ELGA e-Medikation FHIR R5 Implementierungsleitfaden - Local Development build (v0.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: 2 ELGA e-Medication MedicationRequest (eMedRequest)

Description: In the course of treatment, the doctor determines that the ELGA participant must be prescribed one or more medicines. A MedicationRequest always consists of exactly one medication (= one medicine). The e-Medication prescription can consist of several MedicationRequests and thus forms a grouping over them. The prescription and it's MedicationRequests are labelled with one unique, common eMED ID. The doctor is responsible for checking the medicines, e.g. for potential interactions, contraindications, dosages, etc. and this is not part of e-Medication. Storing requests without assigning a prescription is not valid. The prescription is considered to have been checked if the associated prescription is saved in e-Medication.

Beschreibung: Im Zuge der Behandlung stellt der Arzt fest, dass dem ELGA Teilnehmer ein oder mehrere Arzneimittel verordnet werden müssen. Eine Verordnung besteht immer nur aus genau einer Medikation (= ein Arzneimittel). Das Rezept kann aus mehreren Verordnungen/MedicationRequests bestehen und bildet somit die Klammer über die Verordnungen/MedicationRequests. Das Rezept und seine Verordnungen/MedicationRequests werden mit einer eindeutigen, gemeinsamen eMED-ID versehen. Die Prüfungen der Arzneimittel z.B. auf potentielle Wechselwirkungen, Kontraindikationen, Dosierungen, etc. erfolgt in der Eigenverantwortung des Arztes und ist nicht Gegenstand der e-Medikation. Eine Speicherung von Verordnungen/MedicationRequests ohne Zuordnung eines Rezeptes ist nicht gültig. Die Verordnung/MedicationRequest wird als geprüft angesehen, wenn die zugeordnete Verordnung in e-Medikation gespeichert ist.

Usage:

• Use this Resource Profile: 1 ELGA e-Medication Prescription with multiple MedicationRequests (eMedPrescriptionAsRequestOrchestration)
• Refer to this Resource Profile: LINCA Dispense (LINCAMedicationDispense)
• Examples for this Resource Profile: MedicationRequest/Example-eMedRequest

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
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Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier		1..1	Identifier	MedicationRequest ID = {eMed-ID}_{locally assigned ID} | Verordnungs ID = {eMed-ID}_{lokal vergebene ID} ele-1: All FHIR elements must have a @value or children
groupIdentifier	Σ	1..1	Identifier	eMed-ID ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	For CDA compatability: always completed, even if the prescription is still be acted upon. | Für CDA-Kompatibilität: immer abgeschlossen, auch wenn das Rezept noch bearbeitet werden muss. Binding: MedicationrequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. ele-1: All FHIR elements must have a @value or children Required Pattern: completed
intent	?!Σ	1..1	code	The prescription represents a request/demand and authorization for action by the requestor. | Das Rezept stellt eine Anfrage/Anforderung und Ermächtigung zum Handeln durch den Antragsteller dar. Binding: MedicationRequestIntent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children Required Pattern: order
doNotPerform	?!Σ	0..1	boolean	True if patient is to stop taking or not to start taking the medication ele-1: All FHIR elements must have a @value or children
medication	Σ	1..1	CodeableReference(Medication)	Medication in conformance with the ELGA e-Medication used PZN (i.e. ASP-Liste). | Arzneimittel entsprechend der ELGA e-Medikation verwendet PZN (d.h. ASP-Liste). Binding: https://termgit.elga.gv.at/CodeSystem/asp-liste (required) ele-1: All FHIR elements must have a @value or children
concept	Σ	1..1	CodeableConcept	Reference to a concept (by class) ele-1: All FHIR elements must have a @value or children
subject	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Each MedicationRequest is associated with one HL7 Austria patient. | Jede Verordnung/MedicationRequest ist einem HL7 AustriaPatient zugewiesen. ele-1: All FHIR elements must have a @value or children
requester	Σ	1..1	Reference(Practitioner)	ToDo create austrian practitioner with hl7 austria. || The authorizing practitioner for this prescription, identified by their OID according to GDA Index. | Der approbierende Arzt für diese Verschreibung, identifiziert durch seine OID gemäß GDA-Index. ele-1: All FHIR elements must have a @value or children
note		0..*	Annotation	CDA eMed v2: ZINFO || not machine readable Information about the MedicationRequests | nicht maschinenlesbare Informationen über die Verordnung ele-1: All FHIR elements must have a @value or children
effectiveDosePeriod		0..1	Period	Period over which the medication is to be taken | Zeitraum, über den das Medikament eingenommen werden soll ele-1: All FHIR elements must have a @value or children
dosageInstruction		0..*	Dosage	One or more specific instructions for how the medication should be taken | Eine oder mehrere spezifische Anweisungen für die Einnahme des Medikaments ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
patientInstruction	Σ	0..1	string	CDA eMed v2: ALTEIN || Patient or consumer oriented instructions | Patienten- oder verbraucherorientierte Anweisungen ele-1: All FHIR elements must have a @value or children
asNeeded	ΣC	0..1	boolean	Take 'as needed' | Bedarfsmedikation ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationRequest.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0 from the FHIR Standard
MedicationRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0 from the FHIR Standard
MedicationRequest.medication	required	https://termgit.elga.gv.at/CodeSystem/asp-liste https://termgit.elga.gv.at/CodeSystem/asp-liste

