0..1 unsignedInt Number of refills authorized
.... quantity 0..1 SimpleQuantity Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense
.... performer 0..1 Reference(Organization) Intended dispenser
... substitution 0..1 BackboneElement Any restrictions on medication substitution
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1 Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 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 0..1 Reference(MedicationRequest) An order/prescription that is being replaced
... detectedIssue 0..* Reference(DetectedIssue) Clinical Issue with action
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.security:TransplantCenterextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
MedicationRequest.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
MedicationRequest.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categorypreferredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedication Clinical Drug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
sec-rcerrorMedicationRequest.meta.security:TransplantCenter.codeUse transplant center identifier for security tag
: matches('^rc_[0-9]{5}$')

This structure is derived from CancerRelatedMedicationRequest

Summary

Mandatory: 0 element(4 nested mandatory elements)
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of MedicationRequest.meta.security

 

Other representations of profile: CSV, Excel, Schematron