HL7 FHIR Implementation Guide: Rwanda HIV
0.1.0 - STU1
HL7 FHIR Implementation Guide: Rwanda HIV
0.1.0 - STU1
HL7 FHIR Implementation Guide: Rwanda HIV, published by Jembi Health Systems. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/openhie/Rwanda-HIV and changes regularly. See the Directory of published versions
| Active as of 2023-09-15 |
XML representation of the arv-regimen-medication-request resource profile.
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="arv-regimen-medication-request"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">Placeholder</div>
</text>
<url
value="http://openhie.org/fhir/rwanda-hiv/StructureDefinition/arv-regimen-medication-request"/>
<version value="0.1.0"/>
<name value="ARVRegimenMedicationRequest"/>
<title value="ARV Regimen Medication Request"/>
<status value="active"/>
<date value="2023-09-15T07:34:16+00:00"/>
<publisher value="Jembi Health Systems"/>
<contact>
<name value="Jembi Health Systems"/>
<telecom>
<system value="url"/>
<value value="https://www.jembi.org"/>
</telecom>
<telecom>
<system value="email"/>
<value value="info@jembi.org"/>
</telecom>
</contact>
<contact>
<name value="Richard Langford"/>
<telecom>
<system value="email"/>
<value value="richard.langford@jembi.org"/>
<use value="work"/>
</telecom>
</contact>
<description
value="Represents a prescription request for an ARV regimen for a patient."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<fhirVersion value="5.0.0"/>
<mapping>
<identity value="workflow"/>
<uri value="http://hl7.org/fhir/workflow"/>
<name value="Workflow Pattern"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<uri value="http://ncpdp.org/SCRIPT10_6"/>
<name value="Mapping to NCPDP SCRIPT 10.6"/>
</mapping>
<mapping>
<identity value="w5"/>
<uri value="http://hl7.org/fhir/fivews"/>
<name value="FiveWs Pattern Mapping"/>
</mapping>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM Mapping"/>
</mapping>
<mapping>
<identity value="v2"/>
<uri value="http://hl7.org/v2"/>
<name value="HL7 V2 Mapping"/>
</mapping>
<kind value="resource"/>
<abstract value="false"/>
<type value="MedicationRequest"/>
<baseDefinition
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<derivation value="constraint"/>
<snapshot>
<element id="MedicationRequest">
<path value="MedicationRequest"/>
<short value="Ordering of medication for patient or group"/>
<definition
value="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."/>
<alias value="Prescription"/>
<alias value="Order"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest"/>
<min value="0"/>
<max value="*"/>
</base>
<constraint>
<key value="dom-2"/>
<severity value="error"/>
<human
value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
<expression value="contained.contained.empty()"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-3"/>
<severity value="error"/>
<human
value="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"/>
<expression
value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-4"/>
<severity value="error"/>
<human
value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
<expression
value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-5"/>
<severity value="error"/>
<human
value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
<expression value="contained.meta.security.empty()"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown
value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
</extension>
<key value="dom-6"/>
<severity value="warning"/>
<human
value="A resource should have narrative for robust management"/>
<expression value="text.`div`.exists()"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Entity, Role, or Act,CombinedMedicationRequest"/>
</mapping>
<mapping>
<identity value="workflow"/>
<map value="Request"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="clinical.medication"/>
</mapping>
</element>
<element id="MedicationRequest.id">
<path value="MedicationRequest.id"/>
<short value="Logical id of this artifact"/>
<definition
value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
<comment
value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="MedicationRequest.meta">
<path value="MedicationRequest.meta"/>
<short value="Metadata about the resource"/>
<definition
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.meta"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Meta"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="MedicationRequest.implicitRules">
<path value="MedicationRequest.implicitRules"/>
<short value="A set of rules under which this content was created"/>
<definition
value="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."/>
<comment
value="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 its narrative along with other profiles, value sets, etc."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.implicitRules"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation"/>
<isSummary value="true"/>
</element>
<element id="MedicationRequest.language">
<path value="MedicationRequest.language"/>
<short value="Language of the resource content"/>
<definition
value="The base language in which the resource is written."/>
<comment
value="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)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.language"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true"/>
</extension>
<strength value="required"/>
<description value="IETF language tag for a human language"/>
<valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/>
<additional>
<purpose value="starter"/>
<valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
</additional>
</binding>
</element>
<element id="MedicationRequest.text">
<path value="MedicationRequest.text"/>
<short value="Text summary of the resource, for human interpretation"/>
<definition
value="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."/>
<comment
value="Contained resources do not have a 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."/>
<alias value="narrative"/>
<alias value="html"/>
<alias value="xhtml"/>
<alias value="display"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="DomainResource.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Narrative"/>
