ERA FHIR specification
1.0.0 - draft

ERA FHIR specification - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MedicationListDiscontinuationMedicationRequest - Detailed Descriptions

Draft as of 2026-10-28

Definitions for the MedicationListDiscontinuationMedicationRequest resource profile.

See the documentation on how to interpret the contents of this table

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
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesPrescription, Order
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. 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
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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.

Control10..1*
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Fixed Value
{
  "profile" : "http://resepti.kanta.fi/fhir/StructureDefinition/MedicationListDiscontinuationMedicationRequest"
}
<profile value="http://resepti.kanta.fi/fhir/StructureDefinition/MedicationListDiscontinuationMedicationRequest"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. MedicationRequest.meta.tag
Definition

CDA R2 header specification templateId (specification package version).


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.

ShortCDA R2 header specification templateId (specification package version)Tags 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.

Control10..1*
BindingFor example codes, see CommonTagshttp://hl7.org/fhir/ValueSet/common-tags|4.0.1
(example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

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

TypeCoding
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationRequest.meta.tag.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
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Fixed Value
{
  "system" : "http://resepti.kanta.fi/fhir/cdaHeaderTemplateId"
}
<system value="http://resepti.kanta.fi/fhir/cdaHeaderTemplateId"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationRequest.meta.tag.code
Definition

CDA R2 header specification templateId (specification package version).


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).

ShortCDA R2 header specification templateId (specification package version)Symbol in syntax defined by the system
Control10..1
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
12. 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
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()))
14. MedicationRequest.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control50..*
TypeExtension
Is Modifierfalse
Summaryfalse
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
  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

    16. MedicationRequest.extension:versionNumber
    Slice NameversionNumber
    Definition

    Lääkitysasiakirjan versiointinumero.

    ShortAsiakirjan versio
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension versionNumber) (Extension Type: positiveInt)
    Is Modifierfalse
    Summaryfalse
    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())
    18. MedicationRequest.extension:versionNumber.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Value
    {
      "url" : "http://resepti.kanta.fi/StructureDefinition/extension/versionNumber"
    }
    <url value="http://resepti.kanta.fi/StructureDefinition/extension/versionNumber"/>
    20. MedicationRequest.extension:versionNumber.value[x]
    Definition

    Lääkitysasiakirjan versiointinumero.


    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortAsiakirjan versioValue of extension
    Control10..1
    TypepositiveInt, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [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
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. MedicationRequest.extension:effectiveTime
    Slice NameeffectiveTime
    Definition

    The creation time of a document.

    ShortThe creation time of a document
    Control1..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension effectiveTime) (Extension Type: dateTime)
    Is Modifierfalse
    Summaryfalse
    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())
    24. MedicationRequest.extension:continuum
    Slice Namecontinuum
    Definition

    Identifiers of medicine continuum: The identifier of the medicine in use and part identifier of medicine continuum.

    ShortThe identifier of the medicine in use and the part identifier of the medicine continuum
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension continuum) (Complex Extension)
    Is Modifierfalse
    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())
    26. MedicationRequest.extension:continuum.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional 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.

    Control20..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

      28. MedicationRequest.extension:continuum.extension:medicineId
      Slice NamemedicineId
      Definition

      Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

      ShortThe identifier of the drug in useAdditional content defined by implementations
      Control10..1*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      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())
      30. MedicationRequest.extension:continuum.extension:medicineId.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Value
      {
        "url" : "medicineId"
      }
      <url value="medicineId"/>
      32. MedicationRequest.extension:continuum.extension:medicineId.value[x]
      Definition

      Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortThe identifier of the drug in useValue of extension
      Control10..1
      TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationRequest.extension:continuum.extension:medicineId.value[x].use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MedicationRequest.extension:continuum.extension:medicineId.value[x].system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Fixed Value
      {
        "system" : "urn:ietf:rfc:3986"
      }
      <system value="urn:ietf:rfc:3986"/>
      ExampleGeneral: http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. MedicationRequest.extension:continuum.extension:medicineId.value[x].value
      Definition

      Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.


      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe identifier of the drug in useThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      ExampleGeneral: 123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. MedicationRequest.extension:continuum.extension:medicineIdPart
      Slice NamemedicineIdPart
      Definition

      Automatically produced by the information system. Separates the different continuums of the same drug (that is, simultaneously used prescriptions for the same drug). As a rule, the drug used has only one medicine continuum at a time (only one active prescription). When it is necessary to have two or more active prescriptions for a drug, for example, when the patient uses two different strengths of the drug, the medicine continuums are separated by the part identifier of the medicine continuum.

      ShortPart identifier of medicine continuumAdditional content defined by implementations
      Control10..1*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      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())
      42. MedicationRequest.extension:continuum.extension:medicineIdPart.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Value
      {
        "url" : "medicineIdPart"
      }
      <url value="medicineIdPart"/>
      44. MedicationRequest.extension:continuum.extension:medicineIdPart.value[x]
      Definition

      Automatically produced by the information system. Separates the different continuums of the same drug (that is, simultaneously used prescriptions for the same drug). As a rule, the drug used has only one medicine continuum at a time (only one active prescription). When it is necessary to have two or more active prescriptions for a drug, for example, when the patient uses two different strengths of the drug, the medicine continuums are separated by the part identifier of the medicine continuum.


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortPart identifier of medicine continuumValue of extension
      Control10..1
      TypepositiveInt, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [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
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. MedicationRequest.extension:continuum.extension:newest
      Slice Namenewest
      Definition

      Information maintained by the Kanta Prescription Centre on what is the latest prescription in the medicine continuum. The value True says that the prescription is the latest prescription in the continuum.

