xCaliber healthCare Data Mesh

MedicationRequest

Overview

The MedicationRequest API allows creating, retrieving and managing medication orders electronically. Healthcare developers can use it to build solutions that integrate with e-prescribing systems and electronic health records to streamline medication ordering and administration workflows for improved patient safety.

Use Cases

  • Electronic Prescribing - Build interfaces to create, send, receive, and manage electronic prescriptions.
  • Inpatient Ordering - Develop solutions to electronically enter and track inpatient medication orders.
  • Pharmacy Integration - Link with pharmacy systems to automatically send and track electronic medication orders.
  • Decision Support - Incorporate clinical logic to provide dosing guidance, duplicate checking, and alerts during ordering.
  • Order Renewals - Create functionality for providers to easily renew expiring medication orders electronically.
  • Inventory Integration - Update medication inventory in real-time as electronic orders are placed and fulfilled.
  • Reporting & Analytics - Run reports on ordering patterns, volumes, changes etc. across patient cohorts.
  • Formulary Checks - Perform real-time formulary and benefits checks while ordering to determine coverage.

EHR Data Model

EHRSupported?Mapped Source Object
AthenaPrescription
ElationMedication, Medication Order Template
EpicMedication Order Provider, Medication Order

Object Definition

{
  "resourceType": "MedicationRequest",
  "id": "medrx0311",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: medrx0311</p><p><b>contained</b>: </p><p><b>identifier</b>: 12345689 (OFFICIAL)</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>medication</b>: id: med0316; Chlorthalidone 50mg tablet (product) <span>(Details : {SNOMED CT code '317935006' = 'Chlortalidone 50mg tablet', given as 'Chlorthalidone 50mg tablet (product)'})</span>; Tablet dose form (qualifier value) <span>(Details : {SNOMED CT code '385055001' = 'Tablet', given as 'Tablet dose form (qualifier value)'})</span></p><p><b>subject</b>: <a>Donald Duck</a></p><p><b>encounter</b>: <a>encounter who leads to this prescription</a></p><p><b>authoredOn</b>: 15/01/2015</p><p><b>requester</b>: <a>Patrick Pump</a></p><p><b>reasonReference</b>: <a>condition for prescribing this medication</a></p><p><b>note</b>: Chlorthalidone increases urniation so take it in the morning</p><p><b>dosageInstruction</b>: </p><h3>DispenseRequests</h3><table><tr><td>-</td><td><b>ValidityPeriod</b></td><td><b>NumberOfRepeatsAllowed</b></td><td><b>Quantity</b></td><td><b>ExpectedSupplyDuration</b></td></tr><tr><td>*</td><td>15/01/2015 --&gt; 15/01/2016</td><td>1</td><td>30 TAB<span> (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code TAB = 'Tablet')</span></td><td>30 days<span> (Details: UCUM code d = 'd')</span></td></tr></table><h3>Substitutions</h3><table><tr><td>-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td>*</td><td>true</td><td>continuing therapy <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-ActReason code 'CT' = 'continuing therapy', given as 'continuing therapy'})</span></td></tr></table></div>"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0316",
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "317935006",
            "display": "Chlorthalidone 50mg tablet (product)"
          }
        ]
      },
      "form": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "385055001",
            "display": "Tablet dose form (qualifier value)"
          }
        ]
      }
    }
  ],
  "identifier": [
    {
      "use": "official",
      "system": "http://www.bmc.nl/portal/prescriptions",
      "value": "12345689"
    }
  ],
  "status": "active",
  "intent": "order",
  "medicationReference": {
    "reference": "#med0316"
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "encounter": {
    "reference": "Encounter/f001",
    "display": "encounter who leads to this prescription"
  },
  "authoredOn": "2015-01-15",
  "requester": {
    "reference": "Practitioner/f007",
    "display": "Patrick Pump"
  },
  "reasonReference": [
    {
      "reference": "Condition/f201",
      "display": "condition for prescribing this medication"
    }
  ],
  "note": [
    {
      "text": "Chlorthalidone increases urniation so take it in the morning"
    }
  ],
  "dosageInstruction": [
    {
      "sequence": 1,
      "text": "One tablet daily",
      "additionalInstruction": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "311504000",
              "display": "With or after food"
            }
          ]
        }
      ],
      "timing": {
        "code": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-GTSAbbreviation",
              "code": "QD",
              "display": "QD"
            }
          ]
        }
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "26643006",
            "display": "Oral Route"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "421521009",
            "display": "Swallow - dosing instruction imperative (qualifier value)"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseQuantity": {
            "value": 1,
            "unit": "TAB",
            "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
            "code": "TAB"
          }
        }
      ]
    }
  ],
  "dispenseRequest": {
    "validityPeriod": {
      "start": "2015-01-15",
      "end": "2016-01-15"
    },
    "numberOfRepeatsAllowed": 1,
    "quantity": {
      "value": 30,
      "unit": "TAB",
      "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
      "code": "TAB"
    },
    "expectedSupplyDuration": {
      "value": 30,
      "unit": "days",
      "system": "http://unitsofmeasure.org",
      "code": "d"
    }
  },
  "substitution": {
    "allowedBoolean": true,
    "reason": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "code": "CT",
          "display": "continuing therapy"
        }
      ]
    }
  },
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}

