Eyematics Core Data Set
2025.0.0-alpha - ci-build Unknown region code '276'

Eyematics Core Data Set - Local Development build (v2025.0.0-alpha) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MII_EyeMatics_IVI_MedicationRequest - Detailed Descriptions

Draft as of 2025-06-25

Definitions for the mii-eyematics-ivi-medicationrequest resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationRequest
Definition

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.

ShortOrdering of medication for patient or group
Comments

MI-I Medikamentenverordnung

Control0..*
Is Modifierfalse
Alternate NamesPrescription, Order
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: 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-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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
2. MedicationRequest.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeidstring
Is Modifierfalse
Must Supporttrue
Summarytrue
4. MedicationRequest.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
This element is affected by the following invariants: ele-1
TypeMeta
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. MedicationRequest.meta.source
Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.


A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

ShortIdentifies where the resource comes from
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationRequest.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control0..*
This element is affected by the following invariants: ele-1
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MedicationRequest.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Standard StatusNormative (from Trial Use)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 14. MedicationRequest.identifier
    Definition

    Ein Identifikator für die Medikationsverordnung


    Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

    ShortIdentifikatorExternal ids for this request
    Comments

    This is a business identifier, not a resource identifier.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. MedicationRequest.status
    Definition

    aktiv | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | abgebrochen | Entwurf | unbekannt


    A code specifying the current state of the order. Generally, this will be active or completed state.

    ShortStatusactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

    A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. MedicationRequest.intent
    Definition

    Vorschlag | Plan | Auftrag | Original-Auftrag | ergänzender Auftrag | Erfüllungsauftrag | Vorgangsauftrag | Option


    Whether the request is a proposal, plan, or an original order.

    ShortIntentionproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
    Comments

    It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

    An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
    (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

    The kind of medication order.

    Typecode
    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. MedicationRequest.doNotPerform
    Definition

    If true indicates that the provider is asking for the medication request not to occur.

    ShortTrue if request is prohibiting action
    Comments

    If do not perform is not specified, the request is a positive request e.g. "do perform".

    Control0..01
    This element is affected by the following invariants: ele-1
    Typeboolean
    Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. MedicationRequest.medication[x]
    Definition

    Medikation, die verordnet wurde. Code oder Referenz auf Medication-Objekt.


    Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

    ShortMedikationMedication to be taken
    Comments

    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeReference(IVI-Medikament, Medication), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on MedicationRequest.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 24. MedicationRequest.medication[x]:medicationReference
      Slice NamemedicationReference
      Definition

      Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

      ShortMedication to be taken
      Comments

      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

      Control01..1
      This element is affected by the following invariants: ele-1
      TypeReference(MII PR Medikation Medication, Medication), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. MedicationRequest.medication[x]:medicationCodeableConcept
      Slice NamemedicationCodeableConcept
      Definition

      Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

      ShortMedication to be taken
      Comments

      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

      Control01..1
      This element is affected by the following invariants: ele-1
      BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
      (example to http://hl7.org/fhir/ValueSet/medication-codes)

      A coded concept identifying substance or product that can be ordered.

      TypeCodeableConcept, Reference(Medication)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. MedicationRequest.medication[x]:medicationCodeableConcept.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Standard StatusNormative (from Trial Use)
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 30. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer
        Slice NamePharmazentralnummer
        Definition

        Ein Verweis auf einen von der Pharmazentralnummer definierten Code


        A reference to a code defined by a terminology system.

        ShortPZN CodeCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from For codes, see PZN ValueSet
        (required to http://fhir.de/ValueSet/ifa/pzn)
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Pattern Value{
          "system" : "http://fhir.de/CodeSystem/ifa/pzn"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control10..1
        This element is affected by the following invariants: ele-1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe
        Slice NameatcClassDe
        Definition

        Ein Verweis auf einen von der Pharmazentralnummer definierten Code


        A reference to a code defined by a terminology system.

        ShortATC Klassifikation deutsche VersionCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from For codes, see ATC ValueSet
        (required to http://fhir.de/ValueSet/bfarm/atc)
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Pattern Value{
          "system" : "http://fhir.de/CodeSystem/bfarm/atc"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control10..1
        This element is affected by the following invariants: ele-1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn
        Slice NameatcClassEn
        Definition

        Ein Verweis auf einen von der Pharmazentralnummer definierten Code


        A reference to a code defined by a terminology system.

        ShortAnatomical Therapeutic Chemical Classification SystemCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Pattern Value{
          "system" : "http://www.whocc.no/atc"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control10..1
        This element is affected by the following invariants: ele-1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationRequest.medication[x]:medicationCodeableConcept.text
        Definition

        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        ShortPlain text representation of the concept
        Comments

        Very often the text is the same as a displayName of one of the codings.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. MedicationRequest.subject
        Definition

        A link to a resource representing the person or set of individuals to whom the medication will be given.

        ShortWho or group medication request is for
        Comments

        The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeReference(Patient, Group)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        52. MedicationRequest.encounter
        Definition

        Fall oder Kontakt, bei dem die Medikation verordnet wurde.


        The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

        ShortFall oder KontaktEncounter created as part of encounter/admission/stay
        Comments

        This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeReference(Encounter)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        54. MedicationRequest.authoredOn
        Definition

        Das Datum, an dem die Verordnung ursprünglich verfasst wurde.


        The date (and perhaps time) when the prescription was initially written or authored on.

        ShortDatum der VerordnungWhen request was initially authored
        Control0..1
        This element is affected by the following invariants: ele-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. MedicationRequest.requester
        Definition

        Die Person, Organisation oder das Gerät, die die Verordnung initiiert hat und für deren Aktivierung verantwortlich ist.


        The individual, organization, or device that initiated the request and has responsibility for its activation.

        ShortAnfordererWho/What requested the Request
        Comments

        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        58. MedicationRequest.reasonCode
        Definition

        Grund für die Medikationverordnung als Code.


        The reason or the indication for ordering or not ordering the medication.

        ShortGrund CodeReason or indication for ordering or not ordering the medication
        Comments

        This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
        (example to http://hl7.org/fhir/ValueSet/condition-code)

        A coded concept indicating why the medication was ordered.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. MedicationRequest.reasonReference
        Definition

        Grund für die Medikationsverordnung als Referenz auf Condition- oder Observation-Objekt.


        Condition or observation that supports why the medication was ordered.

        ShortGrund ReferenzCondition or observation that supports why the prescription is being written
        Comments

        This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeReference(Condition, Observation)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        62. MedicationRequest.basedOn
        Definition

        Ein Plan oder eine Anforderung, die ganz oder teilweise durch diese Medikationsverordnung erfüllt wird.


        A plan or request that is fulfilled in whole or in part by this medication request.

        ShortBasiert aufWhat request fulfills
        Comments

        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        64. MedicationRequest.note
        Definition

        Zusätzliche Informationen zur Medikationsverordnung als Freitext.


        Extra information about the prescription that could not be conveyed by the other attributes.

        ShortHinweisInformation about the prescription
        Comments

        For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeAnnotation
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. MedicationRequest.dosageInstruction
        Definition

        Gibt an, wie das Medikament vom Patienten zu verwenden ist.


        Indicates how the medication is to be used by the patient.

        ShortDosierungsanweisungHow the medication should be taken
        Comments

        There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeDosage
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        dsg-1: If present, dosage must include free text or structured data (text.exists() or doseAndRate.exists())
        68. MedicationRequest.dosageInstruction.extension:IVI_TreatmentRegimen
        Slice NameIVI_TreatmentRegimen
        Definition

        TODO

        ShortIVI Treatment Regimen Extension
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(IVI Treatment Regimen Extension) (Extension Type: code)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        70. MedicationRequest.dosageInstruction.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        72. MedicationRequest.dosageInstruction.sequence
        Definition

        Indicates the order in which the dosage instructions should be applied or interpreted.

        ShortThe order of the dosage instructions
        Comments

        32 bit number; for values larger than this, use decimal

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeinteger
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. MedicationRequest.dosageInstruction.text
        Definition

        Free text dosage instructions e.g. SIG.

        ShortFree text dosage instructions e.g. SIG
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        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. Additional information about administration or preparation of the medication should be included as text.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. MedicationRequest.dosageInstruction.timing
        Definition

        When medication should be administered.

        ShortWhen medication should be administered
        Comments

        This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeTiming
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. MedicationRequest.dosageInstruction.timing.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        80. MedicationRequest.dosageInstruction.timing.event
        Definition

        Identifies specific times when the event occurs.

        ShortWhen the event occurs
        Control0..*
        This element is affected by the following invariants: ele-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. MedicationRequest.dosageInstruction.timing.repeat
        Definition

        A set of rules that describe when the event is scheduled.

        ShortWhen the event is to occur
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Many timing schedules are determined by regular repetitions.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
        84. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
        Definition

        Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

        ShortLength/Range of lengths, or (Start and/or end) limits
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeChoice of: Duration, Range, Period
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 86. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration
          Slice NameboundsDuration
          Definition

          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

          ShortLength/Range of lengths, or (Start and/or end) limits
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeDuration, Period, Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Pattern Value{
            "system" : "http://unitsofmeasure.org"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control10..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator
          Definition

          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Comments

          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

          Control10..1
          This element is affected by the following invariants: ele-1, qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control10..1
          This element is affected by the following invariants: ele-1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange
          Slice NameboundsRange
          Definition

          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

          ShortLength/Range of lengths, or (Start and/or end) limits
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeRange, Period, Duration
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low
          Definition

          The low limit. The boundary is inclusive.

          ShortLow limit
          Comments

          If the low element is missing, the low boundary is not known.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Pattern Value{
            "system" : "http://unitsofmeasure.org"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
          sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
          102. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control10..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator
          Definition

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..01
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Comments

          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

          Control10..1
          This element is affected by the following invariants: ele-1, qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control10..1
          This element is affected by the following invariants: ele-1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          112. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high
          Definition

          The high limit. The boundary is inclusive.

          ShortHigh limit
          Comments

          If the high element is missing, the high boundary is not known.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Pattern Value{
            "system" : "http://unitsofmeasure.org"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
          sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
          114. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control10..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator
          Definition

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..01
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Comments

          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

          Control10..1
          This element is affected by the following invariants: ele-1, qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control10..1
          This element is affected by the following invariants: ele-1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod
          Slice NameboundsPeriod
          Definition

          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

          ShortLength/Range of lengths, or (Start and/or end) limits
          Control0..1
          This element is affected by the following invariants: ele-1
          TypePeriod, Duration, Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start
          Definition

          The start of the period. The boundary is inclusive.

          ShortStarting time with inclusive boundary
          Comments

          If the low element is missing, the meaning is that the low boundary is not known.

          Control0..1
          This element is affected by the following invariants: ele-1, per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end
          Definition

          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

          ShortEnd time with inclusive boundary, if not ongoing
          Comments

          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

          Control0..1
          This element is affected by the following invariants: ele-1, per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          130. MedicationRequest.dosageInstruction.timing.repeat.count
          Definition

          A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

          ShortNumber of times to repeat
          Comments

          If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Repetitions may be limited by end time or total occurrences.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          132. MedicationRequest.dosageInstruction.timing.repeat.countMax
          Definition

          If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

          ShortMaximum number of times to repeat
          Comments

          32 bit number; for values larger than this, use decimal

          Control0..1
          This element is affected by the following invariants: ele-1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. MedicationRequest.dosageInstruction.timing.repeat.duration
          Definition

          How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

          ShortHow long when it happens
          Comments

          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

          Control0..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Some activities are not instantaneous and need to be maintained for a period of time.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          136. MedicationRequest.dosageInstruction.timing.repeat.durationMax
          Definition

          If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

          ShortHow long when it happens (Max)
          Comments

          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

          Control0..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Some activities are not instantaneous and need to be maintained for a period of time.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          138. MedicationRequest.dosageInstruction.timing.repeat.durationUnit
          Definition

          The units of time for the duration, in UCUM units.

          Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

          A unit of time (units from UCUM).