      ShortStatus information 'Latest'Additional content defined by implementations
      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      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())
      50. MedicationRequest.extension:continuum.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Value
      {
        "url" : "http://resepti.kanta.fi/fhir/StructureDefinition/extension/continuum"
      }
      <url value="http://resepti.kanta.fi/fhir/StructureDefinition/extension/continuum"/>
      52. MedicationRequest.extension:continuum.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control0..01
      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. MedicationRequest.extension:stopDate
      Slice NamestopDate
      Definition

      Lääkkeen lopetuspäivämäärä ja tarvittaessa kellonaika. Päivämäärätieto kertoo lääkehoidon voimassaolon (riippumatta reseptin voimassaolosta). Lopetuspäivämäärä voidaan kirjata lääkkeen käytön lopettamishetkellä tai merkitä suunnitellusti tulevaisuuteen. Tietoa hyödynnetään lääkityslistan muodostamisessa ja potilaan voimassa olevan lääkityksen näyttämisessä.

      ShortLääkkeen lopetuspäivä
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension stopDate) (Extension Type: dateTime)
      Is Modifierfalse
      Summaryfalse
      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())
      56. MedicationRequest.extension:stopReasonCode
      Slice NamestopReasonCode
      Definition

      Lääkkeen lopetuksen syy. THL - Lääkehoidon muutoksen syy -koodiston mukaan.

      ShortLääkkeen lopetuksen syy
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension stopReasonCode) (Extension Type: Coding)
      Is Modifierfalse
      Summaryfalse
      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())
      58. MedicationRequest.extension:stopReasonText
      Slice NamestopReasonText
      Definition

      Lääkkeen lopetukseen liittyvät lisätiedot. Lopetuksen perumisen perustelu ja lopetuksen syynä olevan haittavaikutuksen lisäselvitys on voitu kirjata tähän.

      ShortLääkkeen lopetuksen lisätiedot
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension stopReasonText) (Extension Type: string)
      Is Modifierfalse
      Summaryfalse
      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())
      60. MedicationRequest.extension:adverseEffect
      Slice NameadverseEffect
      Definition

      Diagnosis code and the corresponding name for the adverse effect of the drug. According to the Kanta code system 'THL - Tautiluokitus ICD-10'. Repeated information, there may be several diagnosis codes linked to an adverse effect.

      ShortThe adverse effect of the drug
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension adverseEffect) (Extension Type: Coding)
      Is Modifierfalse
      Summaryfalse
      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())
      62. 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..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      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())
      64. MedicationRequest.identifier
      Definition

      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.

      ShortExternal 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..*
      TypeIdentifier
      Is Modifierfalse
      Summaryfalse
      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.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

        66. MedicationRequest.identifier:id
        Slice Nameid
        Definition

        Unique identifier of the document of prescription discontinuation. The identifier may be, for example, a unique identifier of a particular version of the discontinuation document.


        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.

        ShortDocument identifier (Unique identifier of the prescription discontinuation document)External 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)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. MedicationRequest.identifier:id.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).


        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Fixed Value
        {
          "system" : "http://resepti.kanta.fi/fhir/id/id"
        }
        <system value="http://resepti.kanta.fi/fhir/id/id"/>
        ExampleGeneral: http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. MedicationRequest.identifier:id.value
        Definition

        Unique OID identifier of a document of prescription discontinuation.


        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortUnique OID identifier of a document of prescription discontinuationThe value that is unique
        Comments

        Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)


        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        ExampleGeneral: 123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. MedicationRequest.identifier:setId
        Slice NamesetId
        Definition

        Identifier of the original document of prescription discontinuation that connects different versions of the document.


        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.

        ShortIdentifier of the original document of prescription discontinuationExternal 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)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. MedicationRequest.identifier:setId.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).


        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Fixed Value
        {
          "system" : "http://resepti.kanta.fi/fhir/id/setId"
        }
        <system value="http://resepti.kanta.fi/fhir/id/setId"/>
        ExampleGeneral: http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. MedicationRequest.identifier:setId.value
        Definition

        Identifier of the original document of prescription discontinuation that connects different versions of the document.


        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortIdentifier of the original document of prescription discontinuationThe value that is unique
        Comments

        Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)


        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        ExampleGeneral: 123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. MedicationRequest.status
        Definition

        Information is encoded as values of the Kanta code system 'Sähköinen lääkemääräys - Lopettamismerkinnän voimassaolotila' (1.2.246.537.5.xxxxxx): 1 = active, 3 = completed, 4 = on-hold.

        Used status values: active, cancelled, completed, on-hold


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

        Shortactive | 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
        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
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. MedicationRequest.statusReason
        Definition

        This information describes the type of prescription message that is recorded in the prescription discontinuation. Information is encoded as a value of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation


        Captures the reason for the current state of the MedicationRequest.

        ShortPrescription message typeReason 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.

        Control10..1
        BindingFor example codes, see medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1
        (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1)

        Identifies the reasons for a given status.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. MedicationRequest.statusReason.coding
        Definition

        Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.


        A reference to a code defined by a terminology system.

        ShortPrescription message typeCode 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.

        Control10..1*
        TypeCoding
        Is Modifierfalse
        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()))
        88. MedicationRequest.statusReason.coding.system
        Definition

        OID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.


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

        ShortOID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.Identity 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
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

        Fixed Value
        {
          "system" : "urn:oid:1.2.246.537.5.40105.2006"
        }
        <system value="urn:oid:1.2.246.537.5.40105.2006"/>
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. MedicationRequest.statusReason.coding.code
        Definition

        Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation


        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).

