Implementierungsleitfaden ISiK-Medikation

MedikationsVerordnung (MedicationRequest)

Profil

Name	Canonical
ISiKMedikationsVerordnung	https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerordnung

ISiKMedikationsVerordnung (MedicationRequest)	I		MedicationRequest	There are no (further) constraints on this element Element id MedicationRequest Short description Ordering of medication for patient or group Alternate names Prescription, Order Definition An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. Data type MedicationRequest Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Request script10.6: Message/Body/NewRx rim: CombinedMedicationRequest
id	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationRequest.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationRequest.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id MedicationRequest.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationRequest.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	S I	0..*	Extension	Element id MedicationRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
acceptedRisk	S I	0..1	Extension(string)	Element id MedicationRequest.extension:acceptedRisk Short description akzeptiertes (in Kauf genommenes) Risiko Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments Begründung des Must-Support: Folgeinformation der AMTS-Bewertung, sollte auch an nachfolgende Behandelnde übermittelbar sein Hinweis: Hier kann ein im Rahmen der Medikation festgestelltes, aber in Kauf genommenes Risiko dokumentiert werden, speziell auch die Begründung und ggf. erforderliche Begleitmaßnahmen. Data type Extension(string) Extension URL https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKAcceptedRisk Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:acceptedRisk.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension:acceptedRisk.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.extension:acceptedRisk.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKAcceptedRisk Mappings rim: N/A
value[x]	S	1..1		There are no (further) constraints on this element Element id MedicationRequest.extension:acceptedRisk.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
medikationsart	S I	0..1	Extension(Coding)	Element id MedicationRequest.extension:medikationsart Short description Therapieart der Medikation Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments Begründung des Must-Support: von der Fachseite gewünschte Angabe Hinweis: Angabe Akut- oder Dauermedikation. Data type Extension(Coding) Extension URL https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedikationsart Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedikationsart Mappings rim: N/A
value[x]		1..1	Binding	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding ISiKMedikationsartVS (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCoding			Coding	There are no (further) constraints on this element Data type Coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationRequest.extension:medikationsart.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
behandlungsziel	S I	0..1	Extension(string)	Element id MedicationRequest.extension:behandlungsziel Short description Behandlungsziel (textuell) Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments Begründung des Must-Support: von der Fachseite gewünschte Angabe Hinweis: Freitext-Beschreibung des Behandlungsziels. Data type Extension(string) Extension URL https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKBehandlungsziel Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:behandlungsziel.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension:behandlungsziel.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.extension:behandlungsziel.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKBehandlungsziel Mappings rim: N/A
value[x]	S	1..1		There are no (further) constraints on this element Element id MedicationRequest.extension:behandlungsziel.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
medicationRequestReplaces	S I	0..1	Extension(Reference(MedicationRequest))	Element id MedicationRequest.extension:medicationRequestReplaces Short description Welche Medikationsverordnung wird ersetzt? Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments Begründung des Must-Support: historische Nachvollziehbarkeit Hinweis: Welche Medikationsverordnung wird ersetzt? Data type Extension(Reference(MedicationRequest)) Extension URL https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedicationRequestReplaces Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedicationRequestReplaces Mappings rim: N/A
value[x]	S	1..1		There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x].reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x].type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x].identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.extension:medicationRequestReplaces.value[x].display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueReference			Reference(MedicationRequest)	There are no (further) constraints on this element Data type Reference(MedicationRequest)
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id MedicationRequest.identifier Short description External ids for this request Definition Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. Comments This is a business identifier, not a resource identifier. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.identifier script10.6: Message/Header/PrescriberOrderNumber w5: FiveWs.identifier v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number rim: .id
status	S Σ ?!	1..1	codeBinding	Element id MedicationRequest.status Short description Status der Verordnungsinformation Definition A code specifying the current state of the order. Generally, this will be active or completed state. Comments Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard Data type code Binding A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. medicationrequest Status (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.status script10.6: no mapping w5: FiveWs.status rim: .statusCode
statusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.statusReason Short description Reason for current status Definition Captures the reason for the current state of the MedicationRequest. Comments This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here. Data type CodeableConcept Binding Identifies the reasons for a given status. medicationRequest Status Reason Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
intent	S Σ ?!	1..1	codeBinding	Element id MedicationRequest.intent Short description Ziel der Verordnungsinformation Definition Whether the request is a proposal, plan, or an original order. Comments Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard Hinweis: i.d.R. 'order' Data type code Binding The kind of medication order. medicationRequest Intent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.intent w5: FiveWs.class rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
category		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.category Short description Type of medication usage Definition Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). Comments The category can be used to include where the medication is expected to be consumed or other types of requests. Data type CodeableConcept Binding 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. medicationRequest Category Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Directions or Message/Body/NewRx/MedicationPrescribed/StructuredSIG w5: FiveWs.class rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the Medication Request should be addressed with respect to other requests. Data type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.priority w5: FiveWs.grade rim: .priorityCode
doNotPerform	Σ ?!	0..0	boolean	Element id MedicationRequest.doNotPerform Short description True if request is prohibiting action Definition If true indicates that the provider is asking for the medication request not to occur. Comments Begründung der Kardinalitätsänderung: Use Case für dieses Feld ist nicht im Scope Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: SubstanceAdministration.actionNegationInd
