This page is part of the FHIR Specification (v4.3.0: R4B - STU). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

11.1 Resource MedicationRequest - Content

Pharmacy

Work Group

Maturity Level: 3

Trial Use

Security Category: Patient

Compartments: Encounter, Patient, Practitioner

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.

11.1.1 Scope and Usage

This resource covers all type of orders for medications for a patient. This includes inpatient medication orders as well as community orders (whether filled by the prescriber or by a pharmacy). It also includes orders for over-the-counter medications (e.g. Aspirin), total parenteral nutrition and diet/ vitamin supplements. It may be used to support the order of medication-related devices. It is not intended for use in prescribing particular diets, or for ordering non-medication-related items (eyeglasses, supplies, etc.). In addition, the MedicationRequest may be used to report orders/request from external systems that have been reported for informational purposes and are not authoritative and are not expected to be acted upon (e.g. dispensed or administered).

The MedicationRequest resource is a "request" resource from a FHIR workflow perspective - see Workflow Request.

The MedicationRequest resource allows requesting only a single medication. If a workflow requires requesting multiple items simultaneously, this is done using multiple instances of this resource. These instances can be linked in different ways, depending on the needs of the workflow. For guidance, refer to the Request pattern

11.1.2 Boundaries and Relationships

The MedicationRequest resource is used to request or order medication for a subject. It may also be used to report a medication request or order from one organization or source to another. When requesting supplies or devices when there is a patient focus or instructions regarding their use, SupplyRequest or DeviceRequest should be used instead. When reporting on the usage of a medication by a patient, the MedicationStatementt resource should be used.

The Medication domain includes a number of related resources

MedicationRequest	An order for both supply of the medication and the instructions for administration of the medicine to a patient.
MedicationDispense	Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription).
MedicationAdministration	When a patient actually consumes a medicine, or it is otherwise administered to them
MedicationStatement	This is a record of medication being taken by a patient, or that the medication has been given to a patient where the record is the result of a report from the patient, or another clinician. A medication statement is not a part of the prescribe->dispense->administer sequence but is a report that such a sequence (or at least a part of it) did take place resulting in a belief that the patient has received a particular medication.

11.1.3 References

This resource is referenced by CarePlan, Claim, DiagnosticReport, ExplanationOfBenefit, MedicationAdministration, MedicationDispense, itself, MedicationStatement, Observation and ServiceRequest.

This resource implements the Request pattern.

Structure

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	TU		DomainResource	Ordering of medication for patient or group Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier		0..*	Identifier	External ids for this request
status	?!Σ	1..1	code	active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown medicationrequest Status (Required)
statusReason		0..1	CodeableConcept	Reason for current status medicationRequest Status Reason Codes (Example)
intent	?!Σ	1..1	code	proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option medicationRequest Intent (Required)
category		0..*	CodeableConcept	Type of medication usage medicationRequest Category Codes (Example)
priority	Σ	0..1	code	routine \| urgent \| asap \| stat RequestPriority (Required)
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
medication[x]	Σ	1..1		Medication to be taken SNOMED CT Medication Codes (Example)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
subject	Σ	1..1	Reference(Patient \| Group)	Who or group medication request is for
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Any)	Information to support ordering of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Procedure Performer Role Codes (Example)
recorder		0..1	Reference(Practitioner \| PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Condition/Problem/Diagnosis Codes (Example)
reasonReference		0..*	Reference(Condition \| Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration medicationRequest Course of Therapy Codes (Example)
insurance		0..*	Reference(Coverage \| ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction		0..*	Dosage	How the medication should be taken
dispenseRequest		0..1	BackboneElement	Medication supply authorization
initialFill		0..1	BackboneElement	First fill details
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
quantity		0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
allowed[x]		1..1		Whether substitution is allowed or not ActSubstanceAdminSubstitutionCode (Example)
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made SubstanceAdminSubstitutionReason (Example)
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

UML Diagram (Legend)