</type>
<condition value="dom-6"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Act.text?"/>
</mapping>
</element>
<element id="MedicationRequest.contained">
<path value="MedicationRequest.contained"/>
<short value="Contained, inline Resources"/>
<definition
value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/>
<comment
value="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."/>
<alias value="inline resources"/>
<alias value="anonymous resources"/>
<alias value="contained resources"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.contained"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Resource"/>
</type>
<condition value="dom-2"/>
<condition value="dom-4"/>
<condition value="dom-3"/>
<condition value="dom-5"/>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.extension">
<path value="MedicationRequest.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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 managable, 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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.modifierExtension">
<path value="MedicationRequest.modifierExtension"/>
<short value="Extensions that cannot be ignored"/>
<definition
value="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 managable, 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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.identifier">
<path value="MedicationRequest.identifier"/>
<short value="External ids for this request"/>
<definition
value="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."/>
<comment
value="This is a business identifier, not a resource identifier."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.identifier"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.identifier"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="Message/Header/PrescriberOrderNumber"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.identifier"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="ORC-2-Placer Order Number / ORC-3-Filler Order Number"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".id"/>
</mapping>
</element>
<element id="MedicationRequest.basedOn">
<path value="MedicationRequest.basedOn"/>
<short
value="A plan or request that is fulfilled in whole or in part by this medication request"/>
<definition
value="A plan or request that is fulfilled in whole or in part by this medication request."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.basedOn"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Request.basedOn"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"/>
</mapping>
</element>
<element id="MedicationRequest.priorPrescription">
<path value="MedicationRequest.priorPrescription"/>
<short
value="Reference to an order/prescription that is being replaced by this MedicationRequest"/>
<definition
value="Reference to an order/prescription that is being replaced by this MedicationRequest."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.priorPrescription"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.replaces"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="not mapped"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]"/>
</mapping>
</element>
<element id="MedicationRequest.groupIdentifier">
<path value="MedicationRequest.groupIdentifier"/>
<short value="Composite request this is part of"/>
<definition
value="A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.groupIdentifier"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Request.groupIdentifier"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id"/>
</mapping>
</element>
<element id="MedicationRequest.status">
<path value="MedicationRequest.status"/>
<short
value="active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown"/>
<definition
value="A code specifying the current state of the order. Generally, this will be active or completed state."/>
<comment
value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Clinical decision support systems should take the status into account when determining which medications to include in their algorithms."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="MedicationRequest.status"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestStatus"/>
</extension>
<strength value="required"/>
<description
value="A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.status"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="no mapping"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.status"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".statusCode"/>
</mapping>
</element>
<element id="MedicationRequest.statusReason">
<path value="MedicationRequest.statusReason"/>
<short value="Reason for current status"/>
<definition
value="Captures the reason for the current state of the MedicationRequest."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.statusReason"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestStatusReason"/>
</extension>
<strength value="example"/>
<description value="Identifies the reasons for a given status."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medicationrequest-status-reason"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.statusReason"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"/>
</mapping>
</element>
<element id="MedicationRequest.statusChanged">
<path value="MedicationRequest.statusChanged"/>
<short value="When the status was changed"/>
<definition
value="The date (and perhaps time) when the status was changed."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.statusChanged"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="dateTime"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="subjectOf Observation[code = statusChange].value = date"/>
</mapping>
</element>
<element id="MedicationRequest.intent">
<path value="MedicationRequest.intent"/>
<short
value="proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option"/>
<definition
value="Whether the request is a proposal, plan, or an original order."/>
<comment
value="It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.
An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.