reported[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationRequest.reported[x] Short description Reported rather than primary record Definition Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=INF].role
reportedBoolean			boolean	There are no (further) constraints on this element Data type boolean
reportedReference			Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
medication[x]	Σ	1..1		Element id MedicationRequest.medication[x] Short description Medication to be taken Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. Sliced: Unordered, Open, by $this(Type) Binding A coded concept identifying substance or product that can be ordered. SNOMEDCTMedicationCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.code script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5: FiveWs.what[x] v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim: consumable.administrableMedication
medicationCodeableConcept	S Σ	0..1	CodeableConcept	Element id MedicationRequest.medication[x]:medicationCodeableConcept Short description Medikament in codierter Form oder ggf. als Freitext Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments Begründung des Must-Support: Basisinformation Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren. Data type CodeableConcept Binding A coded concept identifying substance or product that can be ordered. SNOMEDCTMedicationCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.code script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5: FiveWs.what[x] v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim: consumable.administrableMedication
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationCodeableConcept.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationCodeableConcept.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	S Σ	0..*	Coding	Element id MedicationRequest.medication[x]:medicationCodeableConcept.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
PZN	S Σ	0..1	ISiKPZNCodingPattern	Element id MedicationRequest.medication[x]:medicationCodeableConcept.coding:PZN Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKPZNCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://fhir.de/CodeSystem/ifa/pzn" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
ATC-DE	S Σ	0..1	ISiKATCCodingPattern	Element id MedicationRequest.medication[x]:medicationCodeableConcept.coding:ATC-DE Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKATCCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://fhir.de/CodeSystem/bfarm/atc" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
SCT	S Σ	0..1	ISiKSnomedCTCodingPattern	Element id MedicationRequest.medication[x]:medicationCodeableConcept.coding:SCT Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKSnomedCTCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationCodeableConcept.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
medicationReference	S Σ	0..1	Reference(Medication)	Element id MedicationRequest.medication[x]:medicationReference Short description Referenz auf das Medikament (Medication-Ressource) Definition Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. Comments Begründung des Must-Support: Basisinformation Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen Data type Reference(Medication) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.code script10.6: Message/Body/NewRx/MedicationPrescribed Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription w5: FiveWs.what[x] v2: RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code rim: consumable.administrableMedication
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationReference.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationReference.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationReference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationReference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationReference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.medication[x]:medicationReference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
subject	S Σ	1..1	Reference(Patient)	Element id MedicationRequest.subject Short description Referenz auf den Patienten Definition A link to a resource representing the person or set of individuals to whom the medication will be given. Comments Begründung des Must-Support: Basisinformation Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.subject script10.6: Message/Body/NewRx/Patient (need detail to link to specific patient … Patient.Identification in SCRIPT) w5: FiveWs.subject[x] v2: PID-3-Patient ID List rim: .participation[typeCode=AUT].role w5: FiveWs.subject
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.subject.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.subject.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationRequest.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
encounter	S	0..1	Reference(Encounter)	Element id MedicationRequest.encounter Short description Referenz auf den Abteilungskontakt Definition The Encounter during which this [x] was created or to which the creation of this record is tightly associated. Comments Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.context script10.6: no mapping w5: FiveWs.context v2: PV1-19-Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.encounter.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.encounter.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationRequest.encounter.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.encounter.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.encounter.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.encounter.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
supportingInformation		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationRequest.supportingInformation Short description Information to support ordering of the medication Definition Include additional information (for example, patient height and weight) that supports the ordering of the medication. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.supportingInfo w5: FiveWs.context rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
authoredOn	S Σ	0..1	dateTime	Element id MedicationRequest.authoredOn Short description Erstellungsdatum der Verordnung Definition The date (and perhaps time) when the prescription was initially written or authored on. Comments Begründung des Must-Support: Basisinformation Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.authoredOn script10.6: Message/Body/NewRx/MedicationPrescribed/WrittenDate w5: FiveWs.recorded v2: RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction rim: author.time
requester	S Σ	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	Element id MedicationRequest.requester Short description Referenz auf die verordnende Person Definition The individual, organization, or device that initiated the request and has responsibility for its activation. Comments Begründung des Must-Support: Nachvollziehbarkeit Data type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.requester w5: FiveWs.author rim: .participation[typeCode=AUT].role
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.requester.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.requester.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationRequest.requester.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.requester.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.requester.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.requester.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
performer		0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam)	There are no (further) constraints on this element Element id MedicationRequest.performer Short description Intended performer of administration Definition The specified desired performer of the medication treatment (e.g. the performer of the medication administration). Data type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.performer w5: FiveWs.actor rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