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          140. MedicationRequest.dosageInstruction.timing.repeat.frequency
          Definition

          The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

          ShortEvent occurs frequency times per period
          Comments

          32 bit number; for values larger than this, use decimal

          Control0..1
          This element is affected by the following invariants: ele-1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          142. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
          Definition

          If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

          ShortEvent occurs up to frequencyMax times per period
          Comments

          32 bit number; for values larger than this, use decimal

          Control0..1
          This element is affected by the following invariants: ele-1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          144. MedicationRequest.dosageInstruction.timing.repeat.period
          Definition

          Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

          ShortEvent occurs frequency times per period
          Comments

          Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)

          Control0..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          146. MedicationRequest.dosageInstruction.timing.repeat.periodMax
          Definition

          If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

          ShortUpper limit of period (3-4 hours)
          Comments

          Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)

          Control0..1
          This element is affected by the following invariants: ele-1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          148. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
          Definition

          The units of time for the period in UCUM units.

          Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

          A unit of time (units from UCUM).

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          150. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
          Definition

          If one or more days of week is provided, then the action happens only on the specified day(s).

          Shortmon | tue | wed | thu | fri | sat | sun
          Comments

          If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

          Control0..*
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|4.0.1
          (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          152. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
          Definition

          Specified time of day for action to take place.

          ShortTime of day for action
          Comments

          When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

          Control0..*
          This element is affected by the following invariants: ele-1
          Typetime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          154. MedicationRequest.dosageInstruction.timing.repeat.when
          Definition

          An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

          ShortCode for time period of occurrence
          Comments

          When more than one event is listed, the event is tied to the union of the specified events.

          Control0..*
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1
          (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

          Real world event relating to the schedule.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Timings are frequently determined by occurrences such as waking, eating and sleep.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          156. MedicationRequest.dosageInstruction.timing.repeat.offset
          Definition

          The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

          ShortMinutes from event (before or after)
          Comments

          32 bit number; for values larger than this, use decimal

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeunsignedInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          158. MedicationRequest.dosageInstruction.asNeeded[x]
          Definition

          Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

          ShortTake "as needed" (for x)
          Comments

          Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
          (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

          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.

          TypeChoice of: boolean, CodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.asNeeded[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 160. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean
            Slice NameasNeededBoolean
            Definition

            Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

            ShortTake "as needed" (for x)
            Comments

            Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

            Control0..1
            This element is affected by the following invariants: ele-1
            Typeboolean, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Standard StatusNormative (from Trial Use)
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            162. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept
            Slice NameasNeededCodeableConcept
            Definition

            Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

            ShortTake "as needed" (for x)
            Comments

            Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

            Control0..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
            (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

            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.

            TypeCodeableConcept, boolean
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Standard StatusNormative (from Trial Use)
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            164. MedicationRequest.dosageInstruction.site
            Definition

            Der Ort, an dem das Medikament verabreicht werden soll.


            Body site to administer to.

            ShortVerabreichungsortBody site to administer to
            Comments

            If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

            Control0..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For example codes, see Eye Lateralityhttp://hl7.org/fhir/ValueSet/approach-site-codes
            (required to https://eyematics.org/fhir/eyematics-kds/ValueSet/eye-laterality)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            A coded specification of the anatomic site where the medication first enters the body.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            166. MedicationRequest.dosageInstruction.site.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Standard StatusNormative (from Trial Use)
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ $this
            • 168. MedicationRequest.dosageInstruction.site.coding:SNOMED
              Slice NameSNOMED
              Definition

              Ein Verweis auf einen von SNOMED CT definierten Code


              A reference to a code defined by a terminology system.

              ShortSNOMED CT CodeCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..*
              This element is affected by the following invariants: ele-1
              BindingFor example codes, see For codes, see Target Site - IPS
              (example to http://hl7.org/fhir/uv/ips/ValueSet/target-site-uv-ips)

              target site IPS

              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Standard StatusNormative (from Trial Use)
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Pattern Value{
                "system" : "http://snomed.info/sct"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              170. MedicationRequest.dosageInstruction.site.coding:SNOMED.system
              Definition

              The identification of the code system that defines the meaning of the symbol in the code.

              ShortIdentity of the terminology system
              Comments

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

              Control10..1
              This element is affected by the following invariants: ele-1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              Need to be unambiguous about the source of the definition of the symbol.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              172. MedicationRequest.dosageInstruction.site.coding:SNOMED.code
              Definition

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              ShortSymbol in syntax defined by the system
              Comments

              Note that FHIR strings SHALL NOT exceed 1MB in size

              Control10..1
              This element is affected by the following invariants: ele-1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              174. MedicationRequest.dosageInstruction.route
              Definition

              Der Weg, auf dem das Medikament verabreicht werden soll.


              How drug should enter body.

              ShortVerabreichungswegHow drug should enter body
              Comments

              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

              Control0..1
              This element is affected by the following invariants: ele-1
              BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes
              (example to http://hl7.org/fhir/ValueSet/route-codes)

              A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

              Pattern Value{
                "coding" : [{
                  "system" : "http://standardterms.edqm.eu",
                  "code" : "20047000",
                  "display" : "Intravitreal use"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              176. MedicationRequest.dosageInstruction.route.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Standard StatusNormative (from Trial Use)
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ $this
              • 178. MedicationRequest.dosageInstruction.route.coding:EDQM
                Slice NameEDQM
                Definition

                Ein Verweis auf einen durch EDQM Standard Terms definierten Code


                A reference to a code defined by a terminology system.

                ShortEDQM CodeCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..1*
                This element is affected by the following invariants: ele-1
                BindingThe codes SHOULD be taken from For codes, see Medicine Route of Administration - IPS
                (preferred to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)

                EDQM Standard Terms

                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Pattern Value{
                  "system" : "http://standardterms.edqm.eu"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                180. MedicationRequest.dosageInstruction.route.coding:EDQM.system
                Definition

                The identification of the code system that defines the meaning of the symbol in the code.

                ShortIdentity of the terminology system
                Comments

                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                Control10..1
                This element is affected by the following invariants: ele-1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to be unambiguous about the source of the definition of the symbol.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                182. MedicationRequest.dosageInstruction.route.coding:EDQM.code
                Definition

                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                ShortSymbol in syntax defined by the system
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control10..1
                This element is affected by the following invariants: ele-1
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to refer to a particular code in the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                184. MedicationRequest.dosageInstruction.route.coding:SNOMED
                Slice NameSNOMED
                Definition

                Ein Verweis auf einen von SNOMED CT definierten Code


                A reference to a code defined by a terminology system.

                ShortSNOMED CT CodeCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..1*
                This element is affected by the following invariants: ele-1
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Pattern Value{
                  "system" : "http://snomed.info/sct"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                186. MedicationRequest.dosageInstruction.route.coding:SNOMED.system
                Definition

                The identification of the code system that defines the meaning of the symbol in the code.

                ShortIdentity of the terminology system
                Comments

                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                Control10..1
                This element is affected by the following invariants: ele-1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to be unambiguous about the source of the definition of the symbol.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                188. MedicationRequest.dosageInstruction.route.coding:SNOMED.code
                Definition

                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                ShortSymbol in syntax defined by the system
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control10..1
                This element is affected by the following invariants: ele-1
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to refer to a particular code in the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                190. MedicationRequest.dosageInstruction.doseAndRate
                Definition

                The amount of medication administered.

                ShortAmount of medication administered
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeElement
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                192. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                Definition

                Amount of medication per dose.

                ShortAmount of medication per dose
                Comments

                Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeChoice of: Range, Quantity(SimpleQuantity)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                The amount of therapeutic or other substance given at one administration event.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 194. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange
                  Slice NamedoseRange
                  Definition

                  Amount of medication per dose.

                  ShortAmount of medication per dose
                  Comments

                  Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeRange, Quantity(SimpleQuantity)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Standard StatusNormative (from Trial Use)
                  Summarytrue
                  Requirements

                  The amount of therapeutic or other substance given at one administration event.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  196. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low
                  Definition

                  The low limit. The boundary is inclusive.

                  ShortLow limit
                  Comments

                  If the low element is missing, the low boundary is not known.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeQuantity(SimpleQuantity)
                  Is Modifierfalse
                  Must Supporttrue
                  Standard StatusNormative (from Trial Use)
                  Summarytrue
                  Pattern Value{
                    "system" : "http://unitsofmeasure.org"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                  198. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value
                  Definition

                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                  ShortNumerical value (with implicit precision)
                  Comments

                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                  Control10..1
                  This element is affected by the following invariants: ele-1
                  Typedecimal
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Precision is handled implicitly in almost all cases of measurement.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  200. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator
                  Definition

                  Not allowed to be used in this context


                  How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                  Short< | <= | >= | > - how to understand the value
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..01
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                  How the Quantity should be understood and represented.

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  202. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit
                  Definition

                  A human-readable form of the unit.

                  ShortUnit representation
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  204. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system
                  Definition

                  The identification of the system that provides the coded form of the unit.

                  ShortSystem that defines coded unit form
                  Comments

                  see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                  Control10..1
                  This element is affected by the following invariants: ele-1, qty-3
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to know the system that defines the coded form of the unit.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  206. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code
                  Definition

                  A computer processable form of the unit in some unit representation system.

                  ShortCoded form of the unit
                  Comments

                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                  Control10..1
                  This element is affected by the following invariants: ele-1
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  208. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high
                  Definition

                  The high limit. The boundary is inclusive.

                  ShortHigh limit
                  Comments

                  If the high element is missing, the high boundary is not known.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeQuantity(SimpleQuantity)
                  Is Modifierfalse
                  Must Supporttrue
                  Standard StatusNormative (from Trial Use)
                  Summarytrue
                  Pattern Value{
                    "system" : "http://unitsofmeasure.org"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                  210. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value
                  Definition

                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                  ShortNumerical value (with implicit precision)
                  Comments

                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                  Control10..1
                  This element is affected by the following invariants: ele-1
                  Typedecimal
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Precision is handled implicitly in almost all cases of measurement.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  212. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator
                  Definition

                  Not allowed to be used in this context


                  How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                  Short< | <= | >= | > - how to understand the value
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..01
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                  How the Quantity should be understood and represented.

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  214. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit
                  Definition

                  A human-readable form of the unit.

                  ShortUnit representation
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  216. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system
                  Definition

                  The identification of the system that provides the coded form of the unit.

                  ShortSystem that defines coded unit form
                  Comments

                  see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                  Control10..1
                  This element is affected by the following invariants: ele-1, qty-3
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to know the system that defines the coded form of the unit.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  218. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code
                  Definition

                  A computer processable form of the unit in some unit representation system.

                  ShortCoded form of the unit
                  Comments

                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                  Control10..1
                  This element is affected by the following invariants: ele-1
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  220. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                  Slice NamedoseQuantity
                  Definition

                  The comparator is not used on a SimpleQuantity


                  Amount of medication per dose.

                  ShortA fixed quantity (no comparator)Amount of medication per dose
                  Comments

                  The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.


                  Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeQuantity(SimpleQuantity), Range
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Standard StatusNormative (from Trial Use)
                  Summarytrue
                  Requirements

                  The amount of therapeutic or other substance given at one administration event.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                  222. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
                  Definition

                  Amount of medication per unit of time.

                  ShortAmount of medication per unit of time
                  Comments

                  It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                  It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Standard StatusNormative (from Trial Use)
                  Summarytrue
                  Requirements

                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 224. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio
                    Slice NamerateRatio
                    Definition

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

                    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeRatio, Quantity(SimpleQuantity), Range
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Requirements

                    Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    226. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator
                    Definition

                    The value of the numerator.

                    ShortNumerator value
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    228. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    230. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.comparator
                    Definition

                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    232. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    234. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    236. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    238. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator
                    Definition

                    The value of the denominator.

                    ShortDenominator value
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    240. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    242. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.comparator
                    Definition

                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    244. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    246. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    248. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    250. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange
                    Slice NamerateRange
                    Definition

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

                    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeRange, Quantity(SimpleQuantity), Ratio
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Requirements

                    Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    252. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low
                    Definition

                    The low limit. The boundary is inclusive.

                    ShortLow limit
                    Comments

                    If the low element is missing, the low boundary is not known.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                    254. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    256. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.comparator
                    Definition

                    Not allowed to be used in this context


                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    258. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    260. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    262. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    264. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high
                    Definition

                    The high limit. The boundary is inclusive.