This element is labeled as a modifier because the intent alters when and how the resource is actually applicable."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="MedicationRequest.intent"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestIntent"/>
</extension>
<strength value="required"/>
<description value="The kind of medication order."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.intent"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"/>
</mapping>
</element>
<element id="MedicationRequest.category">
<path value="MedicationRequest.category"/>
<short value="Grouping or category of medication request"/>
<definition
value="An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication."/>
<comment
value="The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.category"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestAdministrationLocation"/>
</extension>
<strength value="example"/>
<description
value="A coded concept identifying where the medication is to be consumed or administered."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medicationrequest-admin-location"/>
</binding>
<mapping>
<identity value="script10.6"/>
<map
value="Message/Body/NewRx/MedicationPrescribed/Directions
or
Message/Body/NewRx/MedicationPrescribed/StructuredSIG"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value"/>
</mapping>
</element>
<element id="MedicationRequest.priority">
<path value="MedicationRequest.priority"/>
<short value="routine | urgent | asap | stat"/>
<definition
value="Indicates how quickly the Medication Request should be addressed with respect to other requests."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.priority"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestPriority"/>
</extension>
<strength value="required"/>
<description
value="Identifies the level of importance to be assigned to actioning the request."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/request-priority|5.0.0"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.priority"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.grade"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".priorityCode"/>
</mapping>
</element>
<element id="MedicationRequest.doNotPerform">
<path value="MedicationRequest.doNotPerform"/>
<short
value="True if patient is to stop taking or not to start taking the medication"/>
<definition
value="If true, indicates that the provider is asking for the patient to either stop taking or to not start taking the specified medication. For example, the patient is taking an existing medication and the provider is changing their medication. They want to create two seperate requests: one to stop using the current medication and another to start the new medication."/>
<comment
value="If do not perform is not specified, the request is a positive request e.g. "do perform"."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.doNotPerform"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="true"/>
<isModifierReason
value="This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc.)"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="SubstanceAdministration.actionNegationInd"/>
</mapping>
</element>
<element id="MedicationRequest.medication">
<path value="MedicationRequest.medication"/>
<short value="Medication to be taken"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="MedicationRequest.medication"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableReference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Medication"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<strength value="extensible"/>
<valueSet
value="http://openhie.org/fhir/rwanda-hiv/ValueSet/vs-arv-regimen"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.code"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map
value="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"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.what[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXE-2-Give Code / RXO-1 Requested Give Code / RXC-2 Component Code"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="consumable.administrableMedication"/>
</mapping>
</element>
<element id="MedicationRequest.medication.id">
<path value="MedicationRequest.medication.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<condition value="ele-1"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.medication.extension">
<path value="MedicationRequest.medication.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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 managable, 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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.medication.concept">
<path value="MedicationRequest.medication.concept"/>
<short value="Reference to a concept (by class)"/>
<definition
value="A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableReference.concept"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.medication.concept.id">
<path value="MedicationRequest.medication.concept.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<condition value="ele-1"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.medication.concept.extension">
<path value="MedicationRequest.medication.concept.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="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 managable, 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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.medication.concept.coding">
<path value="MedicationRequest.medication.concept.coding"/>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="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."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="MedicationRequest.medication.concept.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="MedicationRequest.medication.concept.text"/>
<short value="Plain text representation of the concept"/>
<definition
value="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."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<patternString value="ARV regimen"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
</element>
<element id="MedicationRequest.medication.reference">
<path value="MedicationRequest.medication.reference"/>
<short value="Reference to a resource (by instance)"/>
<definition
value="A reference to a resource the provides exact details about the information being referenced."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableReference.reference"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.subject">
<path value="MedicationRequest.subject"/>
<short
value="Individual or group for whom the medication has been requested"/>
<definition
value="The individual or group for whom the medication has been requested."/>
<comment