XML Template

<MedicationRequest xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External ids for this request --></identifier>
 <status value="[code]"/><!-- 1..1 active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <intent value="[code]"/><!-- 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option -->
 <category><!-- 0..* CodeableConcept Type of medication usage --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if request is prohibiting action -->
 <reported[x]><!-- 0..1 boolean|Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Reported rather than primary record --></reported[x]>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Medication to be taken --></medication[x]>
 <subject><!-- 1..1 Reference(Group|Patient) Who or group medication request is for --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Information to support ordering of the medication --></supportingInformation>
 <authoredOn value="[dateTime]"/><!-- 0..1 When request was initially authored -->
 <requester><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who/What requested the Request --></requester>
 <performer><!-- 0..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Intended performer of administration --></performer>
 <performerType><!-- 0..1 CodeableConcept Desired kind of performer of the medication administration --></performerType>
 <recorder><!-- 0..1 Reference(Practitioner|PractitionerRole) Person who entered the request --></recorder>
 <reasonCode><!-- 0..* CodeableConcept Reason or indication for ordering or not ordering the medication --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) Condition or observation that supports why the prescription is being written --></reasonReference>
 <instantiatesCanonical value="[canonical]"/><!-- 0..* Instantiates FHIR protocol or definition -->
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <basedOn><!-- 0..* Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) What request fulfills --></basedOn>
 <groupIdentifier><!-- 0..1 Identifier Composite request this is part of --></groupIdentifier>
 <courseOfTherapyType><!-- 0..1 CodeableConcept Overall pattern of medication administration --></courseOfTherapyType>
 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <note><!-- 0..* Annotation Information about the prescription --></note>
 <dosageInstruction><!-- 0..* Dosage How the medication should be taken --></dosageInstruction>
 <dispenseRequest>  <!-- 0..1 Medication supply authorization -->
  <initialFill>  <!-- 0..1 First fill details -->
   <quantity><!-- 0..1 Quantity(SimpleQuantity) First fill quantity --></quantity>
   <duration><!-- 0..1 Duration First fill duration --></duration>
  </initialFill>
  <dispenseInterval><!-- 0..1 Duration Minimum period of time between dispenses --></dispenseInterval>
  <validityPeriod><!-- 0..1 Period Time period supply is authorized for --></validityPeriod>
  <numberOfRepeatsAllowed value="[unsignedInt]"/><!-- 0..1 Number of refills authorized -->
  <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of medication to supply per dispense --></quantity>
  <expectedSupplyDuration><!-- 0..1 Duration Number of days supply per dispense --></expectedSupplyDuration>
  <performer><!-- 0..1 Reference(Organization) Intended dispenser --></performer>
 </dispenseRequest>
 <substitution>  <!-- 0..1 Any restrictions on medication substitution -->
  <allowed[x]><!-- 1..1 boolean|CodeableConcept Whether substitution is allowed or not  --></allowed[x]>
  <reason><!-- 0..1 CodeableConcept Why should (not) substitution be made  --></reason>
 </substitution>
 <priorPrescription><!-- 0..1 Reference(MedicationRequest) An order/prescription that is being replaced --></priorPrescription>
 <detectedIssue><!-- 0..* Reference(DetectedIssue) Clinical Issue with action --></detectedIssue>
 <eventHistory><!-- 0..* Reference(Provenance) A list of events of interest in the lifecycle --></eventHistory>
</MedicationRequest>