performerType	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.performerType Short description Desired kind of performer of the medication administration Definition Indicates the type of performer of the administration of the medication. Comments If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available. Data type CodeableConcept Binding Identifies the type of individual that is desired to administer the medication. ProcedurePerformerRoleCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.performerType rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
recorder		0..1	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id MedicationRequest.recorder Short description Person who entered the request Definition The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. Data type Reference(Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.who rim: .participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)
reasonCode	S	0..*	CodeableConcept	Element id MedicationRequest.reasonCode Short description Grund der Medikation (codiert) Definition The reason or the indication for ordering or not ordering the medication. Comments Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können. Begründung zu Must-Support: Konsolidierung mit MII Profil: https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/MedicationRequest Data type CodeableConcept Binding A coded concept indicating why the medication was ordered. Condition/Problem/DiagnosisCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.reasonCode script10.6: Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value w5: FiveWs.why[x] v2: ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication rim: reason.observation.reasonCode
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	S Σ	0..*	Coding	Element id MedicationRequest.reasonCode.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Begründung des Must-Support: Falls der Grund kodierbar ist, sollte er auch kodiert werden. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	S Σ	1..1	uri	Element id MedicationRequest.reasonCode.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Begründung des Must-Support und Kardinalität: Ein Coding Element benötigt immer ein System um die Bedeutung des Codes zu definieren. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id MedicationRequest.reasonCode.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Begründung des Must-Support und Kardinalität: Ein Coding Element benötigt immer ein Code um die Bedeutung des Codes zu definieren. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	S Σ	0..1	string	Element id MedicationRequest.reasonCode.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Begründung des Must-Support: Ein Display Element ist für die Lesbarkeit der Information notwendig. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.reasonCode.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
reasonReference	S	0..*	Reference(Condition \| Observation)	Element id MedicationRequest.reasonReference Short description Grund der Medikation (Referenz) Definition Condition or observation that supports why the medication was ordered. Comments Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können. Begründung zu Must-Support: Konsolidierung mit MII. Data type Reference(Condition \| Observation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.reasonReference script10.6: no mapping w5: FiveWs.why[x] rim: reason.observation[code=ASSERTION].value
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.reasonReference.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.reasonReference.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	1..1	string	Element id MedicationRequest.reasonReference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Begründung des Must-Support: Referenz auf die Diagnose oder Untersuchung, die die Medikation begründet. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationRequest.reasonReference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.reasonReference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.reasonReference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
instantiatesCanonical	Σ	0..*	canonical()	There are no (further) constraints on this element Element id MedicationRequest.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. Data type canonical() Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.instantiates rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element id MedicationRequest.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=DEFN].target
basedOn	Σ	0..*	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	There are no (further) constraints on this element Element id MedicationRequest.basedOn Short description What request fulfills Definition A plan or request that is fulfilled in whole or in part by this medication request. Data type Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationRequest.groupIdentifier Short description Composite request this is part of Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. Requirements Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.groupIdentifier rim: .outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id
courseOfTherapyType		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.courseOfTherapyType Short description Overall pattern of medication administration Definition The description of the overall patte3rn of the administration of the medication to the patient. Comments This attribute should not be confused with the protocol of the medication. Data type CodeableConcept Binding Identifies the overall pattern of medication administratio. medicationRequest Course of Therapy Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.code where classCode = LIST and moodCode = EVN
insurance		0..*	Reference(Coverage \| ClaimResponse)	There are no (further) constraints on this element Element id MedicationRequest.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. Data type Reference(Coverage \| ClaimResponse) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.insurance rim: .outboundRelationship[typeCode=COVBY].target
note	S	0..*	Annotation	There are no (further) constraints on this element Element id MedicationRequest.note Short description Information about the prescription Definition Extra information about the prescription that could not be conveyed by the other attributes. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.note script10.6: Message/Body/NewRx/MedicationPrescribed/Note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.note.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.note.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
author[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationRequest.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationRequest.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Act.effectiveTime
text	S Σ	1..1	markdown	Element id MedicationRequest.note.text Short description Freitext-Notiz Definition The text of the annotation in markdown format. Comments Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Act.text
dosageInstruction	S	0..*	Dosage	Element id MedicationRequest.dosageInstruction Short description Dosierungsangaben Definition Indicates how the medication is to be used by the patient. Comments Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation Data type Dosage Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.occurrence[x] rim: see dosageInstruction mapping
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
sequence	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.sequence Short description The order of the dosage instructions Definition Indicates the order in which the dosage instructions should be applied or interpreted. Requirements If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-1 rim: .text