                    ShortHigh limit
                    Comments

                    If the high element is missing, the high boundary is not known.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                    266. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    268. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.comparator
                    Definition

                    Not allowed to be used in this context


                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    270. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    272. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    274. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    276. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity
                    Slice NamerateQuantity
                    Definition

                    The comparator is not used on a SimpleQuantity


                    Amount of medication per unit of time.

                    ShortA fixed quantity (no comparator)Amount of medication per unit of time
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.


                    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity), Ratio, Range
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Requirements

                    Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                    278. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    280. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.comparator
                    Definition

                    Not allowed to be used in this context


                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    282. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    284. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    286. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    288. MedicationRequest.dosageInstruction.maxDosePerPeriod
                    Definition

                    Upper limit on medication per unit of time.

                    ShortUpper limit on medication per unit of time
                    Comments

                    This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeRatio
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                    290. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator
                    Definition

                    The value of the numerator.

                    ShortNumerator value
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    292. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    294. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.comparator
                    Definition

                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    296. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    298. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    300. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    302. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator
                    Definition

                    The value of the denominator.

                    ShortDenominator value
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    304. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    306. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.comparator
                    Definition

                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    308. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    310. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    312. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    314. MedicationRequest.dosageInstruction.maxDosePerAdministration
                    Definition

                    Upper limit on medication per administration.

                    ShortUpper limit on medication per administration
                    Comments

                    This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                    Pattern Value{
                      "system" : "http://unitsofmeasure.org"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                    316. MedicationRequest.dosageInstruction.maxDosePerAdministration.value
                    Definition

                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                    ShortNumerical value (with implicit precision)
                    Comments

                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Precision is handled implicitly in almost all cases of measurement.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    318. MedicationRequest.dosageInstruction.maxDosePerAdministration.comparator
                    Definition

                    Not allowed to be used in this context


                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                    Short< | <= | >= | > - how to understand the value
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                    How the Quantity should be understood and represented.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    320. MedicationRequest.dosageInstruction.maxDosePerAdministration.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    322. MedicationRequest.dosageInstruction.maxDosePerAdministration.system
                    Definition

                    The identification of the system that provides the coded form of the unit.

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    Control10..1
                    This element is affected by the following invariants: ele-1, qty-3
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to know the system that defines the coded form of the unit.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    324. MedicationRequest.dosageInstruction.maxDosePerAdministration.code
                    Definition

                    A computer processable form of the unit in some unit representation system.

                    ShortCoded form of the unit
                    Comments

                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                    Control10..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    326. MedicationRequest.substitution
                    Definition

                    Etwaige Einschränkungen bei der Substitution von Medikamenten


                    Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

                    ShortSubstitutionAny restrictions on medication substitution
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    328. MedicationRequest.substitution.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    330. MedicationRequest.substitution.allowed[x]
                    Definition

                    True if the prescriber allows a different drug to be dispensed from what was prescribed.

                    ShortWhether substitution is allowed or not
                    Comments

                    This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                    Control1..1
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
                    (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                    Identifies the type of substitution allowed.

                    TypeChoice of: boolean, CodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Standard StatusNormative (from Trial Use)
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on MedicationRequest.substitution.allowed[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 332. MedicationRequest.substitution.allowed[x]:allowedBoolean
                      Slice NameallowedBoolean
                      Definition

                      True if the prescriber allows a different drug to be dispensed from what was prescribed.

                      ShortWhether substitution is allowed or not
                      Comments

                      This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                      Control01..1
                      This element is affected by the following invariants: ele-1
                      Typeboolean, CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      334. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
                      Slice NameallowedCodeableConcept
                      Definition

                      True if the prescriber allows a different drug to be dispensed from what was prescribed.

                      ShortWhether substitution is allowed or not
                      Comments

                      This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                      Control01..1
                      This element is affected by the following invariants: ele-1
                      BindingFor example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
                      (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                      Identifies the type of substitution allowed.

                      TypeCodeableConcept, boolean
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      336. MedicationRequest.priorPrescription
                      Definition

                      Eine Verschreibung, die ersetzt wird


                      A link to a resource representing an earlier order related order or prescription.

                      ShortVorherige VerschreibungAn order/prescription that is being replaced
                      Comments

                      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeReference(MedicationRequest)
                      Is Modifierfalse
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. MedicationRequest
                      2. MedicationRequest.medication[x]
                      TypeReference(IVI-Medikament), CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      4. MedicationRequest.dosageInstruction
                      6. MedicationRequest.dosageInstruction.extension:IVI_TreatmentRegimen
                      Slice NameIVI_TreatmentRegimen
                      Control0..1
                      TypeExtension(IVI Treatment Regimen Extension) (Extension Type: code)
                      8. MedicationRequest.dosageInstruction.site
                      BindingThe codes SHALL be taken from Eye Laterality
                      (required to https://eyematics.org/fhir/eyematics-kds/ValueSet/eye-laterality)
                      10. MedicationRequest.dosageInstruction.route
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://standardterms.edqm.eu",
                          "code" : "20047000",
                          "display" : "Intravitreal use"
                        }]
                      }

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. MedicationRequest
                      Definition

                      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.

                      ShortOrdering of medication for patient or group
                      Comments

                      MI-I Medikamentenverordnung

                      Control0..*
                      Alternate NamesPrescription, Order
                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                      dom-4: 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-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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                      2. MedicationRequest.id
                      Definition

                      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                      ShortLogical id of this artifact
                      Comments

                      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                      Control0..1
                      Typeid
                      Must Supporttrue
                      Summarytrue
                      4. MedicationRequest.meta
                      Definition

                      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                      ShortMetadata about the resource
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeMeta
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      6. MedicationRequest.meta.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      XML FormatIn the XML format, this property is represented as an attribute.
                      8. MedicationRequest.meta.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Standard StatusNormative (from Trial Use)
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MedicationRequest.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 10. MedicationRequest.meta.versionId
                        Definition

                        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                        ShortVersion specific identifier
                        Comments

                        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        12. MedicationRequest.meta.lastUpdated
                        Definition

                        When the resource last changed - e.g. when the version changed.

                        ShortWhen the resource version last changed
                        Comments

                        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeinstant
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        14. MedicationRequest.meta.source
                        Definition

                        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                        ShortIdentifies where the resource comes from
                        Comments

                        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        16. MedicationRequest.meta.profile
                        Definition

                        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                        ShortProfiles this resource claims to conform to
                        Comments

                        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        Typecanonical(StructureDefinition)
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        18. MedicationRequest.meta.security
                        Definition

                        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                        ShortSecurity Labels applied to this resource
                        Comments

                        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                        (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                        Security Labels from the Healthcare Privacy and Security Classification System.

                        TypeCoding
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        20. MedicationRequest.meta.tag
                        Definition

                        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                        ShortTags applied to this resource
                        Comments

                        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        BindingFor example codes, see CommonTags
                        (example to http://hl7.org/fhir/ValueSet/common-tags)

                        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                        TypeCoding
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        22. MedicationRequest.implicitRules
                        Definition

                        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                        ShortA set of rules under which this content was created
                        Comments

                        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeuri
                        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        24. MedicationRequest.language
                        Definition

                        The base language in which the resource is written.

                        ShortLanguage of the resource content
                        Comments

                        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHOULD be taken from CommonLanguages
                        (preferred to http://hl7.org/fhir/ValueSet/languages)

                        A human language.

                        Additional BindingsPurpose
                        AllLanguagesMax Binding
                        Typecode
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        26. MedicationRequest.text
                        Definition

                        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                        ShortText summary of the resource, for human interpretation
                        Comments

                        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeNarrative
                        Alternate Namesnarrative, html, xhtml, display
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        28. MedicationRequest.contained
                        Definition

                        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                        ShortContained, inline Resources
                        Comments

                        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                        Control0..*
                        TypeResource
                        Alternate Namesinline resources, anonymous resources, contained resources
                        30. MedicationRequest.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Standard StatusNormative (from Trial Use)
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 32. MedicationRequest.modifierExtension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                          Standard StatusNormative (from Trial Use)
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 34. MedicationRequest.identifier
                            Definition

                            Ein Identifikator für die Medikationsverordnung

                            ShortIdentifikator
                            Comments

                            This is a business identifier, not a resource identifier.

                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeIdentifier
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            36. MedicationRequest.status
                            Definition

                            aktiv | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | abgebrochen | Entwurf | unbekannt

                            ShortStatus
                            Comments

                            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from medicationrequest Status
                            (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

                            A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

                            Typecode
                            Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            38. MedicationRequest.statusReason
                            Definition

                            Captures the reason for the current state of the MedicationRequest.

                            ShortReason for current status
                            Comments

                            This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingFor example codes, see medicationRequest Status Reason Codes
                            (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

                            Identifies the reasons for a given status.

                            TypeCodeableConcept
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            40. MedicationRequest.intent
                            Definition

                            Vorschlag | Plan | Auftrag | Original-Auftrag | ergänzender Auftrag | Erfüllungsauftrag | Vorgangsauftrag | Option

                            ShortIntention
                            Comments

                            It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                            An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                            This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from medicationRequest Intent
                            (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

                            The kind of medication order.

                            Typecode
                            Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            42. MedicationRequest.category
                            Definition

                            Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

                            ShortType of medication usage
                            Comments

                            The category can be used to include where the medication is expected to be consumed or other types of requests.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            BindingFor example codes, see medicationRequest Category Codes
                            (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

                            A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

                            TypeCodeableConcept
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            44. MedicationRequest.priority
                            Definition

                            Indicates how quickly the Medication Request should be addressed with respect to other requests.

                            Shortroutine | urgent | asap | stat
                            Comments

                            Note that FHIR strings SHALL NOT exceed 1MB in size

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from RequestPriority
                            (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

                            Identifies the level of importance to be assigned to actioning the request.

                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            46. MedicationRequest.doNotPerform
                            Definition

                            If true indicates that the provider is asking for the medication request not to occur.

                            ShortTrue if request is prohibiting action
                            Comments

                            If do not perform is not specified, the request is a positive request e.g. "do perform".

                            Control0..0
                            This element is affected by the following invariants: ele-1
                            Typeboolean
                            Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            48. MedicationRequest.reported[x]
                            Definition

                            Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

                            ShortReported rather than primary record
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            50. MedicationRequest.medication[x]
                            Definition

                            Medikation, die verordnet wurde. Code oder Referenz auf Medication-Objekt.

                            ShortMedikation
                            Comments

                            If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            TypeReference(IVI-Medikament)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on MedicationRequest.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 52. MedicationRequest.medication[x]:medicationReference
                              Slice NamemedicationReference
                              Definition

                              Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                              ShortMedication to be taken
                              Comments

                              If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeReference(MII PR Medikation Medication)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              54. MedicationRequest.medication[x]:medicationCodeableConcept
                              Slice NamemedicationCodeableConcept
                              Definition

                              Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                              ShortMedication to be taken
                              Comments

                              If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              BindingFor example codes, see SNOMEDCTMedicationCodes
                              (example to http://hl7.org/fhir/ValueSet/medication-codes)

                              A coded concept identifying substance or product that can be ordered.

                              TypeCodeableConcept
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              56. MedicationRequest.medication[x]:medicationCodeableConcept.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              XML FormatIn the XML format, this property is represented as an attribute.
                              58. MedicationRequest.medication[x]:medicationCodeableConcept.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Standard StatusNormative (from Trial Use)
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on MedicationRequest.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 60. MedicationRequest.medication[x]:medicationCodeableConcept.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeCoding
                                Must Supporttrue
                                Standard StatusNormative (from Trial Use)
                                Summarytrue
                                Requirements

                                Allows for alternative encodings within a code system, and translations to other code systems.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • pattern @ $this
                                • 62. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer
                                  Slice NamePharmazentralnummer
                                  Definition

                                  Ein Verweis auf einen von der Pharmazentralnummer definierten Code

                                  ShortPZN Code
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  BindingThe codes SHALL be taken from PZN ValueSet
                                  (required to http://fhir.de/ValueSet/ifa/pzn)
                                  TypeCoding
                                  Must Supporttrue
                                  Standard StatusNormative (from Trial Use)
                                  Summarytrue
                                  Requirements

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Pattern Value{
                                    "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  64. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  66. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Standard StatusNormative (from Trial Use)
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 68. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.system
                                    Definition

                                    The identification of the code system that defines the meaning of the symbol in the code.