JSON Template

{
  "resourceType" : "MedicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External ids for this request
  "status" : "<code>", // R!  active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
  "statusReason" : { CodeableConcept }, // Reason for current status
  "intent" : "<code>", // R!  proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  "category" : [{ CodeableConcept }], // Type of medication usage
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if request is prohibiting action
  // reported[x]: Reported rather than primary record. One of these 2:
  "reportedBoolean" : <boolean>,
  "reportedReference" : { Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) },
  // medication[x]: Medication to be taken. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Group|Patient) }, // R!  Who or group medication request is for
  "encounter" : { Reference(Encounter) }, // Encounter created as part of encounter/admission/stay
  "supportingInformation" : [{ Reference(Any) }], // Information to support ordering of the medication
  "authoredOn" : "<dateTime>", // When request was initially authored
  "requester" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who/What requested the Request
  "performer" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Intended performer of administration
  "performerType" : { CodeableConcept }, // Desired kind of performer of the medication administration
  "recorder" : { Reference(Practitioner|PractitionerRole) }, // Person who entered the request
  "reasonCode" : [{ CodeableConcept }], // Reason or indication for ordering or not ordering the medication
  "reasonReference" : [{ Reference(Condition|Observation) }], // Condition or observation that supports why the prescription is being written
  "instantiatesCanonical" : ["<canonical>"], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "basedOn" : [{ Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) }], // What request fulfills
  "groupIdentifier" : { Identifier }, // Composite request this is part of
  "courseOfTherapyType" : { CodeableConcept }, // Overall pattern of medication administration
  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "note" : [{ Annotation }], // Information about the prescription
  "dosageInstruction" : [{ Dosage }], // How the medication should be taken
  "dispenseRequest" : { // Medication supply authorization
    "initialFill" : { // First fill details
      "quantity" : { Quantity(SimpleQuantity) }, // First fill quantity
      "duration" : { Duration } // First fill duration
    },
    "dispenseInterval" : { Duration }, // Minimum period of time between dispenses
    "validityPeriod" : { Period }, // Time period supply is authorized for
    "numberOfRepeatsAllowed" : "<unsignedInt>", // Number of refills authorized
    "quantity" : { Quantity(SimpleQuantity) }, // Amount of medication to supply per dispense
    "expectedSupplyDuration" : { Duration }, // Number of days supply per dispense
    "performer" : { Reference(Organization) } // Intended dispenser
  },
  "substitution" : { // Any restrictions on medication substitution
    // allowed[x]: Whether substitution is allowed or not. One of these 2:
    "allowedBoolean" : <boolean>,
    "allowedCodeableConcept" : { CodeableConcept },
    "reason" : { CodeableConcept } // Why should (not) substitution be made 
  },
  "priorPrescription" : { Reference(MedicationRequest) }, // An order/prescription that is being replaced
  "detectedIssue" : [{ Reference(DetectedIssue) }], // Clinical Issue with action
  "eventHistory" : [{ Reference(Provenance) }] // A list of events of interest in the lifecycle
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:MedicationRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationRequest.identifier [ Identifier ], ... ; # 0..* External ids for this request
  fhir:MedicationRequest.status [ code ]; # 1..1 active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
  fhir:MedicationRequest.statusReason [ CodeableConcept ]; # 0..1 Reason for current status
  fhir:MedicationRequest.intent [ code ]; # 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:MedicationRequest.category [ CodeableConcept ], ... ; # 0..* Type of medication usage
  fhir:MedicationRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat
  fhir:MedicationRequest.doNotPerform [ boolean ]; # 0..1 True if request is prohibiting action