text	S Σ	0..1	string	Element id MedicationRequest.dosageInstruction.text Short description Freitext-Dosierungsanweisungen Definition Free text dosage instructions e.g. SIG. Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Comments Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden. Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten. Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://simplifier.net/guide/isik-basis-401/Einfuehrung/UebergreifendeFestlegungen/UebergreifendeFestlegungen_Must-Support-Flags.page.md?version=current): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.' Zum Beispiel könnte ein empfangendes System die Freitext-Dosierungsanweisungen in strukturierte Dosierungsanweisungen umwandeln, um sie in einer Medikationsverwaltung anzuzeigen oder später zu exponieren. Geht es zum Beispiel um eine Angabe zu Tageszeiten der Einnahme in der freitextlichen Dosierungsanweisung als 'Morgens, Mittags, Abends', so könnte das empfangende System diese Angabe in strukturierte Dosierungsanweisungen umwandeln, die die Einnahmezeiten in kodierter Form mit 'MORN', 'NOON', 'EVE' deklariert. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-6; RXE-21 rim: .text
additionalInstruction	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.additionalInstruction Short description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Definition Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. Data type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-7 rim: .text
patientInstruction	S Σ	0..1	string	Element id MedicationRequest.dosageInstruction.patientInstruction Short description besondere Anweisungen für den Patienten Definition Instructions in terms that are understood by the patient or consumer. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-7 rim: .text
timing	S Σ	0..1	Timing	Element id MedicationRequest.dosageInstruction.timing Short description Angaben zum Timing Definition When medication should be administered. Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Data type Timing Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
event	S Σ	0..*	dateTime	Element id MedicationRequest.dosageInstruction.timing.event Short description fester Zeitpunkt Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: QLIST<TS>
repeat	S Σ I	0..1	Element	Element id MedicationRequest.dosageInstruction.timing.repeat Short description Wiederholungs-Angaben Definition A set of rules that describe when the event is scheduled. Requirements Many timing schedules are determined by regular repetitions. Data type Element Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` tim-1: if there's a duration, there needs to be duration units `duration.empty() or durationUnit.exists()` tim-2: if there's a period, there needs to be period units `period.empty() or periodUnit.exists()` tim-4: duration SHALL be a non-negative value `duration.exists() implies duration >= 0` tim-5: period SHALL be a non-negative value `period.exists() implies period >= 0` tim-6: If there's a periodMax, there must be a period `periodMax.empty() or period.exists()` tim-7: If there's a durationMax, there must be a duration `durationMax.empty() or duration.exists()` tim-8: If there's a countMax, there must be a count `countMax.empty() or count.exists()` tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) `offset.empty() or (when.exists() and ((when in ('C' \| 'CM' \| 'CD' \| 'CV')).not()))` tim-10: If there's a timeOfDay, there cannot be a when, or vice versa `timeOfDay.empty() or when.empty()` Mappings rim: Implies PIVL or EIVL
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
bounds[x]	Σ	0..1		Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Sliced: Unordered, Open, by $this(Type) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: IVL(TS) used in a QSI
boundsDuration	S Σ	0..1	DurationPattern	Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short description Begrenzung der Dauer Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://unitsofmeasure.org" } Mappings rim: IVL(TS) used in a QSI
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator Short description < \| <= \| >= \| > - how to understand the value Definition How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	1..1	uriPattern	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern http://unitsofmeasure.org Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
boundsRange	S Σ	0..1	Range	Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange Short description Bereich für die Begrenzung Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Data type Range Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: IVL(TS) used in a QSI
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
low	S Σ	0..1	SimpleQuantityPattern	Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low Short description Low limit Definition The low limit. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://unitsofmeasure.org" } Mappings v2: NR.1 rim: ./low
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	1..1	uriPattern	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern http://unitsofmeasure.org Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
high	S Σ	0..1	SimpleQuantityPattern	Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high Short description High limit Definition The high limit. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://unitsofmeasure.org" } Mappings v2: NR.2 rim: ./high
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	1..1	uriPattern	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern http://unitsofmeasure.org Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
boundsPeriod	S Σ	0..1	Period	Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod Short description begrenzender Zeitraum Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: IVL(TS) used in a QSI
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
start	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low
end	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high
count	S Σ	0..1	positiveInt	Element id MedicationRequest.dosageInstruction.timing.repeat.count Short description Anzahl Wiederholungen Definition A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. Requirements Repetitions may be limited by end time or total occurrences. Comments If you have both bounds and count, then this should be understood as within the bounds period, until count times happens. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.count
countMax	S Σ	0..1	positiveInt	Element id MedicationRequest.dosageInstruction.timing.repeat.countMax Short description maximale Anzahl Wiederholungen Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.count
duration	S Σ	0..1	decimal	Element id MedicationRequest.dosageInstruction.timing.repeat.duration Short description Dauer der Verabreichung Definition How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase
durationMax	S Σ	0..1	decimal	Element id MedicationRequest.dosageInstruction.timing.repeat.durationMax Short description maximale Dauer der Verabreichung Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase
durationUnit	S Σ	0..1	codeBinding	Element id MedicationRequest.dosageInstruction.timing.repeat.durationUnit Short description Einheit der Dauer Definition The units of time for the duration, in UCUM units. Data type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase.unit
frequency	S Σ	0..1	positiveInt	Element id MedicationRequest.dosageInstruction.timing.repeat.frequency Short description Frequenz (Anzahl der Gaben pro Periode) Definition The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. Meaning when missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase
frequencyMax	S Σ	0..1	positiveInt	Element id MedicationRequest.dosageInstruction.timing.repeat.frequencyMax Short description maximale Frequenz Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase
period	S Σ	0..1	decimal	Element id MedicationRequest.dosageInstruction.timing.repeat.period Short description Zeitperiode zur Frequenz Definition Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase
periodMax	S Σ	0..1	decimal	Element id MedicationRequest.dosageInstruction.timing.repeat.periodMax Short description maximale Zeitperiode zur Frequenz Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase
periodUnit	S Σ	0..1	codeBinding	Element id MedicationRequest.dosageInstruction.timing.repeat.periodUnit Short description Einheit der Zeitperiode Definition The units of time for the period in UCUM units. Data type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: PIVL.phase.unit