                                    ShortIdentity of the terminology system
                                    Comments

                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    Typeuri
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to be unambiguous about the source of the definition of the symbol.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    70. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.version
                                    Definition

                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                    ShortVersion of the system - if relevant
                                    Comments

                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    72. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code
                                    Definition

                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                    ShortSymbol in syntax defined by the system
                                    Comments

                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    Typecode
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to refer to a particular code in the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    74. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.display
                                    Definition

                                    A representation of the meaning of the code in the system, following the rules of the system.

                                    ShortRepresentation defined by the system
                                    Comments

                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    76. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.userSelected
                                    Definition

                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                    ShortIf this coding was chosen directly by the user
                                    Comments

                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typeboolean
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    78. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe
                                    Slice NameatcClassDe
                                    Definition

                                    Ein Verweis auf einen von der Pharmazentralnummer definierten Code

                                    ShortATC Klassifikation deutsche Version
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    BindingThe codes SHALL be taken from ATC ValueSet
                                    (required to http://fhir.de/ValueSet/bfarm/atc)
                                    TypeCoding
                                    Must Supporttrue
                                    Standard StatusNormative (from Trial Use)
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Pattern Value{
                                      "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    80. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    82. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Standard StatusNormative (from Trial Use)
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 84. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      86. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.version
                                      Definition

                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                      ShortVersion of the system - if relevant
                                      Comments

                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                      NoteThis is a business version Id, not a resource version Id (see discussion)
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      88. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code
                                      Definition

                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                      ShortSymbol in syntax defined by the system
                                      Comments

                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      Typecode
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Need to refer to a particular code in the system.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      90. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.display
                                      Definition

                                      A representation of the meaning of the code in the system, following the rules of the system.

                                      ShortRepresentation defined by the system
                                      Comments

                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      92. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.userSelected
                                      Definition

                                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                      ShortIf this coding was chosen directly by the user
                                      Comments

                                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typeboolean
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      94. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn
                                      Slice NameatcClassEn
                                      Definition

                                      Ein Verweis auf einen von der Pharmazentralnummer definierten Code

                                      ShortAnatomical Therapeutic Chemical Classification System
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeCoding
                                      Must Supporttrue
                                      Standard StatusNormative (from Trial Use)
                                      Summarytrue
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Pattern Value{
                                        "system" : "http://www.whocc.no/atc"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      96. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      98. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Standard StatusNormative (from Trial Use)
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 100. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.system
                                        Definition

                                        The identification of the code system that defines the meaning of the symbol in the code.

                                        ShortIdentity of the terminology system
                                        Comments

                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        Typeuri
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to be unambiguous about the source of the definition of the symbol.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        102. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.version
                                        Definition

                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                        ShortVersion of the system - if relevant
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        104. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code
                                        Definition

                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                        ShortSymbol in syntax defined by the system
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        Typecode
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        106. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.display
                                        Definition

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortRepresentation defined by the system
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        108. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.userSelected
                                        Definition

                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                        ShortIf this coding was chosen directly by the user
                                        Comments

                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeboolean
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        110. MedicationRequest.medication[x]:medicationCodeableConcept.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        112. MedicationRequest.subject
                                        Definition

                                        A link to a resource representing the person or set of individuals to whom the medication will be given.

                                        ShortWho or group medication request is for
                                        Comments

                                        The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Patient, Group)
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        114. MedicationRequest.encounter
                                        Definition

                                        Fall oder Kontakt, bei dem die Medikation verordnet wurde.

                                        ShortFall oder Kontakt
                                        Comments

                                        This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Encounter)
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        116. MedicationRequest.supportingInformation
                                        Definition

                                        Include additional information (for example, patient height and weight) that supports the ordering of the medication.

                                        ShortInformation to support ordering of the medication
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Resource)
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        118. MedicationRequest.authoredOn
                                        Definition

                                        Das Datum, an dem die Verordnung ursprünglich verfasst wurde.

                                        ShortDatum der Verordnung
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypedateTime
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        120. MedicationRequest.requester
                                        Definition

                                        Die Person, Organisation oder das Gerät, die die Verordnung initiiert hat und für deren Aktivierung verantwortlich ist.

                                        ShortAnforderer
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        122. MedicationRequest.performer
                                        Definition

                                        The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

                                        ShortIntended performer of administration
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        124. MedicationRequest.performerType
                                        Definition

                                        Indicates the type of performer of the administration of the medication.

                                        ShortDesired kind of performer of the medication administration
                                        Comments

                                        If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        BindingFor example codes, see ProcedurePerformerRoleCodes
                                        (example to http://hl7.org/fhir/ValueSet/performer-role)

                                        Identifies the type of individual that is desired to administer the medication.

                                        TypeCodeableConcept
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        126. MedicationRequest.recorder
                                        Definition

                                        Die Person, die den Auftrag im Namen einer anderen Person eingegeben hat, zum Beispiel im Fall eines mündlichen oder telefonischen Auftrags.

                                        ShortAuftragserfasser
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Practitioner, PractitionerRole)
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        128. MedicationRequest.reasonCode
                                        Definition

                                        Grund für die Medikationverordnung als Code.

                                        ShortGrund Code
                                        Comments

                                        This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                        (example to http://hl7.org/fhir/ValueSet/condition-code)

                                        A coded concept indicating why the medication was ordered.

                                        TypeCodeableConcept
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        130. MedicationRequest.reasonReference
                                        Definition

                                        Grund für die Medikationsverordnung als Referenz auf Condition- oder Observation-Objekt.

                                        ShortGrund Referenz
                                        Comments

                                        This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Condition, Observation)
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        132. MedicationRequest.instantiatesCanonical
                                        Definition

                                        The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

                                        ShortInstantiates FHIR protocol or definition
                                        Comments

                                        see Canonical References

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        Typecanonical
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        134. MedicationRequest.instantiatesUri
                                        Definition

                                        The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

                                        ShortInstantiates external protocol or definition
                                        Comments

                                        see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        Typeuri
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        136. MedicationRequest.basedOn
                                        Definition

                                        Ein Plan oder eine Anforderung, die ganz oder teilweise durch diese Medikationsverordnung erfüllt wird.

                                        ShortBasiert auf
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        138. MedicationRequest.groupIdentifier
                                        Definition

                                        A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

                                        ShortComposite request this is part of
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeIdentifier
                                        Summarytrue
                                        Requirements

                                        Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        140. MedicationRequest.courseOfTherapyType
                                        Definition

                                        The description of the overall patte3rn of the administration of the medication to the patient.

                                        ShortOverall pattern of medication administration
                                        Comments

                                        This attribute should not be confused with the protocol of the medication.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        BindingFor example codes, see medicationRequest Course of Therapy Codes
                                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                                        Identifies the overall pattern of medication administratio.

                                        TypeCodeableConcept
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        142. MedicationRequest.insurance
                                        Definition

                                        Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

                                        ShortAssociated insurance coverage
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Coverage, ClaimResponse)
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        144. MedicationRequest.note
                                        Definition

                                        Zusätzliche Informationen zur Medikationsverordnung als Freitext.

                                        ShortHinweis
                                        Comments

                                        For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeAnnotation
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        146. MedicationRequest.dosageInstruction
                                        Definition

                                        Gibt an, wie das Medikament vom Patienten zu verwenden ist.

                                        ShortDosierungsanweisung
                                        Comments

                                        There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeDosage
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        dsg-1: If present, dosage must include free text or structured data (text.exists() or doseAndRate.exists())
                                        148. MedicationRequest.dosageInstruction.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        150. MedicationRequest.dosageInstruction.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        Standard StatusNormative (from Trial Use)
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 152. MedicationRequest.dosageInstruction.extension:IVI_TreatmentRegimen
                                          Slice NameIVI_TreatmentRegimen
                                          Definition

                                          TODO

                                          ShortIVI Treatment Regimen Extension
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(IVI Treatment Regimen Extension) (Extension Type: code)
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          154. MedicationRequest.dosageInstruction.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          156. MedicationRequest.dosageInstruction.sequence
                                          Definition

                                          Indicates the order in which the dosage instructions should be applied or interpreted.

                                          ShortThe order of the dosage instructions
                                          Comments

                                          32 bit number; for values larger than this, use decimal

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeinteger
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          158. MedicationRequest.dosageInstruction.text
                                          Definition

                                          Free text dosage instructions e.g. SIG.

                                          ShortFree text dosage instructions e.g. SIG
                                          Comments

                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          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. Additional information about administration or preparation of the medication should be included as text.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          160. MedicationRequest.dosageInstruction.additionalInstruction
                                          Definition

                                          Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                                          ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                          Comments

                                          Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                          (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

                                          A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                                          TypeCodeableConcept
                                          Summarytrue
                                          Requirements

                                          Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          162. MedicationRequest.dosageInstruction.patientInstruction
                                          Definition

                                          Instructions in terms that are understood by the patient or consumer.

                                          ShortPatient or consumer oriented instructions
                                          Comments

                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          164. MedicationRequest.dosageInstruction.timing
                                          Definition

                                          When medication should be administered.

                                          ShortWhen medication should be administered
                                          Comments

                                          This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeTiming
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          166. MedicationRequest.dosageInstruction.timing.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          168. MedicationRequest.dosageInstruction.timing.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Standard StatusNormative (from Trial Use)
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 170. MedicationRequest.dosageInstruction.timing.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            172. MedicationRequest.dosageInstruction.timing.event
                                            Definition

                                            Identifies specific times when the event occurs.

                                            ShortWhen the event occurs
                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypedateTime
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

                                            In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            174. MedicationRequest.dosageInstruction.timing.repeat
                                            Definition

                                            A set of rules that describe when the event is scheduled.

                                            ShortWhen the event is to occur
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeElement
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

                                            Many timing schedules are determined by regular repetitions.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                                            tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                                            tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                                            tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                                            tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                                            tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                                            tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                                            tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                                            tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                                            176. MedicationRequest.dosageInstruction.timing.repeat.id
                                            Definition

                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            178. MedicationRequest.dosageInstruction.timing.repeat.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standard StatusNormative (from Trial Use)
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 180. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
                                              Definition

                                              Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                              ShortLength/Range of lengths, or (Start and/or end) limits
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeChoice of: Duration, Range, Period
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Standard StatusNormative (from Trial Use)
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • type @ $this
                                              • 182. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration
                                                Slice NameboundsDuration
                                                Definition

                                                Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                                ShortLength/Range of lengths, or (Start and/or end) limits
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeDuration
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Must Supporttrue
                                                Standard StatusNormative (from Trial Use)
                                                Summarytrue
                                                Pattern Value{
                                                  "system" : "http://unitsofmeasure.org"
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                184. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                186. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Trial Use)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 188. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value
                                                  Definition

                                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                  ShortNumerical value (with implicit precision)
                                                  Comments

                                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typedecimal
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  Precision is handled implicitly in almost all cases of measurement.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  190. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator
                                                  Definition

                                                  How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                  Short< | <= | >= | > - how to understand the value
                                                  Comments

                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  BindingThe codes SHALL be taken from QuantityComparator
                                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                  How the Quantity should be understood and represented.

                                                  Typecode
                                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  192. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit
                                                  Definition

                                                  A human-readable form of the unit.

                                                  ShortUnit representation
                                                  Comments

                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  194. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system
                                                  Definition

                                                  The identification of the system that provides the coded form of the unit.

                                                  ShortSystem that defines coded unit form
                                                  Comments

                                                  see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1, qty-3
                                                  Typeuri
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  Need to know the system that defines the coded form of the unit.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  196. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code
                                                  Definition

                                                  A computer processable form of the unit in some unit representation system.

                                                  ShortCoded form of the unit
                                                  Comments

                                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typecode
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  198. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange
                                                  Slice NameboundsRange
                                                  Definition

                                                  Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                                  ShortLength/Range of lengths, or (Start and/or end) limits
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeRange
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  Standard StatusNormative (from Trial Use)
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  200. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  202. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Standard StatusNormative (from Trial Use)
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 204. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low
                                                    Definition

                                                    The low limit. The boundary is inclusive.