        ShortCode of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'Symbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        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()))
        92. MedicationRequest.intent
        Definition

        A standard value is used: order


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

        Shortproposal | 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
        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
        Summarytrue
        Fixed Value
        {
          "intent" : "order"
        }
        <intent value="order"/>
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. 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..0*
        BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1
        (example to http://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1)

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

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

        Shortroutine | urgent | asap | stat
        Control0..01
        BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
        (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
        Is Modifierfalse
        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()))
        98. 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
        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()))
        100. 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..01
        TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
        Is Modifierfalse
        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()))
        102. MedicationRequest.medication[x]
        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.

        ShortReference to MedicationListMedication resourceMedication 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
        TypeReference(MedicationListMedication, Medication)contained, CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. MedicationRequest.subject
        Definition

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

        ShortReference to MedicationListPatient resourceWho 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
        TypeReference(MedicationListPatient, Patient, Group)contained
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. MedicationRequest.encounter
        Definition

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

        ShortEncounter 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..01
        TypeReference(Encounter)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. 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
        Control0..0*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        110. MedicationRequest.authoredOn
        Definition

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

        ShortWhen request was initially authored
        Control0..01
        TypedateTime
        Is Modifierfalse
        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()))
        112. MedicationRequest.requester
        Definition

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

        ShortReference to MedicationlistPractitionerRole resourceWho/What requested the Request
        Control10..1
        TypeReference(MedicationListPractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)contained
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        114. MedicationRequest.performer
        Definition

        The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

        ShortIntended performer of administration
        Control0..01
        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        116. 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..01
        BindingFor example codes, see ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-role|4.0.1
        (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)

        Identifies the type of individual that is desired to administer the medication.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        118. MedicationRequest.recorder
        Definition

        The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

        ShortPerson who entered the request
        Control0..01
        TypeReference(Practitioner, PractitionerRole)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        120. MedicationRequest.reasonCode
        Definition

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

        ShortReason 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..0*
        BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
        (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

        A coded concept indicating why the medication was ordered.

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

        Condition or observation that supports why the medication was ordered.

        ShortCondition 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..0*
        TypeReference(Condition, Observation)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        124. 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
        Control0..0*
        Typecanonical
        Is Modifierfalse
        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()))
        126. 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
        Control0..0*
        Typeuri
        Is Modifierfalse
        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()))
        128. MedicationRequest.basedOn
        Definition

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

        ShortWhat request fulfills
        Control0..0*
        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        130. 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..01
        TypeIdentifier
        Is Modifierfalse
        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()))
        132. 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..01
        BindingFor example codes, see medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1
        (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1)

        Identifies the overall pattern of medication administratio.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        134. 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
        Control0..0*
        TypeReference(Coverage, ClaimResponse)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. MedicationRequest.note
        Definition

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

        ShortInformation about the prescription
        Control0..0*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        138. MedicationRequest.dosageInstruction
        Definition

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

        ShortHow 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..0*
        TypeDosage
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        140. 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..01
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        143. MedicationRequest.substitution
        Definition

        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.

        ShortAny restrictions on medication substitution
        Control0..01
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        147. MedicationRequest.priorPrescription
        Definition

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

        ShortAn order/prescription that is being replaced
        Control0..01
        TypeReference(MedicationRequest)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        149. MedicationRequest.detectedIssue
        Definition

        Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

        ShortClinical Issue with action
        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..0*
        TypeReference(DetectedIssue)
        Is Modifierfalse
        Summaryfalse
        Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        151. 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..0*
        TypeReference(Provenance)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

        See the documentation on how to interpret the contents of this table

        0. MedicationRequest
        2. MedicationRequest.meta
        4. MedicationRequest.meta.profile
        Control1..1
        Fixed Value
        {
          "profile" : "http://resepti.kanta.fi/fhir/StructureDefinition/MedicationListDiscontinuationMedicationRequest"
        }
        <profile value="http://resepti.kanta.fi/fhir/StructureDefinition/MedicationListDiscontinuationMedicationRequest"/>
        6. MedicationRequest.meta.tag
        Definition

        CDA R2 header specification templateId (specification package version).

        ShortCDA R2 header specification templateId (specification package version)
        Control1..1
        8. MedicationRequest.meta.tag.system
        Control1..?
        Fixed Value
        {
          "system" : "http://resepti.kanta.fi/fhir/cdaHeaderTemplateId"
        }
        <system value="http://resepti.kanta.fi/fhir/cdaHeaderTemplateId"/>
        10. MedicationRequest.meta.tag.code
        Definition

        CDA R2 header specification templateId (specification package version).

        ShortCDA R2 header specification templateId (specification package version)
        Control1..?
        12. MedicationRequest.extension
        Control5..?
        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
        • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

          14. MedicationRequest.extension:versionNumber
          Slice NameversionNumber
          Control1..1
          TypeExtension(Extension versionNumber) (Extension Type: positiveInt)
          Is Modifierfalse
          16. MedicationRequest.extension:versionNumber.value[x]
          Control1..?
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          18. MedicationRequest.extension:effectiveTime
          Slice NameeffectiveTime
          Definition

          The creation time of a document.

          Control1..?
          TypeExtension(Extension effectiveTime) (Extension Type: dateTime)
          Is Modifierfalse
          20. MedicationRequest.extension:continuum
          Slice Namecontinuum
          Definition

          Identifiers of medicine continuum: The identifier of the medicine in use and part identifier of medicine continuum.

          ShortThe identifier of the medicine in use and the part identifier of the medicine continuum
          Control1..1
          TypeExtension(Extension continuum) (Complex Extension)
          Is Modifierfalse
          22. MedicationRequest.extension:continuum.extension
          Control2..?
          SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

            24. MedicationRequest.extension:continuum.extension:medicineId
            Slice NamemedicineId
            Control1..1
            26. MedicationRequest.extension:continuum.extension:medicineIdPart
            Slice NamemedicineIdPart
            Control1..1
            28. MedicationRequest.extension:continuum.extension:newest
            Slice Namenewest
            Control0..0
            30. MedicationRequest.extension:stopDate
            Slice NamestopDate
            Control1..1
            TypeExtension(Extension stopDate) (Extension Type: dateTime)
            Is Modifierfalse
            32. MedicationRequest.extension:stopReasonCode
            Slice NamestopReasonCode
            Control1..1
            TypeExtension(Extension stopReasonCode) (Extension Type: Coding)
            Is Modifierfalse
            34. MedicationRequest.extension:stopReasonText
            Slice NamestopReasonText
            Control0..1
            TypeExtension(Extension stopReasonText) (Extension Type: string)
            Is Modifierfalse
            36. MedicationRequest.extension:adverseEffect
            Slice NameadverseEffect
            Control0..?
            TypeExtension(Extension adverseEffect) (Extension Type: Coding)
            Is Modifierfalse
            38. MedicationRequest.identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ system
            • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

              40. MedicationRequest.identifier:id
              Slice Nameid
              Definition

              Unique identifier of the document of prescription discontinuation. The identifier may be, for example, a unique identifier of a particular version of the discontinuation document.

              ShortDocument identifier (Unique identifier of the prescription discontinuation document)
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..1
              42. MedicationRequest.identifier:id.system
              Comments

              Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

              Control1..?
              Fixed Value
              {
                "system" : "http://resepti.kanta.fi/fhir/id/id"
              }
              <system value="http://resepti.kanta.fi/fhir/id/id"/>
              44. MedicationRequest.identifier:id.value
              Definition

              Unique OID identifier of a document of prescription discontinuation.

              ShortUnique OID identifier of a document of prescription discontinuation
              Comments

              Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

              Control1..?
              46. MedicationRequest.identifier:setId
              Slice NamesetId
              Definition

              Identifier of the original document of prescription discontinuation that connects different versions of the document.

              ShortIdentifier of the original document of prescription discontinuation
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..1
              48. MedicationRequest.identifier:setId.system
              Comments

              Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

              Control1..?
              Fixed Value
              {
                "system" : "http://resepti.kanta.fi/fhir/id/setId"
              }
              <system value="http://resepti.kanta.fi/fhir/id/setId"/>
              50. MedicationRequest.identifier:setId.value
              Definition

              Identifier of the original document of prescription discontinuation that connects different versions of the document.

              ShortIdentifier of the original document of prescription discontinuation
              Comments

              Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

              Control1..?
              52. MedicationRequest.status
              Definition

              Information is encoded as values of the Kanta code system 'Sähköinen lääkemääräys - Lopettamismerkinnän voimassaolotila' (1.2.246.537.5.xxxxxx): 1 = active, 3 = completed, 4 = on-hold.

              Used status values: active, cancelled, completed, on-hold

              54. MedicationRequest.statusReason
              Definition

              This information describes the type of prescription message that is recorded in the prescription discontinuation. Information is encoded as a value of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

              ShortPrescription message type
              Control1..?
              56. MedicationRequest.statusReason.coding
              Definition

              Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

              ShortPrescription message type
              Control1..1
              58. MedicationRequest.statusReason.coding.system
              Definition

              OID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

              ShortOID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.
              Control1..?
              Fixed Value
              {
                "system" : "urn:oid:1.2.246.537.5.40105.2006"
              }
              <system value="urn:oid:1.2.246.537.5.40105.2006"/>
              60. MedicationRequest.statusReason.coding.code
              Definition

              Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

              ShortCode of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'
              Control1..?
              62. MedicationRequest.intent
              Definition

              A standard value is used: order

              Fixed Value
              {
                "intent" : "order"
              }
              <intent value="order"/>
              64. MedicationRequest.category
              Control0..0
              66. MedicationRequest.priority
              Control0..0
              68. MedicationRequest.doNotPerform
              Control0..0
              70. MedicationRequest.reported[x]
              Control0..0
              72. MedicationRequest.medication[x]
              ShortReference to MedicationListMedication resource
              TypeReference(MedicationListMedication)contained, CodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              74. MedicationRequest.subject
              ShortReference to MedicationListPatient resource
              TypeReference(MedicationListPatient)contained
              76. MedicationRequest.encounter
              Control0..0
              78. MedicationRequest.supportingInformation
              Control0..0
              80. MedicationRequest.authoredOn
              Control0..0
              82. MedicationRequest.requester
              ShortReference to MedicationlistPractitionerRole resource
              Control1..?
              TypeReference(MedicationListPractitionerRole)contained
              84. MedicationRequest.performer
              Control0..0
              86. MedicationRequest.performerType
              Control0..0
              88. MedicationRequest.recorder
              Control0..0
              90. MedicationRequest.reasonCode
              Control0..0
              92. MedicationRequest.reasonReference
              Control0..0
              94. MedicationRequest.instantiatesCanonical
              Control0..0
              96. MedicationRequest.instantiatesUri
              Control0..0
              98. MedicationRequest.basedOn
              Control0..0
              100. MedicationRequest.groupIdentifier
              Control0..0
              102. MedicationRequest.courseOfTherapyType
              Control0..0
              104. MedicationRequest.insurance
              Control0..0
              106. MedicationRequest.note
              Control0..0
              108. MedicationRequest.dosageInstruction
              Control0..0
              110. MedicationRequest.dispenseRequest
              Control0..0
              112. MedicationRequest.substitution
              Control0..0
              114. MedicationRequest.priorPrescription
              Control0..0
              116. MedicationRequest.detectedIssue
              Control0..0
              118. MedicationRequest.eventHistory
              Control0..0

              See the documentation on how to interpret the contents of this table

              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
              Control0..*
              Is Modifierfalse
              Summaryfalse
              Alternate NamesPrescription, Order
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              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
              Is Modifierfalse
              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
              TypeMeta
              Is Modifierfalse
              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
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              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..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              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
                Typeid
                Is Modifierfalse
                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
                Typeinstant
                Is Modifierfalse
                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
                Typeuri
                Is Modifierfalse
                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()))
                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.

                Control1..1
                Typecanonical(StructureDefinition)
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Fixed Value
                {
                  "profile" : "http://resepti.kanta.fi/fhir/StructureDefinition/MedicationListDiscontinuationMedicationRequest"
                }
                <profile value="http://resepti.kanta.fi/fhir/StructureDefinition/MedicationListDiscontinuationMedicationRequest"/>
                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..*
                BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                Security Labels from the Healthcare Privacy and Security Classification System.

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

                CDA R2 header specification templateId (specification package version).

                ShortCDA R2 header specification templateId (specification package version)
                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.

                Control1..1
                BindingFor example codes, see CommonTags
                (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

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

                TypeCoding
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                22. MedicationRequest.meta.tag.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
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                24. MedicationRequest.meta.tag.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..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                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.tag.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 26. MedicationRequest.meta.tag.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
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

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

                  Fixed Value
                  {
                    "system" : "http://resepti.kanta.fi/fhir/cdaHeaderTemplateId"
                  }
                  <system value="http://resepti.kanta.fi/fhir/cdaHeaderTemplateId"/>
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  28. MedicationRequest.meta.tag.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
                  Typestring
                  Is Modifierfalse
                  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()))
                  30. MedicationRequest.meta.tag.code
                  Definition

                  CDA R2 header specification templateId (specification package version).

                  ShortCDA R2 header specification templateId (specification package version)
                  Control1..1
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  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()))
                  32. MedicationRequest.meta.tag.display
                  Definition

                  A representation of the meaning of the code in the system, following the rules of the system.

                  ShortRepresentation defined by the system
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  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()))
                  34. MedicationRequest.meta.tag.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
                  Typeboolean
                  Is Modifierfalse
                  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()))
                  36. 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
                  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()))
                  38. 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
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  40. 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
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. 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
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  44. MedicationRequest.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control5..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  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
                  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                    46. MedicationRequest.extension:versionNumber
                    Slice NameversionNumber
                    Definition

                    Lääkitysasiakirjan versiointinumero.

                    ShortAsiakirjan versio
                    Control1..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Extension versionNumber) (Extension Type: positiveInt)
                    Is Modifierfalse
                    Summaryfalse
                    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())
                    48. MedicationRequest.extension:versionNumber.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
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    50. MedicationRequest.extension:versionNumber.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..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 52. MedicationRequest.extension:versionNumber.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Value
                      {
                        "url" : "http://resepti.kanta.fi/StructureDefinition/extension/versionNumber"
                      }
                      <url value="http://resepti.kanta.fi/StructureDefinition/extension/versionNumber"/>
                      54. MedicationRequest.extension:versionNumber.value[x]
                      Definition

                      Lääkitysasiakirjan versiointinumero.

                      ShortAsiakirjan versio
                      Control1..1
                      TypepositiveInt
                      [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
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      56. MedicationRequest.extension:effectiveTime
                      Slice NameeffectiveTime
                      Definition

                      The creation time of a document.

                      ShortThe creation time of a document
                      Control1..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension effectiveTime) (Extension Type: dateTime)
                      Is Modifierfalse
                      Summaryfalse
                      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())
                      58. MedicationRequest.extension:continuum
                      Slice Namecontinuum
                      Definition

                      Identifiers of medicine continuum: The identifier of the medicine in use and part identifier of medicine continuum.

                      ShortThe identifier of the medicine in use and the part identifier of the medicine continuum
                      Control1..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension continuum) (Complex Extension)
                      Is Modifierfalse
                      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())
                      60. MedicationRequest.extension:continuum.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
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      62. MedicationRequest.extension:continuum.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control2..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                        64. MedicationRequest.extension:continuum.extension:medicineId
                        Slice NamemedicineId
                        Definition

                        Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

                        ShortThe identifier of the drug in use
                        Control1..1
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        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())
                        66. MedicationRequest.extension:continuum.extension:medicineId.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
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        68. MedicationRequest.extension:continuum.extension:medicineId.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..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        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.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 70. MedicationRequest.extension:continuum.extension:medicineId.url
                          Definition

                          Source of the definition for the extension code - a logical name or a URL.

                          Shortidentifies the meaning of the extension
                          Comments

                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                          Control1..1
                          Typeuri
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          Fixed Value
                          {
                            "url" : "medicineId"
                          }
                          <url value="medicineId"/>
                          72. MedicationRequest.extension:continuum.extension:medicineId.value[x]
                          Definition

                          Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

                          ShortThe identifier of the drug in use
                          Control1..1
                          TypeIdentifier
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. MedicationRequest.extension:continuum.extension:medicineId.value[x].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
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          76. MedicationRequest.extension:continuum.extension:medicineId.value[x].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..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          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.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 78. MedicationRequest.extension:continuum.extension:medicineId.value[x].use
                            Definition

                            The purpose of this identifier.

                            Shortusual | official | temp | secondary | old (If known)
                            Comments

                            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                            Control0..1
                            BindingThe codes SHALL be taken from IdentifierUse
                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                            Identifies the purpose for this identifier, if known .

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            80. MedicationRequest.extension:continuum.extension:medicineId.value[x].type
                            Definition

                            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                            ShortDescription of identifier
                            Comments

                            This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

                            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Allows users to make use of identifiers when the identifier system is not known.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            82. MedicationRequest.extension:continuum.extension:medicineId.value[x].system
                            Definition

                            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                            ShortThe namespace for the identifier value
                            Comments

                            Identifier.system is always case sensitive.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                            Fixed Value
                            {
                              "system" : "urn:ietf:rfc:3986"
                            }
                            <system value="urn:ietf:rfc:3986"/>
                            ExampleGeneral: http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            84. MedicationRequest.extension:continuum.extension:medicineId.value[x].value
                            Definition

                            Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

                            ShortThe identifier of the drug in use
                            Comments

                            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            ExampleGeneral: 123456
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            86. MedicationRequest.extension:continuum.extension:medicineId.value[x].period
                            Definition

                            Time period during which identifier is/was valid for use.

                            ShortTime period when id is/was valid for use
                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            88. MedicationRequest.extension:continuum.extension:medicineId.value[x].assigner
                            Definition

                            Organization that issued/manages the identifier.

                            ShortOrganization that issued id (may be just text)
                            Comments

                            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                            Control0..1
                            TypeReference(Organization)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            90. MedicationRequest.extension:continuum.extension:medicineIdPart
                            Slice NamemedicineIdPart
                            Definition

                            Automatically produced by the information system. Separates the different continuums of the same drug (that is, simultaneously used prescriptions for the same drug). As a rule, the drug used has only one medicine continuum at a time (only one active prescription). When it is necessary to have two or more active prescriptions for a drug, for example, when the patient uses two different strengths of the drug, the medicine continuums are separated by the part identifier of the medicine continuum.

                            ShortPart identifier of medicine continuum
                            Control1..1
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            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())
                            92. MedicationRequest.extension:continuum.extension:medicineIdPart.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
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            94. MedicationRequest.extension:continuum.extension:medicineIdPart.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..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            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.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 96. MedicationRequest.extension:continuum.extension:medicineIdPart.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies the meaning of the extension
                              Comments

                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Value
                              {
                                "url" : "medicineIdPart"
                              }
                              <url value="medicineIdPart"/>
                              98. MedicationRequest.extension:continuum.extension:medicineIdPart.value[x]
                              Definition

                              Automatically produced by the information system. Separates the different continuums of the same drug (that is, simultaneously used prescriptions for the same drug). As a rule, the drug used has only one medicine continuum at a time (only one active prescription). When it is necessary to have two or more active prescriptions for a drug, for example, when the patient uses two different strengths of the drug, the medicine continuums are separated by the part identifier of the medicine continuum.

                              ShortPart identifier of medicine continuum
                              Control1..1
                              TypepositiveInt
                              [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
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              100. MedicationRequest.extension:continuum.extension:newest
                              Slice Namenewest
                              Definition

                              Information maintained by the Kanta Prescription Centre on what is the latest prescription in the medicine continuum. The value True says that the prescription is the latest prescription in the continuum.

                              ShortStatus information 'Latest'
                              Control0..0
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              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())
                              106. MedicationRequest.extension:continuum.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies the meaning of the extension
                              Comments

                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Value
                              {
                                "url" : "http://resepti.kanta.fi/fhir/StructureDefinition/extension/continuum"
                              }
                              <url value="http://resepti.kanta.fi/fhir/StructureDefinition/extension/continuum"/>
                              108. MedicationRequest.extension:continuum.value[x]
                              Definition

                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                              ShortValue of extension
                              Control0..0
                              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              110. MedicationRequest.extension:stopDate
                              Slice NamestopDate
                              Definition

                              Lääkkeen lopetuspäivämäärä ja tarvittaessa kellonaika. Päivämäärätieto kertoo lääkehoidon voimassaolon (riippumatta reseptin voimassaolosta). Lopetuspäivämäärä voidaan kirjata lääkkeen käytön lopettamishetkellä tai merkitä suunnitellusti tulevaisuuteen. Tietoa hyödynnetään lääkityslistan muodostamisessa ja potilaan voimassa olevan lääkityksen näyttämisessä.

                              ShortLääkkeen lopetuspäivä
                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Extension stopDate) (Extension Type: dateTime)
                              Is Modifierfalse
                              Summaryfalse
                              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())
                              112. MedicationRequest.extension:stopReasonCode
                              Slice NamestopReasonCode
                              Definition

                              Lääkkeen lopetuksen syy. THL - Lääkehoidon muutoksen syy -koodiston mukaan.

                              ShortLääkkeen lopetuksen syy
                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Extension stopReasonCode) (Extension Type: Coding)
                              Is Modifierfalse
                              Summaryfalse
                              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())
                              114. MedicationRequest.extension:stopReasonText
                              Slice NamestopReasonText
                              Definition

                              Lääkkeen lopetukseen liittyvät lisätiedot. Lopetuksen perumisen perustelu ja lopetuksen syynä olevan haittavaikutuksen lisäselvitys on voitu kirjata tähän.

                              ShortLääkkeen lopetuksen lisätiedot
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Extension stopReasonText) (Extension Type: string)
                              Is Modifierfalse
                              Summaryfalse
                              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())
                              116. MedicationRequest.extension:adverseEffect
                              Slice NameadverseEffect
                              Definition

                              Diagnosis code and the corresponding name for the adverse effect of the drug. According to the Kanta code system 'THL - Tautiluokitus ICD-10'. Repeated information, there may be several diagnosis codes linked to an adverse effect.

                              ShortThe adverse effect of the drug
                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Extension adverseEffect) (Extension Type: Coding)
                              Is Modifierfalse
                              Summaryfalse
                              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())
                              118. 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..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                              Summaryfalse
                              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())
                              120. MedicationRequest.identifier
                              Definition

                              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.

                              ShortExternal 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..*
                              TypeIdentifier
                              Is Modifierfalse
                              Summaryfalse
                              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.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ system
                              • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                122. MedicationRequest.identifier:id
                                Slice Nameid
                                Definition

                                Unique identifier of the document of prescription discontinuation. The identifier may be, for example, a unique identifier of a particular version of the discontinuation document.

                                ShortDocument identifier (Unique identifier of the prescription discontinuation document)
                                Comments

                                This is a business identifier, not a resource identifier.

                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control1..1
                                TypeIdentifier
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                124. MedicationRequest.identifier:id.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
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                126. MedicationRequest.identifier:id.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..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                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.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 128. MedicationRequest.identifier:id.use
                                  Definition

                                  The purpose of this identifier.

                                  Shortusual | official | temp | secondary | old (If known)
                                  Comments

                                  Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                  Control0..1
                                  BindingThe codes SHALL be taken from IdentifierUse
                                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                  Identifies the purpose for this identifier, if known .

                                  Typecode
                                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                                  A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                  ShortDescription of identifier
                                  Comments

                                  This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                  Control0..1
                                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

                                  A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows users to make use of identifiers when the identifier system is not known.

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

                                  Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                  ShortThe namespace for the identifier value
                                  Comments

                                  Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                  Fixed Value
                                  {
                                    "system" : "http://resepti.kanta.fi/fhir/id/id"
                                  }
                                  <system value="http://resepti.kanta.fi/fhir/id/id"/>
                                  ExampleGeneral: http://www.acme.com/identifiers/patient
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  134. MedicationRequest.identifier:id.value
                                  Definition

                                  Unique OID identifier of a document of prescription discontinuation.

                                  ShortUnique OID identifier of a document of prescription discontinuation
                                  Comments

                                  Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

                                  Control1..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  ExampleGeneral: 123456
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  136. MedicationRequest.identifier:id.period
                                  Definition

                                  Time period during which identifier is/was valid for use.

                                  ShortTime period when id is/was valid for use
                                  Control0..1
                                  TypePeriod
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  138. MedicationRequest.identifier:id.assigner
                                  Definition

                                  Organization that issued/manages the identifier.

                                  ShortOrganization that issued id (may be just text)
                                  Comments

                                  The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                  Control0..1
                                  TypeReference(Organization)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  140. MedicationRequest.identifier:setId
                                  Slice NamesetId
                                  Definition

                                  Identifier of the original document of prescription discontinuation that connects different versions of the document.

                                  ShortIdentifier of the original document of prescription discontinuation
                                  Comments

                                  This is a business identifier, not a resource identifier.

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control1..1
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  142. MedicationRequest.identifier:setId.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
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  144. MedicationRequest.identifier:setId.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..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  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.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 146. MedicationRequest.identifier:setId.use
                                    Definition

                                    The purpose of this identifier.

                                    Shortusual | official | temp | secondary | old (If known)
                                    Comments

                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                    Control0..1
                                    BindingThe codes SHALL be taken from IdentifierUse
                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                    Identifies the purpose for this identifier, if known .

                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    148. MedicationRequest.identifier:setId.type
                                    Definition

                                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                    ShortDescription of identifier
                                    Comments

                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

                                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows users to make use of identifiers when the identifier system is not known.

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

                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

                                    Control1..1
                                    Typeuri
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                    Fixed Value
                                    {
                                      "system" : "http://resepti.kanta.fi/fhir/id/setId"
                                    }
                                    <system value="http://resepti.kanta.fi/fhir/id/setId"/>
                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    152. MedicationRequest.identifier:setId.value
                                    Definition

                                    Identifier of the original document of prescription discontinuation that connects different versions of the document.

                                    ShortIdentifier of the original document of prescription discontinuation
                                    Comments

                                    Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

                                    Control1..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    154. MedicationRequest.identifier:setId.period
                                    Definition

                                    Time period during which identifier is/was valid for use.

                                    ShortTime period when id is/was valid for use
                                    Control0..1
                                    TypePeriod
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    156. MedicationRequest.identifier:setId.assigner
                                    Definition

                                    Organization that issued/manages the identifier.

                                    ShortOrganization that issued id (may be just text)
                                    Comments

                                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                    Control0..1
                                    TypeReference(Organization)
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    158. MedicationRequest.status
                                    Definition

                                    Information is encoded as values of the Kanta code system 'Sähköinen lääkemääräys - Lopettamismerkinnän voimassaolotila' (1.2.246.537.5.xxxxxx): 1 = active, 3 = completed, 4 = on-hold.

                                    Used status values: active, cancelled, completed, on-hold

                                    Shortactive | 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
                                    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
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    160. MedicationRequest.statusReason
                                    Definition

                                    This information describes the type of prescription message that is recorded in the prescription discontinuation. Information is encoded as a value of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

                                    ShortPrescription message type
                                    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.