dayOfWeek	S Σ	0..*	codeBinding	Element id MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek Short description Wochentag Definition If one or more days of week is provided, then the action happens only on the specified day(s). Comments If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek. Data type code Binding DaysOfWeek (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
timeOfDay	S Σ	0..*	time	Element id MedicationRequest.dosageInstruction.timing.repeat.timeOfDay Short description Tageszeit Definition Specified time of day for action to take place. Comments When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
when	S Σ	0..*	codeBinding	Element id MedicationRequest.dosageInstruction.timing.repeat.when Short description Tageszeitpunkt codiert Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Requirements Timings are frequently determined by occurrences such as waking, eating and sleep. Comments When more than one event is listed, the event is tied to the union of the specified events. Data type code Binding Real world event relating to the schedule. EventTiming (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: EIVL.event
offset	S Σ	0..1	unsignedInt	Element id MedicationRequest.dosageInstruction.timing.repeat.offset Short description zeitlicher Abstand der Gabe zum beschriebenen Zeitpunkt Definition The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). Comments BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). Data type CodeableConcept Binding Code for a known / defined timing pattern. TimingAbbreviation (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: QSC.code
asNeeded[x]	Σ	0..1		Element id MedicationRequest.dosageInstruction.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Sliced: Unordered, Open, by $this(Type) Binding 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. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-9 rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
(All Slices)				There are no (further) constraints on this element
asNeededCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
asNeededBoolean	S Σ	0..1	boolean	Element id MedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean Short description Bedarfsmedikation Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-9 rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
site	S Σ	0..1	CodeableConcept	Element id MedicationRequest.dosageInstruction.site Short description Körperstelle der Verabreichung Definition Body site to administer to. Requirements A coded specification of the anatomic site where the medication first enters the body. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-2 rim: .approachSiteCode
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.site.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.site.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	S Σ	0..*	Coding	Element id MedicationRequest.dosageInstruction.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
SNOMED-CT	S Σ	0..1	ISiKSnomedCTCodingPattern	Element id MedicationRequest.dosageInstruction.site.coding:SNOMED-CT Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKSnomedCTCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
route	S Σ	0..1	CodeableConcept	Element id MedicationRequest.dosageInstruction.route Short description Route Definition How drug should enter body. Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Data type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-1 rim: .routeCode
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.route.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.route.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	S Σ	0..*	Coding	Element id MedicationRequest.dosageInstruction.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EDQM	S Σ	0..1	ISiKCodingBindingPattern	Element id MedicationRequest.dosageInstruction.route.coding:EDQM Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKCoding Binding MedicineRouteOfAdministrationUvIps (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://standardterms.edqm.eu" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
SNOMED-CT	S Σ	0..1	ISiKSnomedCTCodingBindingPattern	Element id MedicationRequest.dosageInstruction.route.coding:SNOMED-CT Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKSnomedCTCoding Binding SctRouteOfAdministration (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.method Short description Technique for administering medication Definition Technique for administering medication. Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Comments Terminologies used often pre-coordinate this term with the route and or form of administration. Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-4 rim: .doseQuantity
doseAndRate	S Σ	0..*	Element	Element id MedicationRequest.dosageInstruction.doseAndRate Short description Angaben zu Dosis und Rate Definition The amount of medication administered. Data type Element Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-2
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". Data type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-21; RXE-23
dose[x]	Σ	0..1		Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x] Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Sliced: Unordered, Open, by $this(Type) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-2, RXE-3 rim: .doseQuantity
doseRange	S Σ	0..1	Range	Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange Short description Dosisbereich Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Data type Range Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-2, RXE-3 rim: .doseQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
low	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: NR.1 rim: ./low rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
high	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: NR.2 rim: ./high rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
doseQuantity	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short description Dosis Definition The comparator is not used on a SimpleQuantity Requirements The amount of therapeutic or other substance given at one administration event. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: RXO-2, RXE-3 rim: .doseQuantity rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
rate[x]	Σ	0..1		Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x] Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Sliced: Unordered, Open, by $this(Type) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXE22, RXE23, RXE-24 rim: .rateQuantity
rateRatio	S Σ	0..1	Ratio	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio Short description Raten-Verhältnis Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden KÖNNEN. Beim Empfang und Verarbeitung der eingehenden Daten MÜSSEN dagegen beide Datentypen interpretiert werden können. Data type Ratio Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXE22, RXE23, RXE-24 rim: .rateQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
numerator	S Σ I	1..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: .numerator rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
denominator	S Σ I	1..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: .denominator rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
rateRange	S Σ	0..1	Range	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange Short description Raten-Bereich Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Data type Range Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXE22, RXE23, RXE-24 rim: .rateQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
low	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: NR.1 rim: ./low rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
high	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: NR.2 rim: ./high rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
rateQuantity	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity Short description Rate Definition The comparator is not used on a SimpleQuantity Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden KÖNNEN. Beim Empfang und Verarbeitung der eingehenden Daten MÜSSEN dagegen beide Datentypen interpretiert werden können. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: RXE22, RXE23, RXE-24 rim: .rateQuantity rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
