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.

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

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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.

Уникальный идентификатор элемента в ресурсе (для внутренних ссылок). Это может быть любое строковое значение, не содержащее пробелов.

An Extension

Идентификатор конкретной версии, который отображается в части URL, относящейся к версии. Это значение изменяется при создании, обновлении или удалении ресурса.

Сервер присваивает это значение и игнорирует то, что указывает клиент, за исключением случая, когда сервер устанавливает целостность версии при обновлении/удалении.

Когда ресурс менялся в последний раз - например, когда изменилась версия.

Этот элемент обычно опускается в экземплярах, отправляемых с помощью PUT или POST. Вместо этого он заполняется в экземпляре ответа и при получении информации с помощью GET. Это значение задается менеджером сервера / ресурсов; то, что предоставляет клиент, не имеет значения. Это эквивалентно последнему изменению HTTP и должно иметь такое же значение при взаимодействии read.

uri, который идентифицирует систему-источник ресурса. Он предоставляет минимальный объем информации о [Provenance] (provenance.html#), которую можно использовать для отслеживания или определения источника информации на ресурсе. Источник может идентифицировать другой сервер FHIR, документ, сообщение, базу данных и т.д.

Точное использование источника (и возможное подразумеваемое Provenance.entity.role и agent.role) остается на усмотрение разработчика. Допускается только один указанный источник; для получения дополнительной информации о происхождении следует использовать полный источник. Источник может соответствовать Provenance.entity.what[x] или Provenance.agent.who[x], хотя это может быть и более общая или абстрактная ссылка.

Этот элемент может использоваться для указания текущего главного источника ресурса, имеющего канонический URL-адрес, если ресурс больше не размещен по каноническому URL-адресу.

Список профилей (ссылок на StructureDefinition ресурсы), которым, как утверждается, соответствует этот ресурс. URL-адрес является ссылкой на StructureDefinition.url.

Сервер и/или другая инфраструктура политики должны определять, проверяются ли и/или обновляются ли эти утверждения с течением времени. Список URL-адресов профиля представляет собой набор.

Метки безопасности, применяемые к данному ресурсу. Эти метки связывают определенные ресурсы с общей политикой безопасности и инфраструктурой.

Метки безопасности могут быть обновлены без изменения указанной версии ресурса. Список меток безопасности представляет собой набор. Уникальность основана на системе/коде, а версия и отображение игнорируются.

Защитные этикетки из системы классификации конфиденциальности и безопасности в сфере здравоохранения.

Теги, применяемые к этому ресурсу. Теги предназначены для идентификации ресурсов и соотнесения их с процессами и документооборотом, и приложения не обязаны учитывать теги при интерпретации значения ресурса.

Теги могут быть обновлены без изменения заявленной версии ресурса. Список тегов представляет собой набор. Уникальность основана на системе/коде, а версия и отображение игнорируются.

Коды, представляющие различные типы тегов, обычно связанные с рабочим процессом; например, "Требуется проверка доктором Джонсом".

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.

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 its narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

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).

Языковой тег IETF для человеческого языка

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.

Contained resources do not have a 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.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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.

An Extension

Условия обеспечения лекарственным средством и перевязочным материалом. Поле dispense.extension: factor (decimal) АИС Электронный рецепт. При значении '0' = код'0' За полную стоимость ; '0.1' = код '2' C оплатой 10 процентов; '1' = '1' Бесплатно, '0,5' = код '3' C оплатой 50 процентов

Даты начала и окончания действия рецепта. Поле электронного рецепта 'dispense.validityPeriod'

Периодичность реализации лекарственного препарата. Поле электронного рецепта 'extension: iteration'

Количество доз выписанного лекарственного средства

An Extension

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.

This is a business identifier, not a resource identifier.

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

An Extension

Назначение этого идентификатора.

Приложения могут предполагать, что идентификатор является постоянным, если в нем явно не указано, что он временный.

Определяет назначение этого идентификатора, если оно известно.

Позволяет выбрать соответствующий идентификатор для конкретного контекста использования из набора идентификаторов.

Кодированный тип идентификатора, который может быть использован для определения того, какой идентификатор следует использовать для определенной цели..

Этот элемент относится только к общим категориям идентификаторов. Его не следует использовать для кодов, которые соответствуют 1..1 идентификатору.system. Некоторые идентификаторы могут быть разделены на несколько категорий из-за общего использования. Там, где система известна, тип не требуется, поскольку тип всегда является частью определения системы. Однако системам часто приходится обрабатывать идентификаторы, когда система неизвестна. Между типом и системой не существует соотношения 1:1, поскольку многие различные системы имеют один и тот же тип.

Кодированный тип идентификатора, который может быть использован для определения того, какой идентификатор следует использовать для определенной цели..

Позволяет пользователям использовать идентификаторы, когда система идентификации неизвестна.

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

Identifier.system is always case sensitive.

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.

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

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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.

Период времени, в течение которого идентификатор является/был действителен для использования.

Organization that issued/manages the identifier.

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.

План или запрос, который полностью или частично выполняется в соответствии с этим запросом на получение лекарства.

Reference to an order/prescription that is being replaced by this MedicationRequest.

A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time.

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.

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

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

Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

Captures the reason for the current state of the MedicationRequest.

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.

Identifies the reasons for a given status.

The date (and perhaps time) when the status was changed.

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

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.

Вид заказа лекарств.

An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication.

The category can be used to include where the medication is expected to be consumed or other types of requests. The examplar value set represents where the meds are intended to be administered and is just one example of request categorization.

A coded concept identifying where the medication is to be consumed or administered.

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

Определяет уровень важности, который должен быть присвоен выполнению запроса.

If true, indicates that the provider is asking for the patient to either stop taking or to not start taking the specified medication. For example, the patient is taking an existing medication and the provider is changing their medication. They want to create two seperate requests: one to stop using the current medication and another to start the new medication.

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

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.

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.

Уникальный идентификатор элемента в ресурсе (для внутренних ссылок). Это может быть любое строковое значение, не содержащее пробелов.

An Extension

Сведения о лекарственном средстве как о торговом наименовании

Код формы выпуска лекарственного средства

Дозировка выписанного лекарственного средства

Ссылка на концепцию - например, информация идентифицируется по ее общему классу с той степенью точности, которая предусмотрена терминологией.

Уникальный идентификатор элемента в ресурсе (для внутренних ссылок). Это может быть любое строковое значение, не содержащее пробелов.

An Extension

Ссылка на код в справочнике НСИ Терминология.

Коды могут быть определены очень небрежно в перечислениях или списках кодов, вплоть до очень формальных определений, таких как SNOMED CT - смотрите HL7 v3 Core Principles для получения дополнительной информации. Порядок кодировок не определен и НЕ должен использоваться для определения значения. Как правило, самое большее только одно из значений кодировки будет помечено как UserSelected = true.

Позволяет использовать альтернативные кодировки в рамках одной системы кодирования и переводить их в другие системы кодирования.

Уникальный идентификатор элемента в ресурсе (для внутренних ссылок). Это может быть любое строковое значение, не содержащее пробелов.

An Extension

Идентификация кодовой системы, которая определяет значение символа в коде.

URI может быть OID (urn:oid:...) или UUID (urn:uuid:...). Идентификаторы и UUID-коды ДОЛЖНЫ быть ссылками на реестр OID HL7. В противном случае URI должен быть взят из списка специальных URI, определенных FHIR в HL7, или он должен быть абсолютной ссылкой на какое-либо определение, которое четко и недвусмысленно устанавливает систему.

Необходимо четко указать источник определения символа.

Версия системы кодирования, которая использовалась при выборе этