Medicare Records FHIR Implementation Guide version 1.0.0

1.0 StructureDefinition-medicationrequest-pbs

This profile defines a representation of prescription data to support representation of PBS claim items.

Usage Scenarios

The following are the usage scenarios expected:

  • DHS Medicare sends PBS records to the My Health Record system
Each MedicationRequest SHALL have
  1. a profile assertion to this profile
  2. an intent
  3. a medication
  4. a patient
  5. a date of prescribing
  6. a number of repeats allowed
  7. an amount of medication per dispense
Must Support

In the context of this profile Must Support SHALL be interpreted as follows.

  • The system SHALL be able to store and retrieve the following elements:
    • status
    • intent
    • medication
    • authoredOn
    • dispeseRequest
    • dispenseRequest.numberOfRepeatsAllowed
    • dispeseRequest.quantity
  • The system SHALL be able to take the following elements into account when performing processing:
    • identifier
    • subject
Profile-specific implementation guidance
  • The patient resource should be identified in the subject element with a logical reference, i.e. an Australian IHI
  • If a resource is referenced rather than identified in the applicable element, the referenced resource should be contained
  • The referenced medication resource will include the code for the medication and the manufacturer if known
  • If the number of permitted repeats for a prescription are zero, the numberOfRepeatsAllowed element should not be included - the value of ‘0’ cannot be used
Examples

Sample instances are included within Explanation of Benefit Medicare example instances.

1.0.1 Formal Views of Profile Content

The official URL for this profile is: 

http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs

This profile defines a representation of prescription data to support representation of PBS claim items.

This profile builds on MedicationRequest.

This profile was published on Tue Aug 28 00:00:00 AEST 2018 as a active by Australian Digital Health Agency.

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

This structure is derived from the STU3 FHIR® resource MedicationRequest.

This profile introduces the following variations from the above core resource:

  1. One meta.profile is ‘http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs’
  2. intent is ‘order’
  3. medication as medicationReference
  4. medicationReference contained as Medication Pharmaceutical Benefits Scheme
  5. subject as AU Base Patient
  6. Exactly one authoredOn
  7. requester.agent as AU Base Practitioner, AU Base Organisation
  8. Exactly one dispenseRequest
  9. Exactly one dispenseRequest.quantity
  10. dispenseRequest.performer as AU Base Organisation
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*Ordering of medication for patient or group
inv-dh-mr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs'
... id Σ0..1idLogical id of this artifact
... meta Σ1..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... profile Σ1..*uriProfiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ0..*CodingTags applied to this resource
Binding: Common Tags (example)
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*IdentifierExternal ids for this request
... definition Σ0..*Reference(ActivityDefinition | PlanDefinition)Protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... status ?!SΣ0..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: MedicationRequestStatus (required)
... intent ?!SΣ1..1codeproposal | plan | order | instance-order
Binding: MedicationRequestIntent (required)
Fixed Value: order
... category 0..1CodeableConceptType of medication usage
Binding: MedicationRequestCategory (preferred)
... priority Σ0..1coderoutine | urgent | stat | asap
Binding: MedicationRequestPriority (required)
... medicationReference SΣ1..1Reference(MedicationPharmaceuticalBenefitsScheme) {c}Medication to be taken
... subject SΣ1..1​Reference(AU Base Patient)Who or group medication request is for
... context 0..1Reference(Encounter | EpisodeOfCare)Created during encounter/admission/stay
... supportingInformation 0..*Reference(Resource)Information to support ordering of the medication
... authoredOn SΣ1..1dateTimeWhen request was initially authored
... requester ΣI0..1BackboneElementWho/What requested the Request
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... agent Σ1..1​Reference(AU Base Practitioner | AU Base Organisation)Who ordered the initial medication(s)
.... onBehalfOf ΣI0..1Reference(Organization)Organization agent is acting for
... recorder 0..1Reference(Practitioner)Person who entered the request
... reasonCode 0..*CodeableConceptReason or indication for writing the prescription
Binding: Condition/Problem/Diagnosis Codes (example)
... reasonReference 0..*Reference(Condition | Observation)Condition or Observation that supports why the prescription is being written
... note 0..*AnnotationInformation about the prescription
... dosageInstruction 0..*DosageHow the medication should be taken
... dispenseRequest SI1..1BackboneElementMedication supply authorization
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed S0..1positiveIntNumber of refills authorized
.... quantity S1..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... performer 0..1​Reference(AU Base Organisation)Intended dispenser
... substitution I0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... allowed ?!1..1booleanWhether substitution is allowed or not
.... reason 0..1CodeableConceptWhy should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example)
... priorPrescription 0..1Reference(MedicationRequest)An order/prescription that is being replaced
... detectedIssue 0..*Reference(DetectedIssue)Clinical Issue with action
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

This structure is derived from the STU3 FHIR® resource MedicationRequest.

This profile introduces the following variations from the above core resource:

  1. One meta.profile is ‘http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs’
  2. intent is ‘order’
  3. medication as medicationReference
  4. medicationReference contained as Medication Pharmaceutical Benefits Scheme
  5. subject as AU Base Patient
  6. Exactly one authoredOn
  7. requester.agent as AU Base Practitioner, AU Base Organisation
  8. Exactly one dispenseRequest
  9. Exactly one dispenseRequest.quantity
  10. dispenseRequest.performer as AU Base Organisation

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*Ordering of medication for patient or group
inv-dh-mr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs'
... id Σ0..1idLogical id of this artifact
... meta Σ1..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... profile Σ1..*uriProfiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ0..*CodingTags applied to this resource
Binding: Common Tags (example)
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*IdentifierExternal ids for this request
... definition Σ0..*Reference(ActivityDefinition | PlanDefinition)Protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... status ?!SΣ0..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: MedicationRequestStatus (required)
... intent ?!SΣ1..1codeproposal | plan | order | instance-order
Binding: MedicationRequestIntent (required)
Fixed Value: order
... category 0..1CodeableConceptType of medication usage
Binding: MedicationRequestCategory (preferred)
... priority Σ0..1coderoutine | urgent | stat | asap
Binding: MedicationRequestPriority (required)
... medicationReference SΣ1..1Reference(MedicationPharmaceuticalBenefitsScheme) {c}Medication to be taken
... subject SΣ1..1​Reference(AU Base Patient)Who or group medication request is for
... context 0..1Reference(Encounter | EpisodeOfCare)Created during encounter/admission/stay
... supportingInformation 0..*Reference(Resource)Information to support ordering of the medication
... authoredOn SΣ1..1dateTimeWhen request was initially authored
... requester ΣI0..1BackboneElementWho/What requested the Request
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... agent Σ1..1​Reference(AU Base Practitioner | AU Base Organisation)Who ordered the initial medication(s)
.... onBehalfOf ΣI0..1Reference(Organization)Organization agent is acting for
... recorder 0..1Reference(Practitioner)Person who entered the request
... reasonCode 0..*CodeableConceptReason or indication for writing the prescription
Binding: Condition/Problem/Diagnosis Codes (example)
... reasonReference 0..*Reference(Condition | Observation)Condition or Observation that supports why the prescription is being written
... note 0..*AnnotationInformation about the prescription
... dosageInstruction 0..*DosageHow the medication should be taken
... dispenseRequest SI1..1BackboneElementMedication supply authorization
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed S0..1positiveIntNumber of refills authorized
.... quantity S1..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... performer 0..1​Reference(AU Base Organisation)Intended dispenser
... substitution I0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... allowed ?!1..1booleanWhether substitution is allowed or not
.... reason 0..1CodeableConceptWhy should (not) substitution be made
Binding: SubstanceAdminSubstitutionReason (example)
... priorPrescription 0..1Reference(MedicationRequest)An order/prescription that is being replaced
... detectedIssue 0..*Reference(DetectedIssue)Clinical Issue with action
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron

 

1.0.2 Quick Start

Below is an overview of the required search and read operations.

Summary of Search Criteria for StructureDefinition-medicationrequest-pbs

none defined