Constraints

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

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			MedicationRequest
identifier		1..1	Identifier	MedicationRequest ID = {eMed-ID}_{locally assigned ID} | Verordnungs ID = {eMed-ID}_{lokal vergebene ID}
groupIdentifier		1..1	Identifier	eMed-ID
status		1..1	code	For CDA compatability: always completed, even if the prescription is still be acted upon. | Für CDA-Kompatibilität: immer abgeschlossen, auch wenn das Rezept noch bearbeitet werden muss. Required Pattern: completed
intent		1..1	code	The prescription represents a request/demand and authorization for action by the requestor. | Das Rezept stellt eine Anfrage/Anforderung und Ermächtigung zum Handeln durch den Antragsteller dar. Required Pattern: order
medication		1..1	CodeableReference(Medication)	Medication in conformance with the ELGA e-Medication used PZN (i.e. ASP-Liste). | Arzneimittel entsprechend der ELGA e-Medikation verwendet PZN (d.h. ASP-Liste). Binding: https://termgit.elga.gv.at/CodeSystem/asp-liste (required)
concept		1..1	CodeableConcept	Reference to a concept (by class)
reference		0..0
subject		1..1	Reference(HL7® AT Core Patient Profile)	Each MedicationRequest is associated with one HL7 Austria patient. | Jede Verordnung/MedicationRequest ist einem HL7 AustriaPatient zugewiesen.
requester		1..1	Reference(Practitioner)	ToDo create austrian practitioner with hl7 austria. || The authorizing practitioner for this prescription, identified by their OID according to GDA Index. | Der approbierende Arzt für diese Verschreibung, identifiziert durch seine OID gemäß GDA-Index.
note		0..*	Annotation	CDA eMed v2: ZINFO || not machine readable Information about the MedicationRequests | nicht maschinenlesbare Informationen über die Verordnung
effectiveDosePeriod		0..1	Period	Period over which the medication is to be taken | Zeitraum, über den das Medikament eingenommen werden soll
dosageInstruction		0..*	Dosage	One or more specific instructions for how the medication should be taken | Eine oder mehrere spezifische Anweisungen für die Einnahme des Medikaments
patientInstruction		0..1	string	CDA eMed v2: ALTEIN || Patient or consumer oriented instructions | Patienten- oder verbraucherorientierte Anweisungen
timing
repeat
frequency		0..1	positiveInt	Repetitions within the period | Wiederholungen innerhalb der Dauer
period		0..1	decimal	A defined period with its duration to which the frequency applies | Ein bestimmter Zeitraum mit seiner Dauer, für den die Wiederholungen gelten
periodUnit		0..1	code	Unit of period | Einheit zur Dauer
when		0..*	code	Code for time period of occurrence | Code für die Eintrittszeitspanne Binding: EventTiming (required)
asNeeded		0..1	boolean	Take 'as needed' | Bedarfsmedikation
doseAndRate
Slices for dose[x]		0..1	Range, SimpleQuantity	Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity		0..1	SimpleQuantity	Amount of medication per dose
value		0..1	decimal	Quantity per intake | Menge pro Einnahme
unit		0..1	string	Unit for quantity per intake | Einheit zur Menge pro Einnahme
Slices for rate[x]		0..0
rate[x]:rateRatio		0..0
rate[x]:rateRange		0..0
rate[x]:rateQuantity		0..0
dispenseRequest
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized | Anzahl der genehmigten Einlösungen
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationRequest.medication	required	https://termgit.elga.gv.at/CodeSystem/asp-liste https://termgit.elga.gv.at/CodeSystem/asp-liste
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest ID = {eMed-ID}_{locally assigned ID} | Verordnungs ID = {eMed-ID}_{lokal vergebene ID}
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	A plan or request that is fulfilled in whole or in part by this medication request
priorPrescription		0..1	Reference(MedicationRequest)	Reference to an order/prescription that is being replaced by this MedicationRequest
groupIdentifier	Σ	1..1	Identifier	eMed-ID
status	?!Σ	1..1	code	For CDA compatability: always completed, even if the prescription is still be acted upon. | Für CDA-Kompatibilität: immer abgeschlossen, auch wenn das Rezept noch bearbeitet werden muss. Binding: MedicationrequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Required Pattern: completed
