MedicationRequest

This topic describes information for the MedicationRequest resource.

To interact with the REST endpoints in the MedicationRequest resource, see MedicationRequest.

Overview

The MedicationRequest resource provides orders for all medications with administration instructions for a patient in both the inpatient and outpatient settings (orders or prescriptions filled by a pharmacy and discharge medication orders). This resource also includes a patient's historical or documented home medications reported by the patient, significant other, or another provider.

If the medication request represents a prescription the patient takes at home, then the start, stop, and other information may not be a representation of when the medication was taken. For example, the system may not know if the patient ever filled or took the prescribed medication, or when the prescription was filled. Documented historical, past, and home medications are commonly captured when taking the patient's medical history.

This resource supports the following HL7 FHIR US Core Implementation Guide STU 4.0.0 profile:

• US Core MedicationRequest Profile

The following fields are returned if valued:

• MedicationRequest ID

• Extensions (for more information, see the Extensions section of this topic)

• Status

• Status Reason

• Intent

  • Details in Implementation Notes sections for reads and searches.

• Identifier

• Category

• Priority

• Reported Boolean

• Medication

  • medicationCodeableConcept | CodeableConcept

  • medicationReference | Reference (Medication)

• Patient

• Encounter

• Authored on Date

• Requester

  • Reference (Practitioner)

• Reason Code

• Course of Therapy Type

• Note

  • Annotation

• author

  • Reference (Practitioner) | string

• Dosage Instructions

  • Text

  • Additional Instructions

  • Patient Instructions

  • Timing Schedule

• Timing

  • code | CodeableConcept

  • repeat | Element

  • duration | decimal

  • durationUnit | code

  • bounds

• boundsPeriod | Period

  • As Needed

  • Body Site

  • Route

  • Dose and Rate

• doseAndRate.doseQuantity

• doseAndRate.rateQuantity

• Dispensing Details

  • Validity Period

  • initialFill Quantity

  • Number of Refills

  • Dispense Interval

  • Dispense Quantity

  • Expected Days Supply per Dispense

  • Intended Dispenser

• Substitution

  • Allowed Boolean

• Prior Prescription

Terminology Bindings

• MedicationRequest.status

  Description: The current state of the medication request.

  Details: MedicationRequest Status

  System: http://hl7.org/fhir/CodeSystem/medicationrequest-status

• MedicationRequest.statusReason

  Description: The reason for the current status.

  • Details: MedicationRequest Status Reason Codes

    System: http://terminology.hl7.org/CodeSystem/medicationrequest-status-reason

  • Details: For more information, see Code Set 1309 Cancel Reasons under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/1309

  • Details: For more information, see Code Set 4001970 Void Order Reasons under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/4001970

• MedicationRequest.category

  Description: The type of medication request.

  • Details: Medication Request Category Codes

    System: http://terminology.hl7.org/CodeSystem/medicationrequest-category

  • Details: Medication Usage Category Codes

    System: http://terminology.hl7.org/CodeSystem/medication-statement-category

  • Details: For more information, see Medication Request Category under the Proprietary Systems section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/medicationrequest-category

• MedicationRequest.priority

  Description: The medication request priority.

  Details: Request Priority

  System: http://hl7.org/fhir/request-priority

• MedicationRequest.medication[x]

  Description: A code that defines the medication.

  • Details: RxNorm

    System: http://www.nlm.nih.gov/research/umls/rxnorm

  • Details: For more information, see Medication Request Synonym under the Proprietary Systems section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/synonym

• MedicationRequest.reasonCode

  Description: The reason why the medication is or was taken.

  • Details: SNOMED CT

    System: http://snomed.info/sct

  • Details: ICD-9-cm

    System: http://hl7.org/fhir/sid/icd-9-cm

  • Details: ICD-10

    System: http://hl7.org/fhir/sid/icd-10

• MedicationRequest.dosageInstruction.timing.code

  Description: A code for a known or defined timing pattern.

  • Details: TimingAbbreviation

    System: http://terminology.hl7.org/CodeSystem/v3-GTSAbbreviation

  • Details: SNOMED CT

    System: http://snomed.info/sct

  • Details: For more information, see Code Set 4003 Frequency under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/4003

• MedicationRequest.dosageInstruction.asNeeded[x]

  Description: Indicates whether the medication is only taken when needed or the preconditions for taking the medication.

  • Details: SNOMED CT

    System: http://snomed.info/sct

  • Details: For more information, see Code Set 4005 Reason For Medication under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/4005

• MedicationRequest.dosageInstruction.site

  Description: The anatomic site where the medication first enters the body.

  • Details: SNOMED CT

    System: http://snomed.info/sct

  • Details: For more information, see Code Set 1028 Body Site under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/1028

• MedicationRequest.dosageInstruction.route

  Description: The route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

  • Details: SNOMED CT

    System: http://snomed.info/sct

  • Details: For more information, see Code Set 4001 Medication Administration Route under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/4001

Contained Medication Bindings

• Medication.code

  Description: A code that defines the medication.

  Details: RxNorm

  System: http://www.nlm.nih.gov/research/umls/rxnorm

• Medication.form

  Description: The form of the item.

  • Details: SNOMED CT

    System: http://snomed.info/sct

  • Details: For more information, see Code Set 4002 Form under the List of Code Sets section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/codeSet/4002

  • Details: For more information, see Medication Request Synonym under the Proprietary Systems section in Proprietary Codes and Systems.

    System: https://fhir.cerner.com/<EHR_source_id>/Synonym

Extensions

All URLs for custom extensions are defined as https://fhir-ehr.cerner.com/r4/StructureDefinition/{id}

ID	Value[x] Type	Description
clinical-instruction	String	Extension to MedicationRequest.dosageInstruction. Represents instructions for an order that are intended for healthcare providers.
pharmacy-verification-status	CodeableConcept	Represents whether a medication request was verified by a pharmacist. Supported values are Does not need pharmacy verification, Needs pharmacy verification, or Rejected by pharmacy.

Swedish Extensions

All URLs for Swedish extensions are defined as http://electronichealth.se/fhir/StructureDefinition/{id}

ID	Value[x] Type	Description
NLLPrescriptionFormat	Coding	Current prescription format.
NLLRegistrationBasis	Coding	Format for prescription registration.
NLLDosePackaging	Boolean	Dose dispensed prescription.
NLLConditionsPharmaceuticalBenefitsAct	Boolean	Pharmaceutical benefits act conditions.