maxDosePerPeriod	S Σ	0..1	Ratio	Element id MedicationRequest.dosageInstruction.maxDosePerPeriod Short description Maximaldosis (Zähler) pro Zeitraum (Nenner) Definition Upper limit on medication per unit of time. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Data type Ratio Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-23, RXE-19 rim: .maxDoseQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.maxDosePerPeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.maxDosePerPeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
numerator	S Σ I	1..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: .numerator rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
denominator	S Σ I	1..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: .denominator rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
maxDosePerAdministration	S Σ I	0..1	MedicationQuantity	Element id MedicationRequest.dosageInstruction.maxDosePerAdministration Short description Maximaldosis pro Verabreichung Definition The comparator is not used on a SimpleQuantity Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: not supported rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
maxDosePerLifetime	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationRequest.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: not supported
dispenseRequest	S	0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest Short description Medication supply authorization Definition Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/ExpirationDate rim: component.supplyEvent
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
initialFill		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill Short description First fill details Definition Indicates the quantity or duration for the first dispense of the medication. Comments If populating this element, either the quantity or the duration must be included. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
quantity		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.quantity Short description First fill quantity Definition The amount or quantity to provide as part of the first dispense. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Supply.quantity[moodCode=RQO]
duration		0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.initialFill.duration Short description First fill duration Definition The length of time that the first dispense is expected to last. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Supply.effectivetime[moodCode=RQO]
dispenseInterval		0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.dispenseInterval Short description Minimum period of time between dispenses Definition The minimum period of time that must occur between dispenses of the medication. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Supply.effectivetime[moodCode=RQO]
validityPeriod		0..1	Period	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.validityPeriod Short description Time period supply is authorized for Definition This indicates the validity period of a prescription (stale dating the Prescription). Requirements Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. Comments It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Refills rim: effectiveTime
numberOfRepeatsAllowed		0..1	unsignedInt	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.numberOfRepeatsAllowed Short description Number of refills authorized Definition An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. Comments If displaying "number of authorized fills", add 1 to this number. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Quantity v2: RXE-12-Number of Refills rim: repeatNumber
quantity	S I	0..1	MedicationQuantity	Element id MedicationRequest.dispenseRequest.quantity Short description angeforderte Abgabemenge Definition The comparator is not used on a SimpleQuantity Comments Begründung des Must-Support: Basisinformation Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/DaysSupply v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim: quantity rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
expectedSupplyDuration		0..1	Duration	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.expectedSupplyDuration Short description Number of days supply per dispense Definition Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. Comments In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: Message/Body/NewRx/MedicationPrescribed/Substitutions rim: expectedUseTime
performer		0..1	Reference(Organization)	There are no (further) constraints on this element Element id MedicationRequest.dispenseRequest.performer Short description Intended dispenser Definition Indicates the intended dispensing Organization specified by the prescriber. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.who rim: .outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
substitution	S	0..1	BackboneElement	Element id MedicationRequest.substitution Short description Ersatz zulässig Definition Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done. Comments Begründung des Must-Support: Alignment mit dem (E-)Rezept Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions rim: subjectOf.substitutionPersmission
id		0..1	string	There are no (further) constraints on this element Element id MedicationRequest.substitution.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.substitution.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationRequest.substitution.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
allowed[x]		1..1		Element id MedicationRequest.substitution.allowed[x] Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed. Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Sliced: Unordered, Open, by $this(Type) Binding Identifies the type of substitution allowed. v3.ActSubstanceAdminSubstitutionCode (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: code
(All Slices)				There are no (further) constraints on this element
allowedCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
allowedBoolean	S	0..1	boolean	Element id MedicationRequest.substitution.allowed[x]:allowedBoolean Short description Whether substitution is allowed or not Definition True if the prescriber allows a different drug to be dispensed from what was prescribed. Comments This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: code
reason		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationRequest.substitution.reason Short description Why should (not) substitution be made Definition Indicates the reason for the substitution, or why substitution must or must not be performed. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings script10.6: not mapped v2: RXE-9 Substition status rim: reasonCode
priorPrescription		0..1	Reference(MedicationRequest)	There are no (further) constraints on this element Element id MedicationRequest.priorPrescription Short description An order/prescription that is being replaced Definition A link to a resource representing an earlier order related order or prescription. Data type Reference(MedicationRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.replaces script10.6: not mapped rim: .outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]
detectedIssue		0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element id MedicationRequest.detectedIssue Short description Clinical Issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. Comments This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. Data type Reference(DetectedIssue) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationRequest.eventHistory Short description A list of events of interest in the lifecycle Definition Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. Comments This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data type Reference(Provenance) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.relevantHistory rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Terminology Bindings