                                                    ShortLow limit
                                                    Comments

                                                    If the low element is missing, the low boundary is not known.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeQuantity(SimpleQuantity)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Standard StatusNormative (from Trial Use)
                                                    Summarytrue
                                                    Pattern Value{
                                                      "system" : "http://unitsofmeasure.org"
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                    206. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id
                                                    Definition

                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    208. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Standard StatusNormative (from Trial Use)
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x].low.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 210. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value
                                                      Definition

                                                      The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                      ShortNumerical value (with implicit precision)
                                                      Comments

                                                      The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typedecimal
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      Precision is handled implicitly in almost all cases of measurement.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      212. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator
                                                      Definition

                                                      Not allowed to be used in this context

                                                      Short< | <= | >= | > - how to understand the value
                                                      Comments

                                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                                      Control0..0
                                                      This element is affected by the following invariants: ele-1
                                                      BindingThe codes SHALL be taken from QuantityComparator
                                                      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                      How the Quantity should be understood and represented.

                                                      Typecode
                                                      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                      Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      214. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit
                                                      Definition

                                                      A human-readable form of the unit.

                                                      ShortUnit representation
                                                      Comments

                                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      216. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system
                                                      Definition

                                                      The identification of the system that provides the coded form of the unit.

                                                      ShortSystem that defines coded unit form
                                                      Comments

                                                      see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1, qty-3
                                                      Typeuri
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      Need to know the system that defines the coded form of the unit.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      218. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code
                                                      Definition

                                                      A computer processable form of the unit in some unit representation system.

                                                      ShortCoded form of the unit
                                                      Comments

                                                      The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typecode
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      220. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high
                                                      Definition

                                                      The high limit. The boundary is inclusive.

                                                      ShortHigh limit
                                                      Comments

                                                      If the high element is missing, the high boundary is not known.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeQuantity(SimpleQuantity)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Standard StatusNormative (from Trial Use)
                                                      Summarytrue
                                                      Pattern Value{
                                                        "system" : "http://unitsofmeasure.org"
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                      sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                      222. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      224. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Standard StatusNormative (from Trial Use)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x].high.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 226. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value
                                                        Definition

                                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                        ShortNumerical value (with implicit precision)
                                                        Comments

                                                        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typedecimal
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Precision is handled implicitly in almost all cases of measurement.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        228. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator
                                                        Definition

                                                        Not allowed to be used in this context

                                                        Short< | <= | >= | > - how to understand the value
                                                        Comments

                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                        Control0..0
                                                        This element is affected by the following invariants: ele-1
                                                        BindingThe codes SHALL be taken from QuantityComparator
                                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                        How the Quantity should be understood and represented.

                                                        Typecode
                                                        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        230. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit
                                                        Definition

                                                        A human-readable form of the unit.

                                                        ShortUnit representation
                                                        Comments

                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        232. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system
                                                        Definition

                                                        The identification of the system that provides the coded form of the unit.

                                                        ShortSystem that defines coded unit form
                                                        Comments

                                                        see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1, qty-3
                                                        Typeuri
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Need to know the system that defines the coded form of the unit.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        234. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code
                                                        Definition

                                                        A computer processable form of the unit in some unit representation system.

                                                        ShortCoded form of the unit
                                                        Comments

                                                        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typecode
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        236. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod
                                                        Slice NameboundsPeriod
                                                        Definition

                                                        Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                                        ShortLength/Range of lengths, or (Start and/or end) limits
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypePeriod
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Must Supporttrue
                                                        Standard StatusNormative (from Trial Use)
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        238. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        240. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.extension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Standard StatusNormative (from Trial Use)
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 242. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start
                                                          Definition

                                                          The start of the period. The boundary is inclusive.

                                                          ShortStarting time with inclusive boundary
                                                          Comments

                                                          If the low element is missing, the meaning is that the low boundary is not known.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1, per-1
                                                          TypedateTime
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          244. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end
                                                          Definition

                                                          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                          ShortEnd time with inclusive boundary, if not ongoing
                                                          Comments

                                                          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1, per-1
                                                          TypedateTime
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          246. MedicationRequest.dosageInstruction.timing.repeat.count
                                                          Definition

                                                          A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

                                                          ShortNumber of times to repeat
                                                          Comments

                                                          If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypepositiveInt
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Repetitions may be limited by end time or total occurrences.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          248. MedicationRequest.dosageInstruction.timing.repeat.countMax
                                                          Definition

                                                          If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                                                          ShortMaximum number of times to repeat
                                                          Comments

                                                          32 bit number; for values larger than this, use decimal

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypepositiveInt
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          250. MedicationRequest.dosageInstruction.timing.repeat.duration
                                                          Definition

                                                          How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                                                          ShortHow long when it happens
                                                          Comments

                                                          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typedecimal
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Some activities are not instantaneous and need to be maintained for a period of time.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          252. MedicationRequest.dosageInstruction.timing.repeat.durationMax
                                                          Definition

                                                          If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                                                          ShortHow long when it happens (Max)
                                                          Comments

                                                          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typedecimal
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Some activities are not instantaneous and need to be maintained for a period of time.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          254. MedicationRequest.dosageInstruction.timing.repeat.durationUnit
                                                          Definition

                                                          The units of time for the duration, in UCUM units.

                                                          Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                                                          Comments

                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHALL be taken from UnitsOfTime
                                                          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                                          A unit of time (units from UCUM).

                                                          Typecode
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          256. MedicationRequest.dosageInstruction.timing.repeat.frequency
                                                          Definition

                                                          The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

                                                          ShortEvent occurs frequency times per period
                                                          Comments

                                                          32 bit number; for values larger than this, use decimal

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypepositiveInt
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          258. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
                                                          Definition

                                                          If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                                                          ShortEvent occurs up to frequencyMax times per period
                                                          Comments

                                                          32 bit number; for values larger than this, use decimal

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypepositiveInt
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          260. MedicationRequest.dosageInstruction.timing.repeat.period
                                                          Definition

                                                          Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

                                                          ShortEvent occurs frequency times per period
                                                          Comments

                                                          Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typedecimal
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          262. MedicationRequest.dosageInstruction.timing.repeat.periodMax
                                                          Definition

                                                          If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                                                          ShortUpper limit of period (3-4 hours)
                                                          Comments

                                                          Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typedecimal
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          264. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
                                                          Definition

                                                          The units of time for the period in UCUM units.

                                                          Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                                                          Comments

                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHALL be taken from UnitsOfTime
                                                          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                                          A unit of time (units from UCUM).

                                                          Typecode
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          266. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
                                                          Definition

                                                          If one or more days of week is provided, then the action happens only on the specified day(s).

                                                          Shortmon | tue | wed | thu | fri | sat | sun
                                                          Comments

                                                          If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHALL be taken from DaysOfWeek
                                                          (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                                                          Typecode
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          268. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
                                                          Definition

                                                          Specified time of day for action to take place.

                                                          ShortTime of day for action
                                                          Comments

                                                          When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          Typetime
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          270. MedicationRequest.dosageInstruction.timing.repeat.when
                                                          Definition

                                                          An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

                                                          ShortCode for time period of occurrence
                                                          Comments

                                                          When more than one event is listed, the event is tied to the union of the specified events.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHALL be taken from EventTiming
                                                          (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                                                          Real world event relating to the schedule.

                                                          Typecode
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Timings are frequently determined by occurrences such as waking, eating and sleep.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          272. MedicationRequest.dosageInstruction.timing.repeat.offset
                                                          Definition

                                                          The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

                                                          ShortMinutes from event (before or after)
                                                          Comments

                                                          32 bit number; for values larger than this, use decimal

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeunsignedInt
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          274. MedicationRequest.dosageInstruction.timing.code
                                                          Definition

                                                          A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                                                          ShortBID | TID | QID | AM | PM | QD | QOD | +
                                                          Comments

                                                          BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHOULD be taken from TimingAbbreviation
                                                          (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation)

                                                          Code for a known / defined timing pattern.

                                                          TypeCodeableConcept
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          276. MedicationRequest.dosageInstruction.asNeeded[x]
                                                          Definition

                                                          Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                                          ShortTake "as needed" (for x)
                                                          Comments

                                                          Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                                          (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                                                          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.

                                                          TypeChoice of: boolean, CodeableConcept
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                          Standard StatusNormative (from Trial Use)
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.asNeeded[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • type @ $this
                                                          • 278. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean
                                                            Slice NameasNeededBoolean
                                                            Definition

                                                            Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                                            ShortTake "as needed" (for x)
                                                            Comments

                                                            Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typeboolean
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Standard StatusNormative (from Trial Use)
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            280. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept
                                                            Slice NameasNeededCodeableConcept
                                                            Definition

                                                            Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                                            ShortTake "as needed" (for x)
                                                            Comments

                                                            Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                                            (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                                                            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.

                                                            TypeCodeableConcept
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Must Supporttrue
                                                            Standard StatusNormative (from Trial Use)
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            282. MedicationRequest.dosageInstruction.site
                                                            Definition

                                                            Der Ort, an dem das Medikament verabreicht werden soll.

                                                            ShortVerabreichungsort
                                                            Comments

                                                            If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            BindingThe codes SHALL be taken from Eye Laterality
                                                            (required to https://eyematics.org/fhir/eyematics-kds/ValueSet/eye-laterality)
                                                            TypeCodeableConcept
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            A coded specification of the anatomic site where the medication first enters the body.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            284. MedicationRequest.dosageInstruction.site.id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            286. MedicationRequest.dosageInstruction.site.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension
                                                            Standard StatusNormative (from Trial Use)
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.site.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 288. MedicationRequest.dosageInstruction.site.coding
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeCoding
                                                              Must Supporttrue
                                                              Standard StatusNormative (from Trial Use)
                                                              Summarytrue
                                                              Requirements

                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • pattern @ $this
                                                              • 290. MedicationRequest.dosageInstruction.site.coding:SNOMED
                                                                Slice NameSNOMED
                                                                Definition

                                                                Ein Verweis auf einen von SNOMED CT definierten Code

                                                                ShortSNOMED CT Code
                                                                Comments

                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                BindingFor example codes, see Target Site - IPS
                                                                (example to http://hl7.org/fhir/uv/ips/ValueSet/target-site-uv-ips)

                                                                target site IPS

                                                                TypeCoding
                                                                Must Supporttrue
                                                                Standard StatusNormative (from Trial Use)
                                                                Summarytrue
                                                                Requirements

                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                Pattern Value{
                                                                  "system" : "http://snomed.info/sct"
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                292. MedicationRequest.dosageInstruction.site.coding:SNOMED.id
                                                                Definition

                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                294. MedicationRequest.dosageInstruction.site.coding:SNOMED.extension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension
                                                                Standard StatusNormative (from Trial Use)
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.site.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 296. MedicationRequest.dosageInstruction.site.coding:SNOMED.system
                                                                  Definition

                                                                  The identification of the code system that defines the meaning of the symbol in the code.

                                                                  ShortIdentity of the terminology system
                                                                  Comments

                                                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                  Control1..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typeuri
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to be unambiguous about the source of the definition of the symbol.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  298. MedicationRequest.dosageInstruction.site.coding:SNOMED.version
                                                                  Definition

                                                                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                  ShortVersion of the system - if relevant
                                                                  Comments

                                                                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  300. MedicationRequest.dosageInstruction.site.coding:SNOMED.code
                                                                  Definition

                                                                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                  ShortSymbol in syntax defined by the system
                                                                  Comments

                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                  Control1..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typecode
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to refer to a particular code in the system.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  302. MedicationRequest.dosageInstruction.site.coding:SNOMED.display
                                                                  Definition

                                                                  A representation of the meaning of the code in the system, following the rules of the system.

                                                                  ShortRepresentation defined by the system
                                                                  Comments

                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  304. MedicationRequest.dosageInstruction.site.coding:SNOMED.userSelected
                                                                  Definition

                                                                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                  ShortIf this coding was chosen directly by the user
                                                                  Comments

                                                                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typeboolean
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  306. MedicationRequest.dosageInstruction.site.text
                                                                  Definition

                                                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                  ShortPlain text representation of the concept
                                                                  Comments

                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  308. MedicationRequest.dosageInstruction.route
                                                                  Definition

                                                                  Der Weg, auf dem das Medikament verabreicht werden soll.