  # MedicationRequest.reported[x] : 0..1 Reported rather than primary record. One of these 2
    fhir:MedicationRequest.reportedBoolean [ boolean ]
    fhir:MedicationRequest.reportedReference [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]
  # MedicationRequest.medication[x] : 1..1 Medication to be taken. One of these 2
    fhir:MedicationRequest.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationRequest.medicationReference [ Reference(Medication) ]
  fhir:MedicationRequest.subject [ Reference(Group|Patient) ]; # 1..1 Who or group medication request is for
  fhir:MedicationRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter created as part of encounter/admission/stay
  fhir:MedicationRequest.supportingInformation [ Reference(Any) ], ... ; # 0..* Information to support ordering of the medication
  fhir:MedicationRequest.authoredOn [ dateTime ]; # 0..1 When request was initially authored
  fhir:MedicationRequest.requester [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who/What requested the Request
  fhir:MedicationRequest.performer [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Intended performer of administration
  fhir:MedicationRequest.performerType [ CodeableConcept ]; # 0..1 Desired kind of performer of the medication administration
  fhir:MedicationRequest.recorder [ Reference(Practitioner|PractitionerRole) ]; # 0..1 Person who entered the request
  fhir:MedicationRequest.reasonCode [ CodeableConcept ], ... ; # 0..* Reason or indication for ordering or not ordering the medication
  fhir:MedicationRequest.reasonReference [ Reference(Condition|Observation) ], ... ; # 0..* Condition or observation that supports why the prescription is being written
  fhir:MedicationRequest.instantiatesCanonical [ canonical ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:MedicationRequest.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:MedicationRequest.basedOn [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ], ... ; # 0..* What request fulfills
  fhir:MedicationRequest.groupIdentifier [ Identifier ]; # 0..1 Composite request this is part of
  fhir:MedicationRequest.courseOfTherapyType [ CodeableConcept ]; # 0..1 Overall pattern of medication administration
  fhir:MedicationRequest.insurance [ Reference(ClaimResponse|Coverage) ], ... ; # 0..* Associated insurance coverage
  fhir:MedicationRequest.note [ Annotation ], ... ; # 0..* Information about the prescription
  fhir:MedicationRequest.dosageInstruction [ Dosage ], ... ; # 0..* How the medication should be taken
  fhir:MedicationRequest.dispenseRequest [ # 0..1 Medication supply authorization
    fhir:MedicationRequest.dispenseRequest.initialFill [ # 0..1 First fill details
      fhir:MedicationRequest.dispenseRequest.initialFill.quantity [ Quantity(SimpleQuantity) ]; # 0..1 First fill quantity
      fhir:MedicationRequest.dispenseRequest.initialFill.duration [ Duration ]; # 0..1 First fill duration
    ];
    fhir:MedicationRequest.dispenseRequest.dispenseInterval [ Duration ]; # 0..1 Minimum period of time between dispenses
    fhir:MedicationRequest.dispenseRequest.validityPeriod [ Period ]; # 0..1 Time period supply is authorized for
    fhir:MedicationRequest.dispenseRequest.numberOfRepeatsAllowed [ unsignedInt ]; # 0..1 Number of refills authorized
    fhir:MedicationRequest.dispenseRequest.quantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of medication to supply per dispense
    fhir:MedicationRequest.dispenseRequest.expectedSupplyDuration [ Duration ]; # 0..1 Number of days supply per dispense
    fhir:MedicationRequest.dispenseRequest.performer [ Reference(Organization) ]; # 0..1 Intended dispenser
  ];
  fhir:MedicationRequest.substitution [ # 0..1 Any restrictions on medication substitution
    # MedicationRequest.substitution.allowed[x] : 1..1 Whether substitution is allowed or not. One of these 2
      fhir:MedicationRequest.substitution.allowedBoolean [ boolean ]
      fhir:MedicationRequest.substitution.allowedCodeableConcept [ CodeableConcept ]
    fhir:MedicationRequest.substitution.reason [ CodeableConcept ]; # 0..1 Why should (not) substitution be made
  ];
  fhir:MedicationRequest.priorPrescription [ Reference(MedicationRequest) ]; # 0..1 An order/prescription that is being replaced
  fhir:MedicationRequest.detectedIssue [ Reference(DetectedIssue) ], ... ; # 0..* Clinical Issue with action
  fhir:MedicationRequest.eventHistory [ Reference(Provenance) ], ... ; # 0..* A list of events of interest in the lifecycle
]