value="The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="MedicationRequest.subject"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Request.subject"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map
value="Message/Body/NewRx/Patient
(need detail to link to specific patient … Patient.Identification in SCRIPT)"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.subject[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="PID-3 Patient ID List"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".participation[typeCode=AUT].role"/>
</mapping>
</element>
<element id="MedicationRequest.informationSource">
<path value="MedicationRequest.informationSource"/>
<short
value="The person or organization who provided the information about this request, if the source is someone other than the requestor"/>
<definition
value="The person or organization who provided the information about this request, if the source is someone other than the requestor. This is often used when the MedicationRequest is reported by another person."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.informationSource"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map
value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practitioner or Related Person or Practitioner Role or Organization"/>
</mapping>
</element>
<element id="MedicationRequest.encounter">
<path value="MedicationRequest.encounter"/>
<short value="Encounter created as part of encounter/admission/stay"/>
<definition
value="The Encounter during which this [x] was created or to which the creation of this record is tightly associated."/>
<comment
value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="MedicationRequest.encounter"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.encounter"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="no mapping"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.context"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="PV1-19 Visit Number"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]"/>
</mapping>
</element>
<element id="MedicationRequest.supportingInformation">
<path value="MedicationRequest.supportingInformation"/>
<short value="Information to support fulfilling of the medication"/>
<definition
value="Information to support fulfilling (i.e. dispensing or administering) of the medication, for example, patient height and weight, a MedicationStatement for the patient)."/>
<comment
value="This attribute can be used to reference a MedicationStatement about the patients' medication use."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.supportingInformation"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Resource"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.supportingInfo"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.context"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".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)]"/>
</mapping>
</element>
<element id="MedicationRequest.authoredOn">
<path value="MedicationRequest.authoredOn"/>
<short value="When request was initially authored"/>
<definition
value="The date (and perhaps time) when the prescription was initially written or authored on."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.authoredOn"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="dateTime"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Request.authoredOn"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/WrittenDate"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.recorded"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXE-32 Original Order Date/Time / ORC-9-Date Time of Transaction"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="author.time"/>
</mapping>
</element>
<element id="MedicationRequest.requester">
<path value="MedicationRequest.requester"/>
<short value="Who/What requested the Request"/>
<definition
value="The individual, organization, or device that initiated the request and has responsibility for its activation."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.requester"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Device"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="workflow"/>
<map value="Request.requester"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.author"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".participation[typeCode=AUT].role"/>
</mapping>
</element>
<element id="MedicationRequest.reported">
<path value="MedicationRequest.reported"/>
<short value="Reported rather than primary record"/>
<definition
value="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."/>
<comment
value="If not populated, then assume that this is the original record and not reported"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.reported"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value=".participation[typeCode=INF].role"/>
</mapping>
</element>
<element id="MedicationRequest.performerType">
<path value="MedicationRequest.performerType"/>
<short
value="Desired kind of performer of the medication administration"/>
<definition
value="Indicates the type of performer of the administration of the medication."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.performerType"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestPerformerType"/>
</extension>
<strength value="extensible"/>
<description
value="Identifies the type of individual that is desired to administer the medication."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medication-intended-performer-role"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.performerType"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code"/>
</mapping>
</element>
<element id="MedicationRequest.performer">
<path value="MedicationRequest.performer"/>
<short value="Intended performer of administration"/>
<definition
value="The specified desired performer of the medication treatment (e.g. the performer of the medication administration). For devices, this is the device that is intended to perform the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.performer"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Patient"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/DeviceDefinition"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/HealthcareService"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.performer"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.actor"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/>
</mapping>
</element>
<element id="MedicationRequest.device">
<path value="MedicationRequest.device"/>
<short value="Intended type of device for the administration"/>
<definition