statusReason		0..1	CodeableConcept	Reason for current status Binding: MedicationRequestStatusReasonCodes (example): Identifies the reasons for a given status.
statusChanged		0..1	dateTime	When the status was changed
intent	?!Σ	1..1	code	The prescription represents a request/demand and authorization for action by the requestor. | Das Rezept stellt eine Anfrage/Anforderung und Ermächtigung zum Handeln durch den Antragsteller dar. Binding: MedicationRequestIntent (required): The kind of medication order. Required Pattern: order
category		0..*	CodeableConcept	Grouping or category of medication request Binding: MedicationRequestAdministrationLocationCodes (example): A coded concept identifying where the medication is to be consumed or administered.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if patient is to stop taking or not to start taking the medication
medication	Σ	1..1	CodeableReference(Medication)	Medication in conformance with the ELGA e-Medication used PZN (i.e. ASP-Liste). | Arzneimittel entsprechend der ELGA e-Medikation verwendet PZN (d.h. ASP-Liste). Binding: https://termgit.elga.gv.at/CodeSystem/asp-liste (required)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
concept	Σ	1..1	CodeableConcept	Reference to a concept (by class)
subject	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Each MedicationRequest is associated with one HL7 Austria patient. | Jede Verordnung/MedicationRequest ist einem HL7 AustriaPatient zugewiesen.
informationSource		0..*	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)	The person or organization who provided the information about this request, if the source is someone other than the requestor
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support fulfilling of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	1..1	Reference(Practitioner)	ToDo create austrian practitioner with hl7 austria. || The authorizing practitioner for this prescription, identified by their OID according to GDA Index. | Der approbierende Arzt für diese Verschreibung, identifiziert durch seine OID gemäß GDA-Index.
reported	Σ	0..1	boolean	Reported rather than primary record
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: MedicationIntendedPerformerRole (extensible): Identifies the type of individual that is desired to administer the medication.
performer		0..*	Reference(Practitioner | PractitionerRole | Organization | Patient | DeviceDefinition | RelatedPerson | CareTeam | HealthcareService)	Intended performer of administration
device		0..*	CodeableReference(DeviceDefinition)	Intended type of device for the administration
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reason		0..*	CodeableReference(Condition | Observation)	Reason or indication for ordering or not ordering the medication Binding: ConditionProblemDiagnosisCodes (example): A coded concept indicating why the medication was ordered.
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: MedicationRequestCourseOfTherapyCodes (extensible): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	CDA eMed v2: ZINFO || not machine readable Information about the MedicationRequests | nicht maschinenlesbare Informationen über die Verordnung
renderedDosageInstruction		0..1	markdown	Full representation of the dosage instructions
effectiveDosePeriod		0..1	Period	Period over which the medication is to be taken | Zeitraum, über den das Medikament eingenommen werden soll
dosageInstruction		0..*	Dosage	One or more specific instructions for how the medication should be taken | Eine oder mehrere spezifische Anweisungen für die Einnahme des Medikaments
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	CDA eMed v2: ALTEIN || Patient or consumer oriented instructions | Patienten- oder verbraucherorientierte Anweisungen
timing	Σ	0..1	Timing	When medication should be administered
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
event	Σ	0..*	dateTime	When the event occurs
repeat	ΣC	0..1	Element	When the event is to occur tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x]	Σ	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
count	ΣC	0..1	positiveInt	Number of times to repeat
countMax	ΣC	0..1	positiveInt	Maximum number of times to repeat