                                    Control1..1
                                    BindingFor example codes, see medicationRequest Status Reason Codes
                                    (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1)

                                    Identifies the reasons for a given status.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    162. MedicationRequest.statusReason.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
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    164. MedicationRequest.statusReason.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..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    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.statusReason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 166. MedicationRequest.statusReason.coding
                                      Definition

                                      Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

                                      ShortPrescription message type
                                      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.

                                      Control1..1
                                      TypeCoding
                                      Is Modifierfalse
                                      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()))
                                      168. MedicationRequest.statusReason.coding.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
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      170. MedicationRequest.statusReason.coding.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..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      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.statusReason.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 172. MedicationRequest.statusReason.coding.system
                                        Definition

                                        OID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

                                        ShortOID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.
                                        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
                                        Typeuri
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

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

                                        Fixed Value
                                        {
                                          "system" : "urn:oid:1.2.246.537.5.40105.2006"
                                        }
                                        <system value="urn:oid:1.2.246.537.5.40105.2006"/>
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        174. MedicationRequest.statusReason.coding.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
                                        Typestring
                                        Is Modifierfalse
                                        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()))
                                        176. MedicationRequest.statusReason.coding.code
                                        Definition

                                        Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

                                        ShortCode of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'
                                        Control1..1
                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        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()))
                                        178. MedicationRequest.statusReason.coding.display
                                        Definition

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortRepresentation defined by the system
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        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()))
                                        180. MedicationRequest.statusReason.coding.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
                                        Typeboolean
                                        Is Modifierfalse
                                        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()))
                                        182. MedicationRequest.statusReason.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
                                        Typestring
                                        Is Modifierfalse
                                        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()))
                                        184. MedicationRequest.intent
                                        Definition

                                        A standard value is used: order

                                        Shortproposal | 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
                                        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
                                        Summarytrue
                                        Fixed Value
                                        {
                                          "intent" : "order"
                                        }
                                        <intent value="order"/>
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        186. 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..0
                                        BindingFor example codes, see medicationRequest Category Codes
                                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1)

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

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

                                        Shortroutine | urgent | asap | stat
                                        Control0..0
                                        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
                                        Is Modifierfalse
                                        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()))
                                        190. 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
                                        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()))
                                        192. 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..0
                                        TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                                        Is Modifierfalse
                                        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()))
                                        194. MedicationRequest.medication[x]
                                        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.

                                        ShortReference to MedicationListMedication resource
                                        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
                                        TypeReference(MedicationListMedication)contained
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        196. MedicationRequest.subject
                                        Definition

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

                                        ShortReference to MedicationListPatient resource
                                        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
                                        TypeReference(MedicationListPatient)contained
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        198. MedicationRequest.encounter
                                        Definition

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

                                        ShortEncounter 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..0
                                        TypeReference(Encounter)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        200. 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
                                        Control0..0
                                        TypeReference(Resource)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        202. MedicationRequest.authoredOn
                                        Definition

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

                                        ShortWhen request was initially authored
                                        Control0..0
                                        TypedateTime
                                        Is Modifierfalse
                                        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()))
                                        204. MedicationRequest.requester
                                        Definition

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

                                        ShortReference to MedicationlistPractitionerRole resource
                                        Control1..1
                                        TypeReference(MedicationListPractitionerRole)contained
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        206. MedicationRequest.performer
                                        Definition

                                        The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

                                        ShortIntended performer of administration
                                        Control0..0
                                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        208. 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..0
                                        BindingFor example codes, see ProcedurePerformerRoleCodes
                                        (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)

                                        Identifies the type of individual that is desired to administer the medication.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        210. MedicationRequest.recorder
                                        Definition

                                        The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

                                        ShortPerson who entered the request
                                        Control0..0
                                        TypeReference(Practitioner, PractitionerRole)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        212. MedicationRequest.reasonCode
                                        Definition

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

                                        ShortReason 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..0
                                        BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                        (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                        A coded concept indicating why the medication was ordered.

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

                                        Condition or observation that supports why the medication was ordered.

                                        ShortCondition 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..0
                                        TypeReference(Condition, Observation)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        216. 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
                                        Control0..0
                                        Typecanonical
                                        Is Modifierfalse
                                        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()))
                                        218. 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
                                        Control0..0
                                        Typeuri
                                        Is Modifierfalse
                                        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()))
                                        220. MedicationRequest.basedOn
                                        Definition

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

                                        ShortWhat request fulfills
                                        Control0..0
                                        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        222. 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..0
                                        TypeIdentifier
                                        Is Modifierfalse
                                        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()))
                                        224. 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..0
                                        BindingFor example codes, see medicationRequest Course of Therapy Codes
                                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1)

                                        Identifies the overall pattern of medication administratio.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        226. 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
                                        Control0..0
                                        TypeReference(Coverage, ClaimResponse)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        228. MedicationRequest.note
                                        Definition

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

                                        ShortInformation about the prescription
                                        Control0..0
                                        TypeAnnotation
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        230. MedicationRequest.dosageInstruction
                                        Definition

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

                                        ShortHow 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..0
                                        TypeDosage
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        232. 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..0
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        249. MedicationRequest.substitution
                                        Definition

                                        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.

                                        ShortAny restrictions on medication substitution
                                        Control0..0
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        256. MedicationRequest.priorPrescription
                                        Definition

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

                                        ShortAn order/prescription that is being replaced
                                        Control0..0
                                        TypeReference(MedicationRequest)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        258. MedicationRequest.detectedIssue
                                        Definition

                                        Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

                                        ShortClinical Issue with action
                                        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..0
                                        TypeReference(DetectedIssue)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        260. 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..0
                                        TypeReference(Provenance)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))