value="The intended type of device that is to be used for the administration of the medication (for example, PCA Pump)."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.device"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableReference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/DeviceDefinition"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map
value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/>
</mapping>
</element>
<element id="MedicationRequest.recorder">
<path value="MedicationRequest.recorder"/>
<short value="Person who entered the request"/>
<definition
value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.recorder"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.who"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)"/>
</mapping>
</element>
<element id="MedicationRequest.reason">
<path value="MedicationRequest.reason"/>
<short
value="Reason or indication for ordering or not ordering the medication"/>
<definition
value="The reason or the indication for ordering or not ordering the medication."/>
<comment
value="This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.reason"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="CodeableReference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Observation"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="true"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestReason"/>
</extension>
<strength value="example"/>
<description
value="A coded concept indicating why the medication was ordered."/>
<valueSet value="http://hl7.org/fhir/ValueSet/condition-code"/>
</binding>
<mapping>
<identity value="workflow"/>
<map value="Request.reason"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map
value="Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.why[x]"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="ORC-16 Order Control Code Reason /RXE-27 Give Indication/RXO-20-Indication / RXD-21 Indication / RXG-22 Indication / RXA-19 Indication"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="reason.observation.reasonCode | reason.observation[code=ASSERTION].value"/>
</mapping>
</element>
<element id="MedicationRequest.courseOfTherapyType">
<path value="MedicationRequest.courseOfTherapyType"/>
<short value="Overall pattern of medication administration"/>
<definition
value="The description of the overall pattern of the administration of the medication to the patient."/>
<comment
value="This attribute should not be confused with the protocol of the medication."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.courseOfTherapyType"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestCourseOfTherapy"/>
</extension>
<strength value="extensible"/>
<description
value="Identifies the overall pattern of medication administratio."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy"/>
</binding>
<mapping>
<identity value="rim"/>
<map value="Act.code where classCode = LIST and moodCode = EVN"/>
</mapping>
</element>
<element id="MedicationRequest.insurance">
<path value="MedicationRequest.insurance"/>
<short value="Associated insurance coverage"/>
<definition
value="Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.insurance"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/ClaimResponse"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.insurance"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".outboundRelationship[typeCode=COVBY].target"/>
</mapping>
</element>
<element id="MedicationRequest.note">
<path value="MedicationRequest.note"/>
<short value="Information about the prescription"/>
<definition
value="Extra information about the prescription that could not be conveyed by the other attributes."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.note"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Annotation"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="true"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.note"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/Note"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value"/>
</mapping>
</element>
<element id="MedicationRequest.renderedDosageInstruction">
<path value="MedicationRequest.renderedDosageInstruction"/>
<short value="Full representation of the dosage instructions"/>
<definition
value="The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses."/>
<requirements
value="The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.renderedDosageInstruction"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="markdown"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="SubstanceAdministration.text"/>
</mapping>
</element>
<element id="MedicationRequest.effectiveDosePeriod">
<path value="MedicationRequest.effectiveDosePeriod"/>
<short value="Period over which the medication is to be taken"/>
<definition
value="The period over which the medication is to be taken. Where there are multiple dosageInstruction lines (for example, tapering doses), this is the earliest date and the latest end date of the dosageInstructions."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.effectiveDosePeriod"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="substanceAdministration.effectiveTime"/>
</mapping>
</element>
<element id="MedicationRequest.dosageInstruction">
<path value="MedicationRequest.dosageInstruction"/>
<short
value="Specific instructions for how the medication should be taken"/>
<definition
value="Specific instructions for how the medication is to be used by the patient."/>
<comment
value="There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. In general, each prescribed drug will be a separate Medication Request.
When drug orders are grouped together at the time of order entry, but each of the drugs can be manipulated independently e.g. changing the status of one order to "completed" or "cancelled", changing another order status to "on-hold", the method to "group" all of the medication requests together is to use MedicationRequest.groupIdentifier element. All of the orders grouped together in this manner will have the same groupIdentifier, and separately, each order in the group may have a unique identifier.
There are cases that require grouping of Medication orders together when it is necessary to specify optionality e.g. order two drugs at one time, but stating either of these drugs may be used to treat the patient. The use of a RequestOrchestration should be used as a parent for the Medication orders that require this type of grouping. An example when it may be necessary to group medication orders together is when you specify timing relationships e.g. order drug "xyz" with dose 123, then taper the same drug to a different dose after some interval of time
precedence:
e.g. give drug "abc" followed by drug "def"
e.g. give drug 30 minutes before some procedure was performed
more generically this supports - hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group.