duration	ΣC	0..1	decimal	How long when it happens
durationMax	ΣC	0..1	decimal	How long when it happens (Max)
durationUnit	ΣC	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	Σ	0..1	positiveInt	Repetitions within the period | Wiederholungen innerhalb der Dauer
frequencyMax	Σ	0..1	positiveInt	Event occurs up to frequencyMax times per period
period	ΣC	0..1	decimal	A defined period with its duration to which the frequency applies | Ein bestimmter Zeitraum mit seiner Dauer, für den die Wiederholungen gelten
periodMax	ΣC	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	ΣC	0..1	code	Unit of period | Einheit zur Dauer Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	ΣC	0..*	time	Time of day for action
when	ΣC	0..*	code	Code for time period of occurrence | Code für die Eintrittszeitspanne Binding: EventTiming (required)
offset	ΣC	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	C | BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded	ΣC	0..1	boolean	Take 'as needed' | Bedarfsmedikation
asNeededFor	ΣC	0..*	CodeableConcept	Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureAdministrationSites (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered, to be administered or typical amount to be administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x]	Σ	0..1		Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
dose[x]:doseQuantity	Σ	0..1	SimpleQuantity	Amount of medication per dose
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Quantity per intake | Menge pro Einnahme
unit	Σ	0..1	string	Unit for quantity per intake | Einheit zur Menge pro Einnahme
system	ΣC	0..1	uri	System that defines coded unit form
code	ΣC	0..1	code	Coded form of the unit
maxDosePerPeriod	Σ	0..*	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized | Anzahl der genehmigten Einlösungen
quantity		0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
dispenser		0..1	Reference(Organization)	Intended performer of dispense
dispenserInstruction		0..*	Annotation	Additional information for the dispenser
doseAdministrationAid		0..1	CodeableConcept	Type of adherence packaging to use for the dispense Binding: MedicationDoseAids (example)
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (preferred): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationRequest.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
MedicationRequest.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0 from the FHIR Standard
MedicationRequest.statusReason	example	MedicationRequestStatusReasonCodes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0 from the FHIR Standard
MedicationRequest.category	example	MedicationRequestAdministrationLocationCodes http://hl7.org/fhir/ValueSet/medicationrequest-admin-location from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|5.0.0 from the FHIR Standard
MedicationRequest.medication	required	https://termgit.elga.gv.at/CodeSystem/asp-liste https://termgit.elga.gv.at/CodeSystem/asp-liste
MedicationRequest.performerType	extensible	MedicationIntendedPerformerRole http://hl7.org/fhir/ValueSet/medication-intended-performer-role from the FHIR Standard
MedicationRequest.reason	example	ConditionProblemDiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.courseOfTherapyType	extensible	MedicationRequestCourseOfTherapyCodes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|5.0.0 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|5.0.0 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	required	DaysOfWeek http://hl7.org/fhir/ValueSet/days-of-week|5.0.0 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	TimingAbbreviation http://hl7.org/fhir/ValueSet/timing-abbreviation from the FHIR Standard
MedicationRequest.dosageInstruction.asNeededFor	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureAdministrationSites http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://terminology.hl7.org/ValueSet/dose-rate-type
MedicationRequest.dispenseRequest.doseAdministrationAid	example	MedicationDoseAids http://hl7.org/fhir/ValueSet/medication-dose-aid from the FHIR Standard
MedicationRequest.substitution.allowed[x]	preferred	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse())
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()