                                                                  ShortVerabreichungsweg
                                                                  Comments

                                                                  Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingFor example codes, see SNOMEDCTRouteCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/route-codes)

                                                                  A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                                                  TypeCodeableConcept
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Requirements

                                                                  A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                                                                  Pattern Value{
                                                                    "coding" : [{
                                                                      "system" : "http://standardterms.edqm.eu",
                                                                      "code" : "20047000",
                                                                      "display" : "Intravitreal use"
                                                                    }]
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  310. MedicationRequest.dosageInstruction.route.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  312. MedicationRequest.dosageInstruction.route.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension
                                                                  Standard StatusNormative (from Trial Use)
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 314. MedicationRequest.dosageInstruction.route.coding
                                                                    Definition

                                                                    A reference to a code defined by a terminology system.

                                                                    ShortCode defined by a terminology system
                                                                    Comments

                                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeCoding
                                                                    Must Supporttrue
                                                                    Standard StatusNormative (from Trial Use)
                                                                    Summarytrue
                                                                    Requirements

                                                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • pattern @ $this
                                                                    • 316. MedicationRequest.dosageInstruction.route.coding:EDQM
                                                                      Slice NameEDQM
                                                                      Definition

                                                                      Ein Verweis auf einen durch EDQM Standard Terms definierten Code

                                                                      ShortEDQM Code
                                                                      Comments

                                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      BindingThe codes SHOULD be taken from Medicine Route of Administration - IPS
                                                                      (preferred to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)

                                                                      EDQM Standard Terms

                                                                      TypeCoding
                                                                      Must Supporttrue
                                                                      Standard StatusNormative (from Trial Use)
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                      Pattern Value{
                                                                        "system" : "http://standardterms.edqm.eu"
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      318. MedicationRequest.dosageInstruction.route.coding:EDQM.id
                                                                      Definition

                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      320. MedicationRequest.dosageInstruction.route.coding:EDQM.extension
                                                                      Definition

                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                      Control0..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension
                                                                      Standard StatusNormative (from Trial Use)
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 322. MedicationRequest.dosageInstruction.route.coding:EDQM.system
                                                                        Definition

                                                                        The identification of the code system that defines the meaning of the symbol in the code.

                                                                        ShortIdentity of the terminology system
                                                                        Comments

                                                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                        Control1..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typeuri
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need to be unambiguous about the source of the definition of the symbol.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        324. MedicationRequest.dosageInstruction.route.coding:EDQM.version
                                                                        Definition

                                                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                        ShortVersion of the system - if relevant
                                                                        Comments

                                                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        326. MedicationRequest.dosageInstruction.route.coding:EDQM.code
                                                                        Definition

                                                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                        ShortSymbol in syntax defined by the system
                                                                        Comments

                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                        Control1..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typecode
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need to refer to a particular code in the system.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        328. MedicationRequest.dosageInstruction.route.coding:EDQM.display
                                                                        Definition

                                                                        A representation of the meaning of the code in the system, following the rules of the system.

                                                                        ShortRepresentation defined by the system
                                                                        Comments

                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        330. MedicationRequest.dosageInstruction.route.coding:EDQM.userSelected
                                                                        Definition

                                                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                        ShortIf this coding was chosen directly by the user
                                                                        Comments

                                                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typeboolean
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        332. MedicationRequest.dosageInstruction.route.coding:SNOMED
                                                                        Slice NameSNOMED
                                                                        Definition

                                                                        Ein Verweis auf einen von SNOMED CT definierten Code

                                                                        ShortSNOMED CT Code
                                                                        Comments

                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeCoding
                                                                        Must Supporttrue
                                                                        Standard StatusNormative (from Trial Use)
                                                                        Summarytrue
                                                                        Requirements

                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                        Pattern Value{
                                                                          "system" : "http://snomed.info/sct"
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        334. MedicationRequest.dosageInstruction.route.coding:SNOMED.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        336. MedicationRequest.dosageInstruction.route.coding:SNOMED.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension
                                                                        Standard StatusNormative (from Trial Use)
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 338. MedicationRequest.dosageInstruction.route.coding:SNOMED.system
                                                                          Definition

                                                                          The identification of the code system that defines the meaning of the symbol in the code.

                                                                          ShortIdentity of the terminology system
                                                                          Comments

                                                                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                                          Control1..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typeuri
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be unambiguous about the source of the definition of the symbol.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          340. MedicationRequest.dosageInstruction.route.coding:SNOMED.version
                                                                          Definition

                                                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                          ShortVersion of the system - if relevant
                                                                          Comments

                                                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          342. MedicationRequest.dosageInstruction.route.coding:SNOMED.code
                                                                          Definition

                                                                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                          ShortSymbol in syntax defined by the system
                                                                          Comments

                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                          Control1..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typecode
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to refer to a particular code in the system.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          344. MedicationRequest.dosageInstruction.route.coding:SNOMED.display
                                                                          Definition

                                                                          A representation of the meaning of the code in the system, following the rules of the system.

                                                                          ShortRepresentation defined by the system
                                                                          Comments

                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          346. MedicationRequest.dosageInstruction.route.coding:SNOMED.userSelected
                                                                          Definition

                                                                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                          ShortIf this coding was chosen directly by the user
                                                                          Comments

                                                                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typeboolean
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          348. MedicationRequest.dosageInstruction.route.text
                                                                          Definition

                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                          ShortPlain text representation of the concept
                                                                          Comments

                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          350. MedicationRequest.dosageInstruction.method
                                                                          Definition

                                                                          Technique for administering medication.

                                                                          ShortTechnique for administering medication
                                                                          Comments

                                                                          Terminologies used often pre-coordinate this term with the route and or form of administration.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

                                                                          A coded concept describing the technique by which the medicine is administered.

                                                                          TypeCodeableConcept
                                                                          Summarytrue
                                                                          Requirements

                                                                          A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          352. MedicationRequest.dosageInstruction.doseAndRate
                                                                          Definition

                                                                          The amount of medication administered.

                                                                          ShortAmount of medication administered
                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeElement
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          354. MedicationRequest.dosageInstruction.doseAndRate.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          356. MedicationRequest.dosageInstruction.doseAndRate.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Standard StatusNormative (from Trial Use)
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 358. MedicationRequest.dosageInstruction.doseAndRate.type
                                                                            Definition

                                                                            The kind of dose or rate specified, for example, ordered or calculated.

                                                                            ShortThe kind of dose or rate specified
                                                                            Comments

                                                                            Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            BindingFor example codes, see DoseAndRateType
                                                                            (example to http://hl7.org/fhir/ValueSet/dose-rate-type)

                                                                            The kind of dose or rate specified.

                                                                            TypeCodeableConcept
                                                                            Summarytrue
                                                                            Requirements

                                                                            If the type is not populated, assume to be "ordered".

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            360. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                                                                            Definition

                                                                            Amount of medication per dose.

                                                                            ShortAmount of medication per dose
                                                                            Comments

                                                                            Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeChoice of: Range, Quantity(SimpleQuantity)
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Must Supporttrue
                                                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                                                            Standard StatusNormative (from Trial Use)
                                                                            Summarytrue
                                                                            Requirements

                                                                            The amount of therapeutic or other substance given at one administration event.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • type @ $this
                                                                            • 362. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange
                                                                              Slice NamedoseRange
                                                                              Definition

                                                                              Amount of medication per dose.

                                                                              ShortAmount of medication per dose
                                                                              Comments

                                                                              Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeRange
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Must Supporttrue
                                                                              Standard StatusNormative (from Trial Use)
                                                                              Summarytrue
                                                                              Requirements

                                                                              The amount of therapeutic or other substance given at one administration event.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              364. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              366. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension
                                                                              Standard StatusNormative (from Trial Use)
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 368. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low
                                                                                Definition

                                                                                The low limit. The boundary is inclusive.

                                                                                ShortLow limit
                                                                                Comments

                                                                                If the low element is missing, the low boundary is not known.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeQuantity(SimpleQuantity)
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Standard StatusNormative (from Trial Use)
                                                                                Summarytrue
                                                                                Pattern Value{
                                                                                  "system" : "http://unitsofmeasure.org"
                                                                                }
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                370. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                372. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                Standard StatusNormative (from Trial Use)
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x].low.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 374. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value
                                                                                  Definition

                                                                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                  ShortNumerical value (with implicit precision)
                                                                                  Comments

                                                                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typedecimal
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Precision is handled implicitly in almost all cases of measurement.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  376. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator
                                                                                  Definition

                                                                                  Not allowed to be used in this context

                                                                                  Short< | <= | >= | > - how to understand the value
                                                                                  Comments

                                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                  Control0..0
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  BindingThe codes SHALL be taken from QuantityComparator
                                                                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                  How the Quantity should be understood and represented.

                                                                                  Typecode
                                                                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  378. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit
                                                                                  Definition

                                                                                  A human-readable form of the unit.

                                                                                  ShortUnit representation
                                                                                  Comments

                                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typestring
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  380. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system
                                                                                  Definition

                                                                                  The identification of the system that provides the coded form of the unit.

                                                                                  ShortSystem that defines coded unit form
                                                                                  Comments

                                                                                  see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1, qty-3
                                                                                  Typeuri
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need to know the system that defines the coded form of the unit.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  382. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code
                                                                                  Definition

                                                                                  A computer processable form of the unit in some unit representation system.

                                                                                  ShortCoded form of the unit
                                                                                  Comments

                                                                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typecode
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  384. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high
                                                                                  Definition

                                                                                  The high limit. The boundary is inclusive.

                                                                                  ShortHigh limit
                                                                                  Comments

                                                                                  If the high element is missing, the high boundary is not known.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeQuantity(SimpleQuantity)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Standard StatusNormative (from Trial Use)
                                                                                  Summarytrue
                                                                                  Pattern Value{
                                                                                    "system" : "http://unitsofmeasure.org"
                                                                                  }
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                  386. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  388. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Standard StatusNormative (from Trial Use)
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x].high.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 390. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value
                                                                                    Definition

                                                                                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                    ShortNumerical value (with implicit precision)
                                                                                    Comments

                                                                                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typedecimal
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Precision is handled implicitly in almost all cases of measurement.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    392. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator
                                                                                    Definition

                                                                                    Not allowed to be used in this context

                                                                                    Short< | <= | >= | > - how to understand the value
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control0..0
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHALL be taken from QuantityComparator
                                                                                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                    How the Quantity should be understood and represented.

                                                                                    Typecode
                                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    394. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit
                                                                                    Definition

                                                                                    A human-readable form of the unit.

                                                                                    ShortUnit representation
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    396. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system
                                                                                    Definition

                                                                                    The identification of the system that provides the coded form of the unit.

                                                                                    ShortSystem that defines coded unit form
                                                                                    Comments

                                                                                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1, qty-3
                                                                                    Typeuri
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to know the system that defines the coded form of the unit.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    398. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code
                                                                                    Definition

                                                                                    A computer processable form of the unit in some unit representation system.

                                                                                    ShortCoded form of the unit
                                                                                    Comments

                                                                                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typecode
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    400. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                                                                                    Slice NamedoseQuantity
                                                                                    Definition

                                                                                    The comparator is not used on a SimpleQuantity

                                                                                    ShortA fixed quantity (no comparator)
                                                                                    Comments

                                                                                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeQuantity(SimpleQuantity)
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Standard StatusNormative (from Trial Use)
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    The amount of therapeutic or other substance given at one administration event.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                    402. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
                                                                                    Definition

                                                                                    Amount of medication per unit of time.

                                                                                    ShortAmount of medication per unit of time
                                                                                    Comments

                                                                                    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                                                    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Standard StatusNormative (from Trial Use)
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • type @ $this
                                                                                    • 404. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio
                                                                                      Slice NamerateRatio
                                                                                      Definition

                                                                                      Amount of medication per unit of time.

                                                                                      ShortAmount of medication per unit of time
                                                                                      Comments

                                                                                      It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                                                      It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeRatio
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Must Supporttrue
                                                                                      Standard StatusNormative (from Trial Use)
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      406. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      408. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension
                                                                                      Standard StatusNormative (from Trial Use)
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 410. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator
                                                                                        Definition

                                                                                        The value of the numerator.