Note that one should NOT use the List or Composition resource to accomplish the above requirements. You may use List or Composition for other business requirements, but not to address the specific requirements of grouping medication orders."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.dosageInstruction"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Dosage"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="see dosageInstruction mapping"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest">
<path value="MedicationRequest.dispenseRequest"/>
<short value="Medication supply authorization"/>
<definition
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/ExpirationDate"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="component.supplyEvent"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.id">
<path value="MedicationRequest.dispenseRequest.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<condition value="ele-1"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.extension">
<path value="MedicationRequest.dispenseRequest.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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 managable, 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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.modifierExtension">
<path value="MedicationRequest.dispenseRequest.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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 managable, 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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.initialFill">
<path value="MedicationRequest.dispenseRequest.initialFill"/>
<short value="First fill details"/>
<definition
value="Indicates the quantity or duration for the first dispense of the medication."/>
<comment
value="If populating this element, either the quantity or the duration must be included."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.initialFill"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map
value="SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.initialFill.id">
<path value="MedicationRequest.dispenseRequest.initialFill.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<condition value="ele-1"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.initialFill.extension">
<path value="MedicationRequest.dispenseRequest.initialFill.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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 managable, 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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="MedicationRequest.dispenseRequest.initialFill.modifierExtension">
<path
value="MedicationRequest.dispenseRequest.initialFill.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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 managable, 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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.initialFill.quantity">
<path value="MedicationRequest.dispenseRequest.initialFill.quantity"/>
<short value="First fill quantity"/>
<definition
value="The amount or quantity to provide as part of the first dispense."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.initialFill.quantity"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Supply.quantity[moodCode=RQO]"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.initialFill.duration">
<path value="MedicationRequest.dispenseRequest.initialFill.duration"/>
<short value="First fill duration"/>
<definition
value="The length of time that the first dispense is expected to last."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.initialFill.duration"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Duration"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Supply.effectivetime[moodCode=RQO]"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.dispenseInterval">
<path value="MedicationRequest.dispenseRequest.dispenseInterval"/>
<short value="Minimum period of time between dispenses"/>
<definition
value="The minimum period of time that must occur between dispenses of the medication."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.dispenseInterval"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Duration"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Supply.effectivetime[moodCode=RQO]"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.validityPeriod">
<path value="MedicationRequest.dispenseRequest.validityPeriod"/>
<short value="Time period supply is authorized for"/>
<definition
value="This indicates the validity period of a prescription (stale dating the Prescription)."/>
<comment
value="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."/>
<requirements
value="Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.validityPeriod"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Period"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/Refills"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="effectiveTime"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed">
<path value="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"/>
<short value="Number of refills authorized"/>
<definition
value="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."/>
<comment
value="If displaying "number of authorized fills", add 1 to this number."/>
<min value="0"/>
<max value="1"/>
<base>
<path
value="MedicationRequest.dispenseRequest.numberOfRepeatsAllowed"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="unsignedInt"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/Quantity"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="RXE-12 Number of Refills"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="repeatNumber"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.quantity">
<path value="MedicationRequest.dispenseRequest.quantity"/>
<short value="Amount of medication to supply per dispense"/>
<definition value="The amount that is to be dispensed for one fill."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.quantity"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/DaysSupply"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXD-4 Actual Dispense Amount / RXD-5.1 Actual Dispense Units.code / RXD-5.3 Actual Dispense Units.name of coding system"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="quantity"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.expectedSupplyDuration">
<path value="MedicationRequest.dispenseRequest.expectedSupplyDuration"/>
<short value="Number of days supply per dispense"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path
value="MedicationRequest.dispenseRequest.expectedSupplyDuration"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Duration"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="Message/Body/NewRx/MedicationPrescribed/Substitutions"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="expectedUseTime"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.dispenser">