Changes since R4

MedicationRequest

No Changes

See the Full Difference for further information

This analysis is available as XML or JSON.

Conversions between R3 and R4

See R3 <--> R4 Conversion Maps (status = 36 tests that all execute ok. 8 fail round-trip testing and 36 r3 resources are invalid (0 errors).)

Structure

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	TU		DomainResource	Ordering of medication for patient or group Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier		0..*	Identifier	External ids for this request
status	?!Σ	1..1	code	active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown medicationrequest Status (Required)
statusReason		0..1	CodeableConcept	Reason for current status medicationRequest Status Reason Codes (Example)
intent	?!Σ	1..1	code	proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option medicationRequest Intent (Required)
category		0..*	CodeableConcept	Type of medication usage medicationRequest Category Codes (Example)
priority	Σ	0..1	code	routine \| urgent \| asap \| stat RequestPriority (Required)
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
medication[x]	Σ	1..1		Medication to be taken SNOMED CT Medication Codes (Example)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
subject	Σ	1..1	Reference(Patient \| Group)	Who or group medication request is for
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Any)	Information to support ordering of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson \| CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Procedure Performer Role Codes (Example)
recorder		0..1	Reference(Practitioner \| PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Condition/Problem/Diagnosis Codes (Example)
reasonReference		0..*	Reference(Condition \| Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan \| MedicationRequest \| ServiceRequest \| ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration medicationRequest Course of Therapy Codes (Example)
insurance		0..*	Reference(Coverage \| ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction		0..*	Dosage	How the medication should be taken
dispenseRequest		0..1	BackboneElement	Medication supply authorization
initialFill		0..1	BackboneElement	First fill details
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
quantity		0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
allowed[x]		1..1		Whether substitution is allowed or not ActSubstanceAdminSubstitutionCode (Example)
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made SubstanceAdminSubstitutionReason (Example)
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

UML Diagram (Legend)

XML Template

<MedicationRequest xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External ids for this request --></identifier>
 <status value="[code]"/><!-- 1..1 active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown -->
 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <intent value="[code]"/><!-- 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option -->
 <category><!-- 0..* CodeableConcept Type of medication usage --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if request is prohibiting action -->
 <reported[x]><!-- 0..1 boolean|Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Reported rather than primary record --></reported[x]>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Medication to be taken --></medication[x]>
 <subject><!-- 1..1 Reference(Group|Patient) Who or group medication request is for --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter created as part of encounter/admission/stay --></encounter>
 <supportingInformation><!-- 0..* Reference(Any) Information to support ordering of the medication --></supportingInformation>
 <authoredOn value="[dateTime]"/><!-- 0..1 When request was initially authored -->
 <requester><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who/What requested the Request --></requester>
 <performer><!-- 0..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Intended performer of administration --></performer>
 <performerType><!-- 0..1 CodeableConcept Desired kind of performer of the medication administration --></performerType>
 <recorder><!-- 0..1 Reference(Practitioner|PractitionerRole) Person who entered the request --></recorder>
 <reasonCode><!-- 0..* CodeableConcept Reason or indication for ordering or not ordering the medication --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) Condition or observation that supports why the prescription is being written --></reasonReference>
 <instantiatesCanonical value="[canonical]"/><!-- 0..* Instantiates FHIR protocol or definition -->
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <basedOn><!-- 0..* Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) What request fulfills --></basedOn>
 <groupIdentifier><!-- 0..1 Identifier Composite request this is part of --></groupIdentifier>
 <courseOfTherapyType><!-- 0..1 CodeableConcept Overall pattern of medication administration --></courseOfTherapyType>
 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <note><!-- 0..* Annotation Information about the prescription --></note>
 <dosageInstruction><!-- 0..* Dosage How the medication should be taken --></dosageInstruction>
 <dispenseRequest>  <!-- 0..1 Medication supply authorization -->
  <initialFill>  <!-- 0..1 First fill details -->
   <quantity><!-- 0..1 Quantity(SimpleQuantity) First fill quantity --></quantity>
   <duration><!-- 0..1 Duration First fill duration --></duration>
  </initialFill>
  <dispenseInterval><!-- 0..1 Duration Minimum period of time between dispenses --></dispenseInterval>
  <validityPeriod><!-- 0..1 Period Time period supply is authorized for --></validityPeriod>
  <numberOfRepeatsAllowed value="[unsignedInt]"/><!-- 0..1 Number of refills authorized -->
  <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of medication to supply per dispense --></quantity>
  <expectedSupplyDuration><!-- 0..1 Duration Number of days supply per dispense --></expectedSupplyDuration>
  <performer><!-- 0..1 Reference(Organization) Intended dispenser --></performer>
 </dispenseRequest>
 <substitution>  <!-- 0..1 Any restrictions on medication substitution -->
  <allowed[x]><!-- 1..1 boolean|CodeableConcept Whether substitution is allowed or not  --></allowed[x]>
  <reason><!-- 0..1 CodeableConcept Why should (not) substitution be made  --></reason>
 </substitution>
 <priorPrescription><!-- 0..1 Reference(MedicationRequest) An order/prescription that is being replaced --></priorPrescription>
 <detectedIssue><!-- 0..* Reference(DetectedIssue) Clinical Issue with action --></detectedIssue>
 <eventHistory><!-- 0..* Reference(Provenance) A list of events of interest in the lifecycle --></eventHistory>
</MedicationRequest>