Data Fields

Data FieldTypeDescription
resourceTypeMedicationRequestThis is a MedicationRequest resource
ididThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
metaMetaThe 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.
implicitRulesuriA 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.
languagecodeThe base language in which the resource is written.
textNarrativeA 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.
containedBackboneElementThese 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.
extensionExtensionMay 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.
modifierExtensionExtensionMay 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).
identifierIdentifierIdentifiers 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.
statuscodeA code specifying the current state of the order. Generally, this will be active or completed state.
statusReasonCodeableConceptCaptures the reason for the current state of the MedicationRequest.
intentcodeWhether the request is a proposal, plan, or an original order.
categoryCodeableConceptIndicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
prioritycodeIndicates how quickly the Medication Request should be addressed with respect to other requests.
doNotPerformbooleanIf true indicates that the provider is asking for the medication request not to occur.
reportedBooleanbooleanIndicates 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.
reportedReferenceReferenceIndicates 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.
medicationCodeableConceptCodeableConceptIdentifies 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.
medicationReferenceReferenceIdentifies 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.
subjectReferenceA link to a resource representing the person or set of individuals to whom the medication will be given.
encounterReferenceThe Encounter during which this [x] was created or to which the creation of this record is tightly associated.
supportingInformationReferenceInclude additional information (for example, patient height and weight) that supports the ordering of the medication.
authoredOndateTimeThe date (and perhaps time) when the prescription was initially written or authored on.
requesterReferenceThe individual, organization, or device that initiated the request and has responsibility for its activation.
performerReferenceThe specified desired performer of the medication treatment (e.g. the performer of the medication administration).
performerTypeCodeableConceptIndicates the type of performer of the administration of the medication.
recorderReferenceThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.
reasonCodeCodeableConceptThe reason or the indication for ordering or not ordering the medication.
reasonReferenceReferenceCondition or observation that supports why the medication was ordered.
instantiatesCanonicalcanonicalThe URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.
instantiatesUriuriThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.
basedOnReferenceA plan or request that is fulfilled in whole or in part by this medication request.
groupIdentifierIdentifierA 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.
courseOfTherapyTypeCodeableConceptThe description of the overall patte3rn of the administration of the medication to the patient.
insuranceReferenceInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
noteAnnotationExtra information about the prescription that could not be conveyed by the other attributes.
dosageInstructionDosageIndicates how the medication is to be used by the patient.
dispenseRequestBackboneElementIndicates 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.
dispenseRequest.idstringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
dispenseRequest.extensionExtensionMay 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.
dispenseRequest.modifierExtensionExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
dispenseRequest.initialFillBackboneElementIndicates the quantity or duration for the first dispense of the medication.
dispenseRequest.initialFill.idstringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
dispenseRequest.initialFill.extensionExtensionMay 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.
dispenseRequest.initialFill.modifierExtensionExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
dispenseRequest.initialFill.quantityQuantityThe amount or quantity to provide as part of the first dispense.
dispenseRequest.initialFill.durationDurationThe length of time that the first dispense is expected to last.
dispenseRequest.dispenseIntervalDurationThe minimum period of time that must occur between dispenses of the medication.
dispenseRequest.validityPeriodPeriodThis indicates the validity period of a prescription (stale dating the Prescription).
dispenseRequest.numberOfRepeatsAllowedunsignedIntAn integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.
dispenseRequest.quantityQuantityThe amount that is to be dispensed for one fill.
dispenseRequest.expectedSupplyDurationDurationIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
dispenseRequest.performerReferenceIndicates the intended dispensing Organization specified by the prescriber.
substitutionBackboneElementIndicates 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.
substitution.idstringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
substitution.extensionExtensionMay 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.
substitution.modifierExtensionExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
substitution.allowedBooleanbooleanTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
substitution.allowedCodeableConceptCodeableConceptTrue if the prescriber allows a different drug to be dispensed from what was prescribed.
substitution.reasonCodeableConceptIndicates the reason for the substitution, or why substitution must or must not be performed.
priorPrescriptionReferenceA link to a resource representing an earlier order related order or prescription.
detectedIssueReferenceIndicates 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.
eventHistoryReferenceLinks 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.

Extensions

NameURL

Operations & APIs

MedicationRequest-GET

MedicationRequest-POST

MedicationRequest ID-GET

MedicationRequest ID-PUT

MedicationRequest ID-DELETE

MedicationRequest Export-POST