                                                                                        ShortNumerator value
                                                                                        Comments

                                                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeQuantity
                                                                                        Must Supporttrue
                                                                                        Standard StatusNormative (from Trial Use)
                                                                                        Summarytrue
                                                                                        Pattern Value{
                                                                                          "system" : "http://unitsofmeasure.org"
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                        412. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.id
                                                                                        Definition

                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        414. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                        ShortAdditional content defined by implementations
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeExtension
                                                                                        Standard StatusNormative (from Trial Use)
                                                                                        Alternate Namesextensions, user content
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 416. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value
                                                                                          Definition

                                                                                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                          ShortNumerical value (with implicit precision)
                                                                                          Comments

                                                                                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                          Control1..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          Typedecimal
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Precision is handled implicitly in almost all cases of measurement.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          418. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.comparator
                                                                                          Definition

                                                                                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                                                          Short< | <= | >= | > - how to understand the value
                                                                                          Comments

                                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          BindingThe codes SHALL be taken from QuantityComparator
                                                                                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                          How the Quantity should be understood and represented.

                                                                                          Typecode
                                                                                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          420. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.unit
                                                                                          Definition

                                                                                          A human-readable form of the unit.

                                                                                          ShortUnit representation
                                                                                          Comments

                                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          Typestring
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          422. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.system
                                                                                          Definition

                                                                                          The identification of the system that provides the coded form of the unit.

                                                                                          ShortSystem that defines coded unit form
                                                                                          Comments

                                                                                          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                          Control1..1
                                                                                          This element is affected by the following invariants: ele-1, qty-3
                                                                                          Typeuri
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Need to know the system that defines the coded form of the unit.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          424. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.code
                                                                                          Definition

                                                                                          A computer processable form of the unit in some unit representation system.

                                                                                          ShortCoded form of the unit
                                                                                          Comments

                                                                                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                          Control1..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          Typecode
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          426. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator
                                                                                          Definition

                                                                                          The value of the denominator.

                                                                                          ShortDenominator value
                                                                                          Comments

                                                                                          The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeQuantity
                                                                                          Must Supporttrue
                                                                                          Standard StatusNormative (from Trial Use)
                                                                                          Summarytrue
                                                                                          Pattern Value{
                                                                                            "system" : "http://unitsofmeasure.org"
                                                                                          }
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                          428. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          430. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.extension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                          ShortAdditional content defined by implementations
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeExtension
                                                                                          Standard StatusNormative (from Trial Use)
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 432. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value
                                                                                            Definition

                                                                                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                            ShortNumerical value (with implicit precision)
                                                                                            Comments

                                                                                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            Typedecimal
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Precision is handled implicitly in almost all cases of measurement.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            434. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.comparator
                                                                                            Definition

                                                                                            How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                                                            Short< | <= | >= | > - how to understand the value
                                                                                            Comments

                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            BindingThe codes SHALL be taken from QuantityComparator
                                                                                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                            How the Quantity should be understood and represented.

                                                                                            Typecode
                                                                                            Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            436. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.unit
                                                                                            Definition

                                                                                            A human-readable form of the unit.

                                                                                            ShortUnit representation
                                                                                            Comments

                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            438. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.system
                                                                                            Definition

                                                                                            The identification of the system that provides the coded form of the unit.

                                                                                            ShortSystem that defines coded unit form
                                                                                            Comments

                                                                                            see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1, qty-3
                                                                                            Typeuri
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Need to know the system that defines the coded form of the unit.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            440. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.code
                                                                                            Definition

                                                                                            A computer processable form of the unit in some unit representation system.

                                                                                            ShortCoded form of the unit
                                                                                            Comments

                                                                                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            Typecode
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            442. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange
                                                                                            Slice NamerateRange
                                                                                            Definition

                                                                                            Amount of medication per unit of time.

                                                                                            ShortAmount of medication per unit of time
                                                                                            Comments

                                                                                            It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                                                            It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeRange
                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                            Must Supporttrue
                                                                                            Standard StatusNormative (from Trial Use)
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            444. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.id
                                                                                            Definition

                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                            ShortUnique id for inter-element referencing
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            446. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.extension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                            ShortAdditional content defined by implementations
                                                                                            Comments

                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeExtension
                                                                                            Standard StatusNormative (from Trial Use)
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 448. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low
                                                                                              Definition

                                                                                              The low limit. The boundary is inclusive.

                                                                                              ShortLow limit
                                                                                              Comments

                                                                                              If the low element is missing, the low boundary is not known.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeQuantity(SimpleQuantity)
                                                                                              Is Modifierfalse
                                                                                              Must Supporttrue
                                                                                              Standard StatusNormative (from Trial Use)
                                                                                              Summarytrue
                                                                                              Pattern Value{
                                                                                                "system" : "http://unitsofmeasure.org"
                                                                                              }
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                              sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                              450. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.id
                                                                                              Definition

                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              ShortUnique id for inter-element referencing
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              452. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension
                                                                                              Standard StatusNormative (from Trial Use)
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].low.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 454. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.value
                                                                                                Definition

                                                                                                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                ShortNumerical value (with implicit precision)
                                                                                                Comments

                                                                                                The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                Typedecimal
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Precision is handled implicitly in almost all cases of measurement.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                456. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.comparator
                                                                                                Definition

                                                                                                Not allowed to be used in this context

                                                                                                Short< | <= | >= | > - how to understand the value
                                                                                                Comments

                                                                                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                Control0..0
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingThe codes SHALL be taken from QuantityComparator
                                                                                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                How the Quantity should be understood and represented.

                                                                                                Typecode
                                                                                                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                458. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.unit
                                                                                                Definition

                                                                                                A human-readable form of the unit.

                                                                                                ShortUnit representation
                                                                                                Comments

                                                                                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                Typestring
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                460. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.system
                                                                                                Definition

                                                                                                The identification of the system that provides the coded form of the unit.

                                                                                                ShortSystem that defines coded unit form
                                                                                                Comments

                                                                                                see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1, qty-3
                                                                                                Typeuri
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Need to know the system that defines the coded form of the unit.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                462. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.code
                                                                                                Definition

                                                                                                A computer processable form of the unit in some unit representation system.

                                                                                                ShortCoded form of the unit
                                                                                                Comments

                                                                                                The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                Typecode
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                464. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high
                                                                                                Definition

                                                                                                The high limit. The boundary is inclusive.

                                                                                                ShortHigh limit
                                                                                                Comments

                                                                                                If the high element is missing, the high boundary is not known.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeQuantity(SimpleQuantity)
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Standard StatusNormative (from Trial Use)
                                                                                                Summarytrue
                                                                                                Pattern Value{
                                                                                                  "system" : "http://unitsofmeasure.org"
                                                                                                }
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                                466. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.id
                                                                                                Definition

                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                468. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.extension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                ShortAdditional content defined by implementations
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension
                                                                                                Standard StatusNormative (from Trial Use)
                                                                                                Alternate Namesextensions, user content
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].high.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ url
                                                                                                • 470. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.value
                                                                                                  Definition

                                                                                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                  ShortNumerical value (with implicit precision)
                                                                                                  Comments

                                                                                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  Typedecimal
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Precision is handled implicitly in almost all cases of measurement.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  472. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.comparator
                                                                                                  Definition

                                                                                                  Not allowed to be used in this context

                                                                                                  Short< | <= | >= | > - how to understand the value
                                                                                                  Comments

                                                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                  Control0..0
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  BindingThe codes SHALL be taken from QuantityComparator
                                                                                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                  How the Quantity should be understood and represented.

                                                                                                  Typecode
                                                                                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  474. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.unit
                                                                                                  Definition

                                                                                                  A human-readable form of the unit.

                                                                                                  ShortUnit representation
                                                                                                  Comments

                                                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  Typestring
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  476. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.system
                                                                                                  Definition

                                                                                                  The identification of the system that provides the coded form of the unit.

                                                                                                  ShortSystem that defines coded unit form
                                                                                                  Comments

                                                                                                  see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: ele-1, qty-3
                                                                                                  Typeuri
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Need to know the system that defines the coded form of the unit.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  478. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.code
                                                                                                  Definition

                                                                                                  A computer processable form of the unit in some unit representation system.

                                                                                                  ShortCoded form of the unit
                                                                                                  Comments

                                                                                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  Typecode
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  480. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity
                                                                                                  Slice NamerateQuantity
                                                                                                  Definition

                                                                                                  The comparator is not used on a SimpleQuantity

                                                                                                  ShortA fixed quantity (no comparator)
                                                                                                  Comments

                                                                                                  The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeQuantity(SimpleQuantity)
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  Is Modifierfalse
                                                                                                  Must Supporttrue
                                                                                                  Standard StatusNormative (from Trial Use)
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                  Pattern Value{
                                                                                                    "system" : "http://unitsofmeasure.org"
                                                                                                  }
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                                  482. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  484. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.extension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension
                                                                                                  Standard StatusNormative (from Trial Use)
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 486. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.value
                                                                                                    Definition

                                                                                                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                    ShortNumerical value (with implicit precision)
                                                                                                    Comments

                                                                                                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    Typedecimal
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Precision is handled implicitly in almost all cases of measurement.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    488. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.comparator
                                                                                                    Definition

                                                                                                    Not allowed to be used in this context

                                                                                                    Short< | <= | >= | > - how to understand the value
                                                                                                    Comments

                                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                    Control0..0
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    BindingThe codes SHALL be taken from QuantityComparator
                                                                                                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                    How the Quantity should be understood and represented.

                                                                                                    Typecode
                                                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    490. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.unit
                                                                                                    Definition

                                                                                                    A human-readable form of the unit.

                                                                                                    ShortUnit representation
                                                                                                    Comments

                                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    Typestring
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    492. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.system
                                                                                                    Definition

                                                                                                    The identification of the system that provides the coded form of the unit.

                                                                                                    ShortSystem that defines coded unit form
                                                                                                    Comments

                                                                                                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: ele-1, qty-3
                                                                                                    Typeuri
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Need to know the system that defines the coded form of the unit.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    494. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.code
                                                                                                    Definition

                                                                                                    A computer processable form of the unit in some unit representation system.

                                                                                                    ShortCoded form of the unit
                                                                                                    Comments

                                                                                                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    Typecode
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    496. MedicationRequest.dosageInstruction.maxDosePerPeriod
                                                                                                    Definition

                                                                                                    Upper limit on medication per unit of time.

                                                                                                    ShortUpper limit on medication per unit of time
                                                                                                    Comments

                                                                                                    This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeRatio
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                                    498. MedicationRequest.dosageInstruction.maxDosePerPeriod.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    500. MedicationRequest.dosageInstruction.maxDosePerPeriod.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension
                                                                                                    Standard StatusNormative (from Trial Use)
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.maxDosePerPeriod.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 502. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator
                                                                                                      Definition

                                                                                                      The value of the numerator.

                                                                                                      ShortNumerator value
                                                                                                      Comments

                                                                                                      The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeQuantity
                                                                                                      Must Supporttrue
                                                                                                      Summarytrue
                                                                                                      Pattern Value{
                                                                                                        "system" : "http://unitsofmeasure.org"
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                      504. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.id
                                                                                                      Definition

                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      506. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeExtension
                                                                                                      Standard StatusNormative (from Trial Use)
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 508. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value
                                                                                                        Definition

                                                                                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                        ShortNumerical value (with implicit precision)
                                                                                                        Comments

                                                                                                        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        Typedecimal
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Precision is handled implicitly in almost all cases of measurement.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        510. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.comparator
                                                                                                        Definition

                                                                                                        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                                                                        Short< | <= | >= | > - how to understand the value
                                                                                                        Comments

                                                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        BindingThe codes SHALL be taken from QuantityComparator
                                                                                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                        How the Quantity should be understood and represented.

                                                                                                        Typecode
                                                                                                        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        512. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.unit
                                                                                                        Definition

                                                                                                        A human-readable form of the unit.

                                                                                                        ShortUnit representation
                                                                                                        Comments

                                                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        Typestring
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        514. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system
                                                                                                        Definition

                                                                                                        The identification of the system that provides the coded form of the unit.