This structure is derived from MedicationRequest

Summary

Mandatory: 4 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

• HL7® AT Core Patient Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.dose[x]
• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.rate[x]

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier		1..1	Identifier	MedicationRequest ID = {eMed-ID}_{locally assigned ID} | Verordnungs ID = {eMed-ID}_{lokal vergebene ID} ele-1: All FHIR elements must have a @value or children
groupIdentifier	Σ	1..1	Identifier	eMed-ID ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	For CDA compatability: always completed, even if the prescription is still be acted upon. | Für CDA-Kompatibilität: immer abgeschlossen, auch wenn das Rezept noch bearbeitet werden muss. Binding: MedicationrequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. ele-1: All FHIR elements must have a @value or children Required Pattern: completed
intent	?!Σ	1..1	code	The prescription represents a request/demand and authorization for action by the requestor. | Das Rezept stellt eine Anfrage/Anforderung und Ermächtigung zum Handeln durch den Antragsteller dar. Binding: MedicationRequestIntent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children Required Pattern: order
doNotPerform	?!Σ	0..1	boolean	True if patient is to stop taking or not to start taking the medication ele-1: All FHIR elements must have a @value or children
medication	Σ	1..1	CodeableReference(Medication)	Medication in conformance with the ELGA e-Medication used PZN (i.e. ASP-Liste). | Arzneimittel entsprechend der ELGA e-Medikation verwendet PZN (d.h. ASP-Liste). Binding: https://termgit.elga.gv.at/CodeSystem/asp-liste (required) ele-1: All FHIR elements must have a @value or children
concept	Σ	1..1	CodeableConcept	Reference to a concept (by class) ele-1: All FHIR elements must have a @value or children
subject	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Each MedicationRequest is associated with one HL7 Austria patient. | Jede Verordnung/MedicationRequest ist einem HL7 AustriaPatient zugewiesen. ele-1: All FHIR elements must have a @value or children
requester	Σ	1..1	Reference(Practitioner)	ToDo create austrian practitioner with hl7 austria. || The authorizing practitioner for this prescription, identified by their OID according to GDA Index. | Der approbierende Arzt für diese Verschreibung, identifiziert durch seine OID gemäß GDA-Index. ele-1: All FHIR elements must have a @value or children
note		0..*	Annotation	CDA eMed v2: ZINFO || not machine readable Information about the MedicationRequests | nicht maschinenlesbare Informationen über die Verordnung ele-1: All FHIR elements must have a @value or children
effectiveDosePeriod		0..1	Period	Period over which the medication is to be taken | Zeitraum, über den das Medikament eingenommen werden soll ele-1: All FHIR elements must have a @value or children
dosageInstruction		0..*	Dosage	One or more specific instructions for how the medication should be taken | Eine oder mehrere spezifische Anweisungen für die Einnahme des Medikaments ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
patientInstruction	Σ	0..1	string	CDA eMed v2: ALTEIN || Patient or consumer oriented instructions | Patienten- oder verbraucherorientierte Anweisungen ele-1: All FHIR elements must have a @value or children
asNeeded	ΣC	0..1	boolean	Take 'as needed' | Bedarfsmedikation ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationRequest.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0 from the FHIR Standard
MedicationRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0 from the FHIR Standard
MedicationRequest.medication	required	https://termgit.elga.gv.at/CodeSystem/asp-liste https://termgit.elga.gv.at/CodeSystem/asp-liste

