LK NEHR Sri Lanka Patient Summary (IPS based) Implementation Guide
0.1.0 - STU1

LK NEHR Sri Lanka Patient Summary (IPS based) Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Medication Request

Official URL: http://fhir.health.gov.lk/ips/StructureDefinition/no-medication-requested | Version: 0.1.0
Active as of 2025-06-18 | Computable Name: NoPrescriptions

This is to indicate that the patient has not received any prescriptions for drugs.

Usages:

- Use this Profile: HIMS Transactional Bundle
- Examples for this Profile: MedicationRequest/NoPrescriptionsExample

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestIPS | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Required Pattern: completed
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | Medication to be taken Slice: Unordered, Closed by type:$this Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: no-medication-info
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | Who or group medication request is for
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
encounter |  | 1..1 | Reference(Target Facility Encounter) | Encounter created as part of encounter/admission/stay
note | S | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.status | required | Pattern Value: completed `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` From the FHIR Standard
MedicationRequest.intent | required | Pattern Value: order `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknown `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`
MedicationRequest.medication[x]:medicationCodeableConcept | preferred | Pattern Value: no-medication-info `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from MedicationRequestIPS

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | MedicationRequestIPS |
status |  | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Required Pattern: completed
intent |  | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order
Slices for medication[x] |  | 1..1 | CodeableConcept | Medication to be taken Slice: Unordered, Open by type:$this
medication[x]:medicationCodeableConcept |  | 1..1 | CodeableConcept | Medication to be taken Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: no-medication-info
subject |  | 1..1 | Reference(Patient) | Who or group medication request is for
encounter |  | 1..1 | Reference(Target Facility Encounter) | Encounter created as part of encounter/admission/stay
note | S | 0..* | Annotation | Information about the prescription
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestIPS | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External ids for this request
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Required Pattern: completed
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | Medication to be taken Slice: Unordered, Closed by type:$this Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: no-medication-info
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | Who or group medication request is for
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter |  | 1..1 | Reference(Target Facility Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note | S | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route |  | 0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason |  | 0..1 | code | validityPeriod absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | Pattern Value: completed `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` From the FHIR Standard
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | Pattern Value: order `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknown `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`
MedicationRequest.medication[x]:medicationCodeableConcept | preferred | Pattern Value: no-medication-info `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` From the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` From the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIps `http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration`
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` From the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from MedicationRequestIPS

Summary

Mandatory: 2 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

- Patient (http://fhir.health.gov.lk/ips/StructureDefinition/ips-patient)
- Target Facility Encounter (http://fhir.health.gov.lk/ips/StructureDefinition/target-facility-encounter)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestIPS | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Required Pattern: completed
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | Medication to be taken Slice: Unordered, Closed by type:$this Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: no-medication-info
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | Who or group medication request is for
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
encounter |  | 1..1 | Reference(Target Facility Encounter) | Encounter created as part of encounter/admission/stay
note | S | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.status | required | Pattern Value: completed `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` From the FHIR Standard
MedicationRequest.intent | required | Pattern Value: order `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknown `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`
MedicationRequest.medication[x]:medicationCodeableConcept | preferred | Pattern Value: no-medication-info `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Differential View

This structure is derived from MedicationRequestIPS

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | MedicationRequestIPS |
status |  | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Required Pattern: completed
intent |  | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order
Slices for medication[x] |  | 1..1 | CodeableConcept | Medication to be taken Slice: Unordered, Open by type:$this
medication[x]:medicationCodeableConcept |  | 1..1 | CodeableConcept | Medication to be taken Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: no-medication-info
subject |  | 1..1 | Reference(Patient) | Who or group medication request is for
encounter |  | 1..1 | Reference(Target Facility Encounter) | Encounter created as part of encounter/admission/stay
note | S | 0..* | Annotation | Information about the prescription
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestIPS | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External ids for this request
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Required Pattern: completed
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | Medication to be taken Slice: Unordered, Closed by type:$this Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Medication to be taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: no-medication-info
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | Who or group medication request is for
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter |  | 1..1 | Reference(Target Facility Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note | S | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route |  | 0..1 | CodeableConceptIPS | Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:data-absent-reason |  | 0..1 | code | validityPeriod absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | Pattern Value: completed `http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1` From the FHIR Standard
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | Pattern Value: order `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.medication[x] | preferred | MedicationSnomedCodesAbsentUnknown `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`
MedicationRequest.medication[x]:medicationCodeableConcept | preferred | Pattern Value: no-medication-info `http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips`
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` From the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` From the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.route | preferred | MedicineRouteOfAdministrationUvIps `http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration`
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` From the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` From the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from MedicationRequestIPS

Summary

Mandatory: 2 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

- Patient (http://fhir.health.gov.lk/ips/StructureDefinition/ips-patient)
- Target Facility Encounter (http://fhir.health.gov.lk/ips/StructureDefinition/target-facility-encounter)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Other representations of profile: CSV, Excel, Schematron