JSON Template

{
  "resourceType" : "MedicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External ids for this request
  "status" : "<code>", // R!  active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
  "statusReason" : { CodeableConcept }, // Reason for current status
  "intent" : "<code>", // R!  proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  "category" : [{ CodeableConcept }], // Type of medication usage
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if request is prohibiting action
  // reported[x]: Reported rather than primary record. One of these 2:
  "reportedBoolean" : <boolean>,
  "reportedReference" : { Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) },
  // medication[x]: Medication to be taken. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Group|Patient) }, // R!  Who or group medication request is for
  "encounter" : { Reference(Encounter) }, // Encounter created as part of encounter/admission/stay
  "supportingInformation" : [{ Reference(Any) }], // Information to support ordering of the medication
  "authoredOn" : "<dateTime>", // When request was initially authored
  "requester" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who/What requested the Request
  "performer" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Intended performer of administration
  "performerType" : { CodeableConcept }, // Desired kind of performer of the medication administration
  "recorder" : { Reference(Practitioner|PractitionerRole) }, // Person who entered the request
  "reasonCode" : [{ CodeableConcept }], // Reason or indication for ordering or not ordering the medication
  "reasonReference" : [{ Reference(Condition|Observation) }], // Condition or observation that supports why the prescription is being written
  "instantiatesCanonical" : ["<canonical>"], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "basedOn" : [{ Reference(CarePlan|ImmunizationRecommendation|
   MedicationRequest|ServiceRequest) }], // What request fulfills
  "groupIdentifier" : { Identifier }, // Composite request this is part of
  "courseOfTherapyType" : { CodeableConcept }, // Overall pattern of medication administration
  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "note" : [{ Annotation }], // Information about the prescription
  "dosageInstruction" : [{ Dosage }], // How the medication should be taken
  "dispenseRequest" : { // Medication supply authorization
    "initialFill" : { // First fill details
      "quantity" : { Quantity(SimpleQuantity) }, // First fill quantity
      "duration" : { Duration } // First fill duration
    },
    "dispenseInterval" : { Duration }, // Minimum period of time between dispenses
    "validityPeriod" : { Period }, // Time period supply is authorized for
    "numberOfRepeatsAllowed" : "<unsignedInt>", // Number of refills authorized
    "quantity" : { Quantity(SimpleQuantity) }, // Amount of medication to supply per dispense
    "expectedSupplyDuration" : { Duration }, // Number of days supply per dispense
    "performer" : { Reference(Organization) } // Intended dispenser
  },
  "substitution" : { // Any restrictions on medication substitution
    // allowed[x]: Whether substitution is allowed or not. One of these 2:
    "allowedBoolean" : <boolean>,
    "allowedCodeableConcept" : { CodeableConcept },
    "reason" : { CodeableConcept } // Why should (not) substitution be made 
  },
  "priorPrescription" : { Reference(MedicationRequest) }, // An order/prescription that is being replaced
  "detectedIssue" : [{ Reference(DetectedIssue) }], // Clinical Issue with action
  "eventHistory" : [{ Reference(Provenance) }] // A list of events of interest in the lifecycle
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:MedicationRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationRequest.identifier [ Identifier ], ... ; # 0..* External ids for this request
  fhir:MedicationRequest.status [ code ]; # 1..1 active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
  fhir:MedicationRequest.statusReason [ CodeableConcept ]; # 0..1 Reason for current status
  fhir:MedicationRequest.intent [ code ]; # 1..1 proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:MedicationRequest.category [ CodeableConcept ], ... ; # 0..* Type of medication usage
  fhir:MedicationRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat
  fhir:MedicationRequest.doNotPerform [ boolean ]; # 0..1 True if request is prohibiting action
  # MedicationRequest.reported[x] : 0..1 Reported rather than primary record. One of these 2
    fhir:MedicationRequest.reportedBoolean [ boolean ]