                                                                                                        ShortSystem that defines coded unit form
                                                                                                        Comments

                                                                                                        see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1, qty-3
                                                                                                        Typeuri
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need to know the system that defines the coded form of the unit.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        516. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.code
                                                                                                        Definition

                                                                                                        A computer processable form of the unit in some unit representation system.

                                                                                                        ShortCoded form of the unit
                                                                                                        Comments

                                                                                                        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        Typecode
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        518. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator
                                                                                                        Definition

                                                                                                        The value of the denominator.

                                                                                                        ShortDenominator value
                                                                                                        Comments

                                                                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeQuantity
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Pattern Value{
                                                                                                          "system" : "http://unitsofmeasure.org"
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                        520. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        522. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension
                                                                                                        Standard StatusNormative (from Trial Use)
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 524. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value
                                                                                                          Definition

                                                                                                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                          ShortNumerical value (with implicit precision)
                                                                                                          Comments

                                                                                                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          Typedecimal
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Precision is handled implicitly in almost all cases of measurement.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          526. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.comparator
                                                                                                          Definition

                                                                                                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                                                                          Short< | <= | >= | > - how to understand the value
                                                                                                          Comments

                                                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          BindingThe codes SHALL be taken from QuantityComparator
                                                                                                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                          How the Quantity should be understood and represented.

                                                                                                          Typecode
                                                                                                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          528. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.unit
                                                                                                          Definition

                                                                                                          A human-readable form of the unit.

                                                                                                          ShortUnit representation
                                                                                                          Comments

                                                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          530. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system
                                                                                                          Definition

                                                                                                          The identification of the system that provides the coded form of the unit.

                                                                                                          ShortSystem that defines coded unit form
                                                                                                          Comments

                                                                                                          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: ele-1, qty-3
                                                                                                          Typeuri
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Need to know the system that defines the coded form of the unit.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          532. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.code
                                                                                                          Definition

                                                                                                          A computer processable form of the unit in some unit representation system.

                                                                                                          ShortCoded form of the unit
                                                                                                          Comments

                                                                                                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          Typecode
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          534. MedicationRequest.dosageInstruction.maxDosePerAdministration
                                                                                                          Definition

                                                                                                          Upper limit on medication per administration.

                                                                                                          ShortUpper limit on medication per administration
                                                                                                          Comments

                                                                                                          This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeQuantity(SimpleQuantity)
                                                                                                          Is Modifierfalse
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                                                                                          Pattern Value{
                                                                                                            "system" : "http://unitsofmeasure.org"
                                                                                                          }
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                          sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                                          536. MedicationRequest.dosageInstruction.maxDosePerAdministration.id
                                                                                                          Definition

                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          538. MedicationRequest.dosageInstruction.maxDosePerAdministration.extension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                          ShortAdditional content defined by implementations
                                                                                                          Comments

                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension
                                                                                                          Standard StatusNormative (from Trial Use)
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.maxDosePerAdministration.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 540. MedicationRequest.dosageInstruction.maxDosePerAdministration.value
                                                                                                            Definition

                                                                                                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                            ShortNumerical value (with implicit precision)
                                                                                                            Comments

                                                                                                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            Typedecimal
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Precision is handled implicitly in almost all cases of measurement.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            542. MedicationRequest.dosageInstruction.maxDosePerAdministration.comparator
                                                                                                            Definition

                                                                                                            Not allowed to be used in this context

                                                                                                            Short< | <= | >= | > - how to understand the value
                                                                                                            Comments

                                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                            Control0..0
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            BindingThe codes SHALL be taken from QuantityComparator
                                                                                                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                            How the Quantity should be understood and represented.

                                                                                                            Typecode
                                                                                                            Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            544. MedicationRequest.dosageInstruction.maxDosePerAdministration.unit
                                                                                                            Definition

                                                                                                            A human-readable form of the unit.

                                                                                                            ShortUnit representation
                                                                                                            Comments

                                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            Typestring
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            546. MedicationRequest.dosageInstruction.maxDosePerAdministration.system
                                                                                                            Definition

                                                                                                            The identification of the system that provides the coded form of the unit.

                                                                                                            ShortSystem that defines coded unit form
                                                                                                            Comments

                                                                                                            see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: ele-1, qty-3
                                                                                                            Typeuri
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need to know the system that defines the coded form of the unit.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            548. MedicationRequest.dosageInstruction.maxDosePerAdministration.code
                                                                                                            Definition

                                                                                                            A computer processable form of the unit in some unit representation system.

                                                                                                            ShortCoded form of the unit
                                                                                                            Comments

                                                                                                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            Typecode
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            550. MedicationRequest.dosageInstruction.maxDosePerLifetime
                                                                                                            Definition

                                                                                                            Upper limit on medication per lifetime of the patient.

                                                                                                            ShortUpper limit on medication per lifetime of the patient
                                                                                                            Comments

                                                                                                            The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeQuantity(SimpleQuantity)
                                                                                                            Is Modifierfalse
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                            sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                                            552. MedicationRequest.dispenseRequest
                                                                                                            Definition

                                                                                                            Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

                                                                                                            ShortMedication supply authorization
                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeBackboneElement
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            554. MedicationRequest.dispenseRequest.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            556. MedicationRequest.dispenseRequest.extension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension
                                                                                                            Standard StatusNormative (from Trial Use)
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 558. MedicationRequest.dispenseRequest.modifierExtension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeExtension
                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              560. MedicationRequest.dispenseRequest.initialFill
                                                                                                              Definition

                                                                                                              Indicates the quantity or duration for the first dispense of the medication.

                                                                                                              ShortFirst fill details
                                                                                                              Comments

                                                                                                              If populating this element, either the quantity or the duration must be included.

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeBackboneElement
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              562. MedicationRequest.dispenseRequest.initialFill.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              564. MedicationRequest.dispenseRequest.initialFill.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeExtension
                                                                                                              Standard StatusNormative (from Trial Use)
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.initialFill.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 566. MedicationRequest.dispenseRequest.initialFill.modifierExtension
                                                                                                                Definition

                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeExtension
                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                568. MedicationRequest.dispenseRequest.initialFill.quantity
                                                                                                                Definition

                                                                                                                The amount or quantity to provide as part of the first dispense.

                                                                                                                ShortFirst fill quantity
                                                                                                                Comments

                                                                                                                The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeQuantity(SimpleQuantity)
                                                                                                                Is Modifierfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                                                570. MedicationRequest.dispenseRequest.initialFill.duration
                                                                                                                Definition

                                                                                                                The length of time that the first dispense is expected to last.

                                                                                                                ShortFirst fill duration
                                                                                                                Comments

                                                                                                                The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeDuration
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                                                                                572. MedicationRequest.dispenseRequest.dispenseInterval
                                                                                                                Definition

                                                                                                                The minimum period of time that must occur between dispenses of the medication.

                                                                                                                ShortMinimum period of time between dispenses
                                                                                                                Comments

                                                                                                                The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeDuration
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                                                                                574. MedicationRequest.dispenseRequest.validityPeriod
                                                                                                                Definition

                                                                                                                This indicates the validity period of a prescription (stale dating the Prescription).

                                                                                                                ShortTime period supply is authorized for
                                                                                                                Comments

                                                                                                                It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypePeriod
                                                                                                                Requirements

                                                                                                                Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                                                                576. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                                                                                                Definition

                                                                                                                An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

                                                                                                                ShortNumber of refills authorized
                                                                                                                Comments

                                                                                                                If displaying "number of authorized fills", add 1 to this number.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeunsignedInt
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                578. MedicationRequest.dispenseRequest.quantity
                                                                                                                Definition

                                                                                                                The amount that is to be dispensed for one fill.

                                                                                                                ShortAmount of medication to supply per dispense
                                                                                                                Comments

                                                                                                                The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeQuantity(SimpleQuantity)
                                                                                                                Is Modifierfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                                                580. MedicationRequest.dispenseRequest.expectedSupplyDuration
                                                                                                                Definition

                                                                                                                Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

                                                                                                                ShortNumber of days supply per dispense
                                                                                                                Comments

                                                                                                                In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeDuration
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                                                drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                                                                                582. MedicationRequest.dispenseRequest.performer
                                                                                                                Definition

                                                                                                                Indicates the intended dispensing Organization specified by the prescriber.

                                                                                                                ShortIntended dispenser
                                                                                                                Comments

                                                                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeReference(Organization)
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                                584. MedicationRequest.substitution
                                                                                                                Definition

                                                                                                                Etwaige Einschränkungen bei der Substitution von Medikamenten

                                                                                                                ShortSubstitution
                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeBackboneElement
                                                                                                                Must Supporttrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                586. MedicationRequest.substitution.id
                                                                                                                Definition

                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                Control0..1
                                                                                                                Typestring
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                588. MedicationRequest.substitution.extension
                                                                                                                Definition

                                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                ShortAdditional content defined by implementations
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeExtension
                                                                                                                Standard StatusNormative (from Trial Use)
                                                                                                                Alternate Namesextensions, user content
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                SlicingThis element introduces a set of slices on MedicationRequest.substitution.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 590. MedicationRequest.substitution.modifierExtension
                                                                                                                  Definition

                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                  Comments

                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  TypeExtension
                                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                  592. MedicationRequest.substitution.allowed[x]
                                                                                                                  Definition

                                                                                                                  True if the prescriber allows a different drug to be dispensed from what was prescribed.

                                                                                                                  ShortWhether substitution is allowed or not
                                                                                                                  Comments

                                                                                                                  This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                                                                                                  Control1..1
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                                                                                  (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                                                                                  Identifies the type of substitution allowed.

                                                                                                                  TypeChoice of: boolean, CodeableConcept
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Must Supporttrue
                                                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                  Standard StatusNormative (from Trial Use)
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  SlicingThis element introduces a set of slices on MedicationRequest.substitution.allowed[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • type @ $this
                                                                                                                  • 594. MedicationRequest.substitution.allowed[x]:allowedBoolean
                                                                                                                    Slice NameallowedBoolean
                                                                                                                    Definition

                                                                                                                    True if the prescriber allows a different drug to be dispensed from what was prescribed.

                                                                                                                    ShortWhether substitution is allowed or not
                                                                                                                    Comments

                                                                                                                    This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    Typeboolean
                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Must Supporttrue
                                                                                                                    Standard StatusNormative (from Trial Use)
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    596. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
                                                                                                                    Slice NameallowedCodeableConcept
                                                                                                                    Definition

                                                                                                                    True if the prescriber allows a different drug to be dispensed from what was prescribed.

                                                                                                                    ShortWhether substitution is allowed or not
                                                                                                                    Comments

                                                                                                                    This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                                                                                    (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                                                                                    Identifies the type of substitution allowed.

                                                                                                                    TypeCodeableConcept
                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                    Must Supporttrue
                                                                                                                    Standard StatusNormative (from Trial Use)
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    598. MedicationRequest.substitution.reason
                                                                                                                    Definition

                                                                                                                    Indicates the reason for the substitution, or why substitution must or must not be performed.

                                                                                                                    ShortWhy should (not) substitution be made
                                                                                                                    Comments

                                                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    BindingFor example codes, see SubstanceAdminSubstitutionReason
                                                                                                                    (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                                                                                                                    A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    600. MedicationRequest.priorPrescription
                                                                                                                    Definition

                                                                                                                    Eine Verschreibung, die ersetzt wird

                                                                                                                    ShortVorherige Verschreibung
                                                                                                                    Comments

                                                                                                                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    TypeReference(MedicationRequest)
                                                                                                                    Must Supporttrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                                    602. MedicationRequest.detectedIssue
                                                                                                                    Definition

                                                                                                                    Ein tatsächliches oder potenzielles klinisches Problem mit oder zwischen einer oder mehreren aktiven oder vorgeschlagenen klinischen Maßnahmen für einen Patienten; z.B. Arzneimittelwechselwirkung, Doppeltherapie, Dosierungsalarm etc.

                                                                                                                    ShortErkannte Probleme
                                                                                                                    Comments

                                                                                                                    This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    TypeReference(DetectedIssue)
                                                                                                                    Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                                                    604. MedicationRequest.eventHistory
                                                                                                                    Definition

                                                                                                                    Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

                                                                                                                    ShortA list of events of interest in the lifecycle
                                                                                                                    Comments

                                                                                                                    This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    TypeReference(Provenance)
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))