2026 US Quality Core Implementation Guide
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2026 US Quality Core Implementation Guide - Downloaded Version 0.5.0 See the Directory of published versions

Resource Profile: US Quality Core Medication Not Requested

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested Version: 0.5.0
Active as of 2026-06-05 Computable Name: USQualityCoreMedicationNotRequested

Negation profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

  • doNotPerform: (USCDI+ Quality) True if medication was not requested
  • reasonCode: (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Profile Specific Implementation Guidance

This profile represents a medication request that was intentionally not requested for a medical, patient, or system reason. To represent medication requests that were requested, use the US Quality Core MedicationRequest profile.

Additional informational guidance for authoring CQL using this profile is provided in the CQL Authoring Usage (Informational) section of this page.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
Constraints: us-core-21, mnr-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (USCDI) 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.
... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): 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.
.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... doNotPerform ?!Σ 1..1 boolean (USCDI+ Quality) True if medication was not requested
Fixed Value: true
... reported[x] SΣ 0..1 Reference S(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient | US Quality Core RelatedPerson) (USCDI) Reported rather than primary record
... medication[x] SΣ 1..1 CodeableConcept (USCDI) Medication to be taken
Binding: SNOMEDCTMedicationCodes (preferred)
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding ΣC 0..* Coding Code defined by a terminology system
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(US Quality Core Encounter) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient) (USCDI) Who/What requested the Request
... reasonCode 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication
Binding: USQualityCore Negation Reason Codes (extensible): The reason the medication was not requested
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core Simple Observation) (USCDI) US Core Condition or Observation that supports the prescription
... dosageInstruction S 0..* Dosage (USCDI) How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string (USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (USCDI) 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
.... 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.
.... doseAndRate SΣ 0..* Element (USCDI) Amount of medication administered
..... dose[x] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
... dispenseRequest S 0..1 BackboneElement (USCDI) Medication supply authorization
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... numberOfRepeatsAllowed S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.medication[x] Base preferred SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest 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 error MedicationRequest 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 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mnr-1 error MedicationRequest To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()
us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
Constraints: mnr-1
... status 1..1 code (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
... doNotPerform 1..1 boolean (USCDI+ Quality) True if medication was not requested
Fixed Value: true
... reported[x] 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient | US Quality Core RelatedPerson) (USCDI) Reported rather than primary record
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding C 0..* Coding Code defined by a terminology system
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Who or group medication request is for
... encounter 0..1 Reference(US Quality Core Encounter) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn 1..1 dateTime (USCDI) When request was initially authored
... requester 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient) (USCDI) Who/What requested the Request
... reasonCode 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication
Binding: USQualityCore Negation Reason Codes (extensible): The reason the medication was not requested
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core Simple Observation) (USCDI) US Core Condition or Observation that supports the prescription
... dosageInstruction 0..* Dosage (USCDI) How the medication should be taken
.... text 0..1 string (USCDI) Free text dosage instructions e.g. SIG
.... timing 0..1 Timing (USCDI) When medication should be administered
.... asNeeded[x] 0..1 boolean, CodeableConcept Take "as needed" (for x)
.... route 0..1 CodeableConcept How drug should enter body
.... doseAndRate 0..* Element (USCDI) Amount of medication administered
..... dose[x] 0..1 Quantity, Range (USCDI) Amount of medication per dose
... dispenseRequest
.... quantity 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationRequest.medication[x] Base preferred SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG

Constraints

Id Grade Path(s) Description Expression
mnr-1 error MedicationRequest To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
Constraints: us-core-21, mnr-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code (USCDI) 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 ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): 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.
.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... 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 1..1 boolean (USCDI+ Quality) True if medication was not requested
Fixed Value: true
... reported[x] SΣ 0..1 Reference S(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient | US Quality Core RelatedPerson) (USCDI) Reported rather than primary record
... medication[x] SΣ 1..1 CodeableConcept (USCDI) Medication to be taken
Binding: SNOMEDCTMedicationCodes (preferred)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding ΣC 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(US Quality Core Encounter) (USCDI) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient) (USCDI) 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 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication
Binding: USQualityCore Negation Reason Codes (extensible): The reason the medication was not requested
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core Simple Observation) (USCDI) US Core Condition or Observation that supports the prescription
... 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 (USCDI) 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 (USCDI) 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 SΣ 0..1 Timing (USCDI) 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 SΣ 0..* Element (USCDI) 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] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
..... 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 S 0..1 BackboneElement (USCDI) 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 S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) 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: V3 Value SetActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: V3 Value SetSubstanceAdminSubstitutionReason (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