    fhir:MedicationRequest.reportedReference [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]
  # MedicationRequest.medication[x] : 1..1 Medication to be taken. One of these 2
    fhir:MedicationRequest.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationRequest.medicationReference [ Reference(Medication) ]
  fhir:MedicationRequest.subject [ Reference(Group|Patient) ]; # 1..1 Who or group medication request is for
  fhir:MedicationRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter created as part of encounter/admission/stay
  fhir:MedicationRequest.supportingInformation [ Reference(Any) ], ... ; # 0..* Information to support ordering of the medication
  fhir:MedicationRequest.authoredOn [ dateTime ]; # 0..1 When request was initially authored
  fhir:MedicationRequest.requester [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who/What requested the Request
  fhir:MedicationRequest.performer [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Intended performer of administration
  fhir:MedicationRequest.performerType [ CodeableConcept ]; # 0..1 Desired kind of performer of the medication administration
  fhir:MedicationRequest.recorder [ Reference(Practitioner|PractitionerRole) ]; # 0..1 Person who entered the request
  fhir:MedicationRequest.reasonCode [ CodeableConcept ], ... ; # 0..* Reason or indication for ordering or not ordering the medication
  fhir:MedicationRequest.reasonReference [ Reference(Condition|Observation) ], ... ; # 0..* Condition or observation that supports why the prescription is being written
  fhir:MedicationRequest.instantiatesCanonical [ canonical ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:MedicationRequest.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:MedicationRequest.basedOn [ Reference(CarePlan|ImmunizationRecommendation|MedicationRequest|ServiceRequest) ], ... ; # 0..* What request fulfills
  fhir:MedicationRequest.groupIdentifier [ Identifier ]; # 0..1 Composite request this is part of
  fhir:MedicationRequest.courseOfTherapyType [ CodeableConcept ]; # 0..1 Overall pattern of medication administration
  fhir:MedicationRequest.insurance [ Reference(ClaimResponse|Coverage) ], ... ; # 0..* Associated insurance coverage
  fhir:MedicationRequest.note [ Annotation ], ... ; # 0..* Information about the prescription
  fhir:MedicationRequest.dosageInstruction [ Dosage ], ... ; # 0..* How the medication should be taken
  fhir:MedicationRequest.dispenseRequest [ # 0..1 Medication supply authorization
    fhir:MedicationRequest.dispenseRequest.initialFill [ # 0..1 First fill details
      fhir:MedicationRequest.dispenseRequest.initialFill.quantity [ Quantity(SimpleQuantity) ]; # 0..1 First fill quantity
      fhir:MedicationRequest.dispenseRequest.initialFill.duration [ Duration ]; # 0..1 First fill duration
    ];
    fhir:MedicationRequest.dispenseRequest.dispenseInterval [ Duration ]; # 0..1 Minimum period of time between dispenses
    fhir:MedicationRequest.dispenseRequest.validityPeriod [ Period ]; # 0..1 Time period supply is authorized for
    fhir:MedicationRequest.dispenseRequest.numberOfRepeatsAllowed [ unsignedInt ]; # 0..1 Number of refills authorized
    fhir:MedicationRequest.dispenseRequest.quantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount of medication to supply per dispense
    fhir:MedicationRequest.dispenseRequest.expectedSupplyDuration [ Duration ]; # 0..1 Number of days supply per dispense
    fhir:MedicationRequest.dispenseRequest.performer [ Reference(Organization) ]; # 0..1 Intended dispenser
  ];
  fhir:MedicationRequest.substitution [ # 0..1 Any restrictions on medication substitution
    # MedicationRequest.substitution.allowed[x] : 1..1 Whether substitution is allowed or not. One of these 2
      fhir:MedicationRequest.substitution.allowedBoolean [ boolean ]
      fhir:MedicationRequest.substitution.allowedCodeableConcept [ CodeableConcept ]
    fhir:MedicationRequest.substitution.reason [ CodeableConcept ]; # 0..1 Why should (not) substitution be made
  ];
  fhir:MedicationRequest.priorPrescription [ Reference(MedicationRequest) ]; # 0..1 An order/prescription that is being replaced
  fhir:MedicationRequest.detectedIssue [ Reference(DetectedIssue) ], ... ; # 0..* Clinical Issue with action
  fhir:MedicationRequest.eventHistory [ Reference(Provenance) ], ... ; # 0..* A list of events of interest in the lifecycle
]

Changes since Release 4

MedicationRequest

No Changes

See the Full Difference for further information

This analysis is available as XML or JSON.