Constraints

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

Differential View

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			MedicationRequest
identifier		1..1	Identifier	MedicationRequest ID = {eMed-ID}_{locally assigned ID} | Verordnungs ID = {eMed-ID}_{lokal vergebene ID}
groupIdentifier		1..1	Identifier	eMed-ID
status		1..1	code	For CDA compatability: always completed, even if the prescription is still be acted upon. | Für CDA-Kompatibilität: immer abgeschlossen, auch wenn das Rezept noch bearbeitet werden muss. Required Pattern: completed
intent		1..1	code	The prescription represents a request/demand and authorization for action by the requestor. | Das Rezept stellt eine Anfrage/Anforderung und Ermächtigung zum Handeln durch den Antragsteller dar. Required Pattern: order
medication		1..1	CodeableReference(Medication)	Medication in conformance with the ELGA e-Medication used PZN (i.e. ASP-Liste). | Arzneimittel entsprechend der ELGA e-Medikation verwendet PZN (d.h. ASP-Liste). Binding: https://termgit.elga.gv.at/CodeSystem/asp-liste (required)
concept		1..1	CodeableConcept	Reference to a concept (by class)
reference		0..0
subject		1..1	Reference(HL7® AT Core Patient Profile)	Each MedicationRequest is associated with one HL7 Austria patient. | Jede Verordnung/MedicationRequest ist einem HL7 AustriaPatient zugewiesen.
requester		1..1	Reference(Practitioner)	ToDo create austrian practitioner with hl7 austria. || The authorizing practitioner for this prescription, identified by their OID according to GDA Index. | Der approbierende Arzt für diese Verschreibung, identifiziert durch seine OID gemäß GDA-Index.
note		0..*	Annotation	CDA eMed v2: ZINFO || not machine readable Information about the MedicationRequests | nicht maschinenlesbare Informationen über die Verordnung
effectiveDosePeriod		0..1	Period	Period over which the medication is to be taken | Zeitraum, über den das Medikament eingenommen werden soll
dosageInstruction		0..*	Dosage	One or more specific instructions for how the medication should be taken | Eine oder mehrere spezifische Anweisungen für die Einnahme des Medikaments
patientInstruction		0..1	string	CDA eMed v2: ALTEIN || Patient or consumer oriented instructions | Patienten- oder verbraucherorientierte Anweisungen
timing
repeat
frequency		0..1	positiveInt	Repetitions within the period | Wiederholungen innerhalb der Dauer
period		0..1	decimal	A defined period with its duration to which the frequency applies | Ein bestimmter Zeitraum mit seiner Dauer, für den die Wiederholungen gelten
periodUnit		0..1	code	Unit of period | Einheit zur Dauer
when		0..*	code	Code for time period of occurrence | Code für die Eintrittszeitspanne Binding: EventTiming (required)
asNeeded		0..1	boolean	Take 'as needed' | Bedarfsmedikation
doseAndRate
Slices for dose[x]		0..1	Range, SimpleQuantity	Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity		0..1	SimpleQuantity	Amount of medication per dose
value		0..1	decimal	Quantity per intake | Menge pro Einnahme
unit		0..1	string	Unit for quantity per intake | Einheit zur Menge pro Einnahme
Slices for rate[x]		0..0
rate[x]:rateRatio		0..0
rate[x]:rateRange		0..0
rate[x]:rateQuantity		0..0
dispenseRequest
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized | Anzahl der genehmigten Einlösungen
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationRequest.medication	required	https://termgit.elga.gv.at/CodeSystem/asp-liste https://termgit.elga.gv.at/CodeSystem/asp-liste
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	MedicationRequest	Ordering of medication for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest ID = {eMed-ID}_{locally assigned ID} | Verordnungs ID = {eMed-ID}_{lokal vergebene ID}
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	A plan or request that is fulfilled in whole or in part by this medication request
priorPrescription		0..1	Reference(MedicationRequest)	Reference to an order/prescription that is being replaced by this MedicationRequest
groupIdentifier	Σ	1..1	Identifier	eMed-ID
status	?!Σ	1..1	code	For CDA compatability: always completed, even if the prescription is still be acted upon. | Für CDA-Kompatibilität: immer abgeschlossen, auch wenn das Rezept noch bearbeitet werden muss. Binding: MedicationrequestStatus (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. Required Pattern: completed