Path	Name	Strength	URL
MedicationRequest.dosageInstruction.route.coding	medicine-route-of-administration	required	http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
MedicationRequest.dosageInstruction.route.coding	SctRouteOfAdministration	required	https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration

Anmerkungen zu Must-Support-Feldern

Feldname	Kurzbeschreibung	Hinweise
MedicationRequest.extension:acceptedRisk	akzeptiertes (in Kauf genommenes) Risiko	Begründung des Must-Support: Folgeinformation der AMTS-Bewertung, sollte auch an nachfolgende Behandelnde übermittelbar sein Hinweis: Hier kann ein im Rahmen der Medikation festgestelltes, aber in Kauf genommenes Risiko dokumentiert werden, speziell auch die Begründung und ggf. erforderliche Begleitmaßnahmen.
MedicationRequest.extension:medikationsart	Therapieart der Medikation	Begründung des Must-Support: von der Fachseite gewünschte Angabe Hinweis: Angabe Akut- oder Dauermedikation.
MedicationRequest.extension:behandlungsziel	Behandlungsziel (textuell)	Begründung des Must-Support: von der Fachseite gewünschte Angabe Hinweis: Freitext-Beschreibung des Behandlungsziels.
MedicationRequest.extension:medicationRequestReplaces	Welche Medikationsverordnung wird ersetzt?	Begründung des Must-Support: historische Nachvollziehbarkeit Hinweis: Welche Medikationsverordnung wird ersetzt?
MedicationRequest.status	Status der Verordnungsinformation	Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard
MedicationRequest.intent	Ziel der Verordnungsinformation	Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard Hinweis: i.d.R. 'order'
MedicationRequest.medication[x]:medicationCodeableConcept	Medikament in codierter Form oder ggf. als Freitext	Begründung des Must-Support: Basisinformation Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.
MedicationRequest.medication[x]:medicationReference	Referenz auf das Medikament (Medication-Ressource)	Begründung des Must-Support: Basisinformation Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen
MedicationRequest.subject	Referenz auf den Patienten	Begründung des Must-Support: Basisinformation
MedicationRequest.encounter	Referenz auf den Abteilungskontakt	Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext
MedicationRequest.authoredOn	Erstellungsdatum der Verordnung	Begründung des Must-Support: Basisinformation
MedicationRequest.requester	Referenz auf die verordnende Person	Begründung des Must-Support: Nachvollziehbarkeit
MedicationRequest.reasonCode	Grund der Medikation (codiert)	Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können. Begründung zu Must-Support: Konsolidierung mit MII Profil: https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/MedicationRequest
MedicationRequest.reasonReference	Grund der Medikation (Referenz)	Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können. Begründung zu Must-Support: Konsolidierung mit MII.
MedicationRequest.note.text	Freitext-Notiz	Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein
MedicationRequest.dosageInstruction	Dosierungsangaben	Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation
MedicationRequest.dosageInstruction.text	Freitext-Dosierungsanweisungen	Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden. `Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten. Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem ISiK Basismodul: 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.'` Zum Beispiel könnte ein empfangendes System die Freitext-Dosierungsanweisungen in strukturierte Dosierungsanweisungen umwandeln, um sie in einer Medikationsverwaltung anzuzeigen oder später zu exponieren. Geht es zum Beispiel um eine Angabe zu Tageszeiten der Einnahme in der freitextlichen Dosierungsanweisung als 'Morgens, Mittags, Abends', so könnte das empfangende System diese Angabe in strukturierte Dosierungsanweisungen umwandeln, die die Einnahmezeiten in kodierter Form mit 'MORN', 'NOON', 'EVE' deklariert.
MedicationRequest.dosageInstruction.patientInstruction	besondere Anweisungen für den Patienten
MedicationRequest.dosageInstruction.timing	Angaben zum Timing
MedicationRequest.dosageInstruction.timing.event	fester Zeitpunkt
MedicationRequest.dosageInstruction.timing.repeat	Wiederholungs-Angaben
MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration	Begrenzung der Dauer
MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange	Bereich für die Begrenzung
MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod	begrenzender Zeitraum
MedicationRequest.dosageInstruction.timing.repeat.count	Anzahl Wiederholungen
MedicationRequest.dosageInstruction.timing.repeat.countMax	maximale Anzahl Wiederholungen
MedicationRequest.dosageInstruction.timing.repeat.duration	Dauer der Verabreichung
MedicationRequest.dosageInstruction.timing.repeat.durationMax	maximale Dauer der Verabreichung
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	Einheit der Dauer
MedicationRequest.dosageInstruction.timing.repeat.frequency	Frequenz (Anzahl der Gaben pro Periode)
MedicationRequest.dosageInstruction.timing.repeat.frequencyMax	maximale Frequenz
MedicationRequest.dosageInstruction.timing.repeat.period	Zeitperiode zur Frequenz
MedicationRequest.dosageInstruction.timing.repeat.periodMax	maximale Zeitperiode zur Frequenz
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	Einheit der Zeitperiode
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	Wochentag
MedicationRequest.dosageInstruction.timing.repeat.timeOfDay	Tageszeit
MedicationRequest.dosageInstruction.timing.repeat.when	Tageszeitpunkt codiert
MedicationRequest.dosageInstruction.timing.repeat.offset	zeitlicher Abstand der Gabe zum beschriebenen Zeitpunkt
MedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean	Bedarfsmedikation
MedicationRequest.dosageInstruction.site	Körperstelle der Verabreichung
MedicationRequest.dosageInstruction.route	Route
MedicationRequest.dosageInstruction.doseAndRate	Angaben zu Dosis und Rate
MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange	Dosisbereich
MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity	Dosis
MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio	Raten-Verhältnis	Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden KÖNNEN. Beim Empfang und Verarbeitung der eingehenden Daten MÜSSEN dagegen beide Datentypen interpretiert werden können.
MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange	Raten-Bereich
MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity	Rate	Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden KÖNNEN. Beim Empfang und Verarbeitung der eingehenden Daten MÜSSEN dagegen beide Datentypen interpretiert werden können.
MedicationRequest.dosageInstruction.maxDosePerPeriod	Maximaldosis (Zähler) pro Zeitraum (Nenner)
MedicationRequest.dosageInstruction.maxDosePerAdministration	Maximaldosis pro Verabreichung
MedicationRequest.dispenseRequest.quantity	angeforderte Abgabemenge	Begründung des Must-Support: Basisinformation
MedicationRequest.substitution	Ersatz zulässig	Begründung des Must-Support: Alignment mit dem (E-)Rezept