Path Status Usage ValueSet Version Source
MedicationRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
MedicationRequest.statusReason Base example Medication request status reason codes 📦4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base preferred SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationRequest.substitution.​allowed[x] Base example V3 Value SetActSubstanceAdminSubstitutionCode 📦2014-03-26 FHIR Std.
MedicationRequest.substitution.​reason Base example V3 Value SetSubstanceAdminSubstitutionReason 📦2014-03-26 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest 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 error MedicationRequest 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 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mnr-1 error MedicationRequest To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()
us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
Constraints: us-core-21, mnr-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (USCDI) 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.
... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): 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.
.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... doNotPerform ?!Σ 1..1 boolean (USCDI+ Quality) True if medication was not requested
Fixed Value: true
... reported[x] SΣ 0..1 Reference S(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient | US Quality Core RelatedPerson) (USCDI) Reported rather than primary record
... medication[x] SΣ 1..1 CodeableConcept (USCDI) Medication to be taken
Binding: SNOMEDCTMedicationCodes (preferred)
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding ΣC 0..* Coding Code defined by a terminology system
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(US Quality Core Encounter) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient) (USCDI) Who/What requested the Request
... reasonCode 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication
Binding: USQualityCore Negation Reason Codes (extensible): The reason the medication was not requested
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core Simple Observation) (USCDI) US Core Condition or Observation that supports the prescription
... dosageInstruction S 0..* Dosage (USCDI) How the medication should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string (USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (USCDI) 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
.... 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.
.... doseAndRate SΣ 0..* Element (USCDI) Amount of medication administered
..... dose[x] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
... dispenseRequest S 0..1 BackboneElement (USCDI) Medication supply authorization
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... numberOfRepeatsAllowed S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.medication[x] Base preferred SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest 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 error MedicationRequest 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 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mnr-1 error MedicationRequest To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()
us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
Constraints: mnr-1
... status 1..1 code (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
... doNotPerform 1..1 boolean (USCDI+ Quality) True if medication was not requested
Fixed Value: true
... reported[x] 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient | US Quality Core RelatedPerson) (USCDI) Reported rather than primary record
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding C 0..* Coding Code defined by a terminology system
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Who or group medication request is for
... encounter 0..1 Reference(US Quality Core Encounter) (USCDI) Encounter created as part of encounter/admission/stay
... authoredOn 1..1 dateTime (USCDI) When request was initially authored
... requester 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient) (USCDI) Who/What requested the Request
... reasonCode 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication
Binding: USQualityCore Negation Reason Codes (extensible): The reason the medication was not requested
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core Simple Observation) (USCDI) US Core Condition or Observation that supports the prescription
... dosageInstruction 0..* Dosage (USCDI) How the medication should be taken
.... text 0..1 string (USCDI) Free text dosage instructions e.g. SIG
.... timing 0..1 Timing (USCDI) When medication should be administered
.... asNeeded[x] 0..1 boolean, CodeableConcept Take "as needed" (for x)
.... route 0..1 CodeableConcept How drug should enter body
.... doseAndRate 0..* Element (USCDI) Amount of medication administered
..... dose[x] 0..1 Quantity, Range (USCDI) Amount of medication per dose
... dispenseRequest
.... quantity 0..1 SimpleQuantity (USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1 Duration Number of days supply per dispense

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationRequest.medication[x] Base preferred SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG

Constraints

Id Grade Path(s) Description Expression
mnr-1 error MedicationRequest To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationRequest C 0..* USCoreMedicationRequestProfile(6.1.0) Ordering of medication for patient or group
Constraints: us-core-21, mnr-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External ids for this request
... status ?!SΣ 1..1 code (USCDI) 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 ?!SΣC 1..1 code (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.
... Slices for category S 0..* CodeableConcept (USCDI) Type of medication usage
Slice: Unordered, Open by pattern:$this
Binding: medicationRequest Category Codes (example): 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.
.... category:us-core S 0..* CodeableConcept (USCDI) Type of medication usage
Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... 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 1..1 boolean (USCDI+ Quality) True if medication was not requested
Fixed Value: true
... reported[x] SΣ 0..1 Reference S(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient | US Quality Core RelatedPerson) (USCDI) Reported rather than primary record
... medication[x] SΣ 1..1 CodeableConcept (USCDI) Medication to be taken
Binding: SNOMEDCTMedicationCodes (preferred)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding ΣC 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who or group medication request is for
... encounter S 0..1 Reference(US Quality Core Encounter) (USCDI) Encounter created as part of encounter/admission/stay
... supportingInformation 0..* Reference(Resource) Information to support ordering of the medication
... authoredOn SΣ 1..1 dateTime (USCDI) When request was initially authored
... requester SΣC 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Patient) (USCDI) 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 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Reason or indication for ordering or not ordering the medication
Binding: USQualityCore Negation Reason Codes (extensible): The reason the medication was not requested
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core Simple Observation) (USCDI) US Core Condition or Observation that supports the prescription
... 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 (USCDI) 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 (USCDI) 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 SΣ 0..1 Timing (USCDI) 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 SΣ 0..* Element (USCDI) 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] SΣ 0..1 (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
..... 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 S 0..1 BackboneElement (USCDI) 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 S 0..1 unsignedInt (USCDI) Number of refills authorized
.... quantity S 0..1 SimpleQuantity (USCDI) 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: V3 Value SetActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason 0..1 CodeableConcept Why should (not) substitution be made
Binding: V3 Value SetSubstanceAdminSubstitutionReason (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

Path Status Usage ValueSet Version Source
MedicationRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationRequest.status Base required Medicationrequest status 📦4.0.1 FHIR Std.
MedicationRequest.statusReason Base example Medication request status reason codes 📦4.0.1 FHIR Std.
MedicationRequest.intent Base required Medication request intent 📦4.0.1 FHIR Std.
MedicationRequest.category Base example Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.category:us-core Base required Medication request category codes 📦4.0.1 FHIR Std.
MedicationRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
MedicationRequest.medication[x] Base preferred SNOMED CT Medication Codes 📦4.0.1 FHIR Std.
MedicationRequest.performerType Base example Procedure Performer Role Codes 📦4.0.1 FHIR Std.
MedicationRequest.reasonCode Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationRequest.courseOfTherapyType Base example Medication request course of therapy codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationRequest.substitution.​allowed[x] Base example V3 Value SetActSubstanceAdminSubstitutionCode 📦2014-03-26 FHIR Std.
MedicationRequest.substitution.​reason Base example V3 Value SetSubstanceAdminSubstitutionReason 📦2014-03-26 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationRequest 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 error MedicationRequest 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 error MedicationRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mnr-1 error MedicationRequest To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()
us-core-21 error MedicationRequest requester SHALL be present if intent is "order" (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

CQL Authoring Usage (Informational)

The MedicationRequest and MedicationNotRequested profiles represent the positive and negative statements for a medication order.

The following illustrative CQL shows an exclusion pattern for medications not requested:

define "Reason for Not Ordering Antithrombotic":
  ["MedicationNotRequested": "Antithrombotic Therapy"] NoAntithromboticDischarge
    where (NoAntithromboticDischarge.reasonCode in "Medical Reason"
      or NoAntithromboticDischarge.reasonCode in "Patient Refusal")
      and (NoAntithromboticDischarge.isCommunity() or NoAntithromboticDischarge.isDischarge())
      and NoAntithromboticDischarge.status in { 'active', 'completed' }
      and NoAntithromboticDischarge.intent = 'order'

For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.