statusReason		0..1	CodeableConcept	Reason for current status Binding: MedicationRequestStatusReasonCodes (example): Identifies the reasons for a given status.
statusChanged		0..1	dateTime	When the status was changed
intent	?!Σ	1..1	code	The prescription represents a request/demand and authorization for action by the requestor. | Das Rezept stellt eine Anfrage/Anforderung und Ermächtigung zum Handeln durch den Antragsteller dar. Binding: MedicationRequestIntent (required): The kind of medication order. Required Pattern: order
category		0..*	CodeableConcept	Grouping or category of medication request Binding: MedicationRequestAdministrationLocationCodes (example): A coded concept identifying where the medication is to be consumed or administered.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if patient is to stop taking or not to start taking the medication
medication	Σ	1..1	CodeableReference(Medication)	Medication in conformance with the ELGA e-Medication used PZN (i.e. ASP-Liste). | Arzneimittel entsprechend der ELGA e-Medikation verwendet PZN (d.h. ASP-Liste). Binding: https://termgit.elga.gv.at/CodeSystem/asp-liste (required)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
concept	Σ	1..1	CodeableConcept	Reference to a concept (by class)
subject	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Each MedicationRequest is associated with one HL7 Austria patient. | Jede Verordnung/MedicationRequest ist einem HL7 AustriaPatient zugewiesen.
informationSource		0..*	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)	The person or organization who provided the information about this request, if the source is someone other than the requestor
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support fulfilling of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	1..1	Reference(Practitioner)	ToDo create austrian practitioner with hl7 austria. || The authorizing practitioner for this prescription, identified by their OID according to GDA Index. | Der approbierende Arzt für diese Verschreibung, identifiziert durch seine OID gemäß GDA-Index.
reported	Σ	0..1	boolean	Reported rather than primary record
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: MedicationIntendedPerformerRole (extensible): Identifies the type of individual that is desired to administer the medication.
performer		0..*	Reference(Practitioner | PractitionerRole | Organization | Patient | DeviceDefinition | RelatedPerson | CareTeam | HealthcareService)	Intended performer of administration
device		0..*	CodeableReference(DeviceDefinition)	Intended type of device for the administration
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reason		0..*	CodeableReference(Condition | Observation)	Reason or indication for ordering or not ordering the medication Binding: ConditionProblemDiagnosisCodes (example): A coded concept indicating why the medication was ordered.
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: MedicationRequestCourseOfTherapyCodes (extensible): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	CDA eMed v2: ZINFO || not machine readable Information about the MedicationRequests | nicht maschinenlesbare Informationen über die Verordnung
renderedDosageInstruction		0..1	markdown	Full representation of the dosage instructions
effectiveDosePeriod		0..1	Period	Period over which the medication is to be taken | Zeitraum, über den das Medikament eingenommen werden soll
dosageInstruction		0..*	Dosage	One or more specific instructions for how the medication should be taken | Eine oder mehrere spezifische Anweisungen für die Einnahme des Medikaments
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	CDA eMed v2: ALTEIN || Patient or consumer oriented instructions | Patienten- oder verbraucherorientierte Anweisungen
timing	Σ	0..1	Timing	When medication should be administered
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
event	Σ	0..*	dateTime	When the event occurs
repeat	ΣC	0..1	Element	When the event is to occur tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x]	Σ	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
count	ΣC	0..1	positiveInt	Number of times to repeat
countMax	ΣC	0..1	positiveInt	Maximum number of times to repeat
duration	ΣC	0..1	decimal	How long when it happens
durationMax	ΣC	0..1	decimal	How long when it happens (Max)
durationUnit	ΣC	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	Σ	0..1	positiveInt	Repetitions within the period | Wiederholungen innerhalb der Dauer