Beispiele

Valide Beispiele für das Profil MedikationsVerordnung:

Dauermedikation morgens/mittags/abends:

{
    "resourceType": "MedicationRequest",
    "id": "ExampleISiKMedikationsVerordnung",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerordnung"
        ]
    },
    "extension":  [
        {
            "url": "https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKAcceptedRisk",
            "valueString": "Erhöhtes Blutungsrisiko ist in diesem Fall vertretbar."
        },
        {
            "url": "https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedikationsart",
            "valueCoding": {
                "code": "akut",
                "system": "https://gematik.de/fhir/isik/CodeSystem/ISiKMedikationsartCS"
            }
        },
        {
            "url": "https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKBehandlungsziel",
            "valueString": "Schmerztherapie postoperativ"
        }
    ],
    "dosageInstruction":  [
        {
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "system": "http://unitsofmeasure.org",
                        "value": 1,
                        "unit": "Brausetablette",
                        "code": "1"
                    }
                }
            ],
            "timing": {
                "repeat": {
                    "when":  [
                        "MORN",
                        "NOON",
                        "EVE"
                    ]
                }
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "Medication/ExampleISiKMedikament1"
    },
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "encounter": {
        "reference": "Encounter/Fachabteilungskontakt"
    },
    "authoredOn": "2021-07-01",
    "requester": {
        "reference": "Practitioner/PractitionerWalterArzt"
    },
    "reasonReference":  [
        {
            "reference": "Condition/BehandlungsDiagnoseFreitext"
        }
    ]
}

Einfaches Zytostatikum-Therapieschema (Chemotherapie):

{
    "resourceType": "MedicationRequest",
    "id": "ExampleISiKMedikationsVerordnung2",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerordnung"
        ]
    },
    "extension":  [
        {
            "url": "https://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedicationRequestReplaces",
            "valueReference": {
                "reference": "MedicationRequest/77777"
            }
        }
    ],
    "dosageInstruction":  [
        {
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "system": "http://unitsofmeasure.org",
                        "value": 500,
                        "unit": "ml Infusionslösung",
                        "code": "mL"
                    }
                }
            ],
            "timing": {
                "repeat": {
                    "count": 6,
                    "frequency": 1,
                    "duration": 6,
                    "durationUnit": "wk",
                    "period": 1,
                    "periodUnit": "wk"
                }
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "Medication/ExampleISiKMedikament8"
    },
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "encounter": {
        "reference": "Encounter/Fachabteilungskontakt"
    },
    "authoredOn": "2024-01-17",
    "requester": {
        "reference": "Practitioner/PractitionerWalterArzt"
    }
}

Interaktionen

Für die Ressource MedicationRequest MÜSSEN die REST-Interaktionen "READ", "CREATE" und "UPDATE" implementiert werden.

Folgende Suchparameter sind für das Bestätigungsverfahren relevant, auch in Kombination:

Der Suchparameter "_id" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?_id=103270

Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "authoredon" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?authoredon=2022-03-21

Anwendungshinweise: Weitere Informationen zur Suche nach Date-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Date".
Der Suchparameter "code" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationStatement?code=http://fhir.de/CodeSystem/bfarm/atc|V03AB23

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "date" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?date=2022-03-23

Anwendungshinweise: Weitere Informationen zur Suche nach Date-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Date".
Der Suchparameter "encounter" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?encounter=Encounter/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "encounter.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?encounter.identifier=http://mein-krankenhaus.example/fhir/sid/fallnummern|7567867

GET [base]/MedicationRequest?encounter.identifier=7567867

Use Case Zusammenhang: Um bei einem wiederkehrenden Patienten eine Verwechslung des Falls und damit eine falsche Verordnung zu vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "intent" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?intent=order

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "medication" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?medication=Medication/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "medication.code" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?medication.code=http://fhir.de/CodeSystem/bfarm/atc|V03AB23

Use Case Zusammenhang: Um eine Wechselwirkung bei der Verordnung auf Basis des Wirkstoffes zu vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "patient" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?patient=Patient/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "patient.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?patient.identifier=http://mein-krankenhaus.example/fhir/sid/patienten|1032702

GET [base]/MedicationRequest?patient.identifier=1032702

Use Case Zusammenhang: Um bei der Verordnung einer Medikation eine Verwechslung zwischen verschiedenen Patienten vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "requester" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?requester=Practitioner/101112

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "requester.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?requester.identifier=http://fhir.de/sid/bundesaerztekammer/efn|123456789123456

GET [base]/MedicationRequest?requester.identifier=123456789123456

Use Case Zusammenhang: Um mich als Heilberufler über die Historie meiner Medikationsverordnungen zur informieren.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "status" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?status=active

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".