Conversions between R3 and R4

See R3 <--> R4 Conversion Maps (status = 36 tests that all execute ok. 8 fail round-trip testing and 36 r3 resources are invalid (0 errors).)

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

11.1.4.1 Terminology Bindings

Path	Type	Reference
MedicationRequest.status	Required	medicationrequest Status
MedicationRequest.statusReason	Example	medicationRequest Status Reason Codes
MedicationRequest.intent	Required	medicationRequest Intent
MedicationRequest.category	Example	medicationRequest Category Codes
MedicationRequest.priority	Required	RequestPriority
MedicationRequest.medication[x]	Example	SNOMEDCTMedicationCodes
MedicationRequest.performerType	Example	ProcedurePerformerRoleCodes
MedicationRequest.reasonCode	Example	Condition/Problem/DiagnosisCodes
MedicationRequest.courseOfTherapyType	Example	medicationRequest Course of Therapy Codes
MedicationRequest.substitution.allowed[x]	Example	ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	Example	SubstanceAdminSubstitutionReason

Path

Definition

Type

Reference

MedicationRequest.status

Required

medicationrequest Status

MedicationRequest.statusReason

Example

medicationRequest Status Reason Codes

MedicationRequest.intent

Required

medicationRequest Intent

MedicationRequest.category

Example

medicationRequest Category Codes

MedicationRequest.priority

Required

RequestPriority

MedicationRequest.medication[x]

Example

SNOMEDCTMedicationCodes

MedicationRequest.performerType

Example

ProcedurePerformerRoleCodes

MedicationRequest.reasonCode

Example

Condition/Problem/DiagnosisCodes

MedicationRequest.courseOfTherapyType

Example

medicationRequest Course of Therapy Codes

MedicationRequest.substitution.allowed[x]

Example

ActSubstanceAdminSubstitutionCode

MedicationRequest.substitution.reason

Example

SubstanceAdminSubstitutionReason

11.1.4.2 Dosage Instructions

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.

11.1.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
authoredon	date	Return prescriptions written on this date	MedicationRequest.authoredOn
category	token	Returns prescriptions with different categories	MedicationRequest.category
code	token	Return prescriptions of this medication code	(MedicationRequest.medication as CodeableConcept)
date	date	Returns medication request to be administered on a specific date	MedicationRequest.dosageInstruction.timing.event
encounter	reference	Return prescriptions with this encounter identifier	MedicationRequest.encounter (Encounter)
identifier	token	Return prescriptions with this external identifier	MedicationRequest.identifier
intended-dispenser	reference	Returns prescriptions intended to be dispensed by this Organization	MedicationRequest.dispenseRequest.performer (Organization)
intended-performer	reference	Returns the intended performer of the administration of the medication request	MedicationRequest.performer (Practitioner, Organization, CareTeam, Device, Patient, PractitionerRole, RelatedPerson)
intended-performertype	token	Returns requests for a specific type of performer	MedicationRequest.performerType
intent	token	Returns prescriptions with different intents	MedicationRequest.intent
medication	reference	Return prescriptions for this medication reference	(MedicationRequest.medication as Reference) (Medication)
patient	reference	Returns prescriptions for a specific patient	MedicationRequest.subject.where(resolve() is Patient) (Patient)
priority	token	Returns prescriptions with different priorities	MedicationRequest.priority
requester	reference	Returns prescriptions prescribed by this prescriber	MedicationRequest.requester (Practitioner, Organization, Device, Patient, PractitionerRole, RelatedPerson)
status	token	Status of the prescription	MedicationRequest.status
subject	reference	The identity of a patient to list orders for	MedicationRequest.subject (Group, Patient)