frequencyMax	Σ	0..1	positiveInt	Event occurs up to frequencyMax times per period
period	ΣC	0..1	decimal	A defined period with its duration to which the frequency applies | Ein bestimmter Zeitraum mit seiner Dauer, für den die Wiederholungen gelten
periodMax	ΣC	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	ΣC	0..1	code	Unit of period | Einheit zur Dauer Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	ΣC	0..*	time	Time of day for action
when	ΣC	0..*	code	Code for time period of occurrence | Code für die Eintrittszeitspanne Binding: EventTiming (required)
offset	ΣC	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	C | BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded	ΣC	0..1	boolean	Take 'as needed' | Bedarfsmedikation
asNeededFor	ΣC	0..*	CodeableConcept	Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureAdministrationSites (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered, to be administered or typical amount to be administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x]	Σ	0..1		Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
dose[x]:doseQuantity	Σ	0..1	SimpleQuantity	Amount of medication per dose
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Quantity per intake | Menge pro Einnahme
unit	Σ	0..1	string	Unit for quantity per intake | Einheit zur Menge pro Einnahme
system	ΣC	0..1	uri	System that defines coded unit form
code	ΣC	0..1	code	Coded form of the unit
maxDosePerPeriod	Σ	0..*	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed		0..1	unsignedInt	Number of refills authorized | Anzahl der genehmigten Einlösungen
quantity		0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
dispenser		0..1	Reference(Organization)	Intended performer of dispense
dispenserInstruction		0..*	Annotation	Additional information for the dispenser
doseAdministrationAid		0..1	CodeableConcept	Type of adherence packaging to use for the dispense Binding: MedicationDoseAids (example)
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (preferred): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationRequest.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
MedicationRequest.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0 from the FHIR Standard
MedicationRequest.statusReason	example	MedicationRequestStatusReasonCodes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0 from the FHIR Standard
MedicationRequest.category	example	MedicationRequestAdministrationLocationCodes http://hl7.org/fhir/ValueSet/medicationrequest-admin-location from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|5.0.0 from the FHIR Standard
MedicationRequest.medication	required	https://termgit.elga.gv.at/CodeSystem/asp-liste https://termgit.elga.gv.at/CodeSystem/asp-liste
MedicationRequest.performerType	extensible	MedicationIntendedPerformerRole http://hl7.org/fhir/ValueSet/medication-intended-performer-role from the FHIR Standard
MedicationRequest.reason	example	ConditionProblemDiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.courseOfTherapyType	extensible	MedicationRequestCourseOfTherapyCodes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|5.0.0 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|5.0.0 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	required	DaysOfWeek http://hl7.org/fhir/ValueSet/days-of-week|5.0.0 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	TimingAbbreviation http://hl7.org/fhir/ValueSet/timing-abbreviation from the FHIR Standard
MedicationRequest.dosageInstruction.asNeededFor	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureAdministrationSites http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://terminology.hl7.org/ValueSet/dose-rate-type
MedicationRequest.dispenseRequest.doseAdministrationAid	example	MedicationDoseAids http://hl7.org/fhir/ValueSet/medication-dose-aid from the FHIR Standard
MedicationRequest.substitution.allowed[x]	preferred	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse())
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()

This structure is derived from MedicationRequest

Summary

Mandatory: 4 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

• HL7® AT Core Patient Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.dose[x]
• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.doseAndRate.rate[x]

Other representations of profile: CSV, Excel, Schematron