<path value="MedicationRequest.dispenseRequest.dispenser"/>
<short value="Intended performer of dispense"/>
<definition
value="Indicates the intended performing Organization that will dispense the medication as specified by the prescriber."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.dispenseRequest.dispenser"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.who"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.dispenserInstruction">
<path value="MedicationRequest.dispenseRequest.dispenserInstruction"/>
<short value="Additional information for the dispenser"/>
<definition
value="Provides additional information to the dispenser, for example, counselling to be provided to the patient."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.dispenseRequest.dispenserInstruction"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Annotation"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Supply.text"/>
</mapping>
</element>
<element id="MedicationRequest.dispenseRequest.doseAdministrationAid">
<path value="MedicationRequest.dispenseRequest.doseAdministrationAid"/>
<short value="Type of adherence packaging to use for the dispense"/>
<definition
value="Provides information about the type of adherence packaging to be supplied for the medication dispense."/>
<min value="0"/>
<max value="1"/>
<base>
<path
value="MedicationRequest.dispenseRequest.doseAdministrationAid"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestDoseAdministrationAid"/>
</extension>
<strength value="example"/>
<valueSet value="http://hl7.org/fhir/ValueSet/medication-dose-aid"/>
</binding>
<mapping>
<identity value="rim"/>
<map
value="Supply.administerableMedication.product.asContent.container.code"/>
</mapping>
</element>
<element id="MedicationRequest.substitution">
<path value="MedicationRequest.substitution"/>
<short value="Any restrictions on medication substitution"/>
<definition
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.substitution"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map
value="specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="subjectOf.substitutionPersmission"/>
</mapping>
</element>
<element id="MedicationRequest.substitution.id">
<path value="MedicationRequest.substitution.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<condition value="ele-1"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.substitution.extension">
<path value="MedicationRequest.substitution.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="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 managable, 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."/>
<comment
value="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."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="MedicationRequest.substitution.modifierExtension">
<path value="MedicationRequest.substitution.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="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 managable, 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)."/>
<comment
value="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."/>
<requirements
value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="MedicationRequest.substitution.allowed[x]">
<path value="MedicationRequest.substitution.allowed[x]"/>
<short value="Whether substitution is allowed or not"/>
<definition
value="True if the prescriber allows a different drug to be dispensed from what was prescribed."/>
<comment
value="This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="MedicationRequest.substitution.allowed[x]"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationRequestSubstitution"/>
</extension>
<strength value="preferred"/>
<description value="Identifies the type of substitution allowed."/>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/>
</binding>
<mapping>
<identity value="script10.6"/>
<map
value="specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="RXO-9 Allow Substitutions / RXE-9 Substitution Status"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="code"/>
</mapping>
</element>
<element id="MedicationRequest.substitution.reason">
<path value="MedicationRequest.substitution.reason"/>
<short value="Why should (not) substitution be made"/>
<definition
value="Indicates the reason for the substitution, or why substitution must or must not be performed."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="MedicationRequest.substitution.reason"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/binding-definition">
<valueMarkdown
value="A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed."/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationIntendedSubstitutionReason"/>
</extension>
<strength value="example"/>
<description value="SubstanceAdminSubstitutionReason"/>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"/>
</binding>
<mapping>
<identity value="script10.6"/>
<map value="not mapped"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="RXE-9 Substition status"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="reasonCode"/>
</mapping>
</element>
<element id="MedicationRequest.eventHistory">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use"/>
</extension>
<path value="MedicationRequest.eventHistory"/>
<short value="A list of events of interest in the lifecycle"/>
<definition
value="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."/>
<comment
value="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.)."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="MedicationRequest.eventHistory"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Provenance"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="workflow"/>
<map value="Request.relevantHistory"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/>
</mapping>
</element>
</snapshot>
<differential>
<element id="MedicationRequest">
<path value="MedicationRequest"/>
</element>
<element id="MedicationRequest.medication">
<path value="MedicationRequest.medication"/>
<binding>
<strength value="extensible"/>
<valueSet
value="http://openhie.org/fhir/rwanda-hiv/ValueSet/vs-arv-regimen"/>
</binding>
</element>
<element id="MedicationRequest.medication.concept.text">
<path value="MedicationRequest.medication.concept.text"/>
<patternString value="ARV regimen"/>
</element>
<element id="MedicationRequest.encounter">
<path value="MedicationRequest.encounter"/>
<min value="1"/>
</element>
<element id="MedicationRequest.reason">
<path value="MedicationRequest.reason"/>
<mustSupport value="true"/>
</element>
<element id="MedicationRequest.note">
<path value="MedicationRequest.note"/>
<mustSupport value="true"/>
</element>
</differential>
</StructureDefinition>
IG © 2021+ Jembi Health Systems. Package openhie.fhir.rwanda.hiv#0.1.0 based on FHIR 5.0.0. Generated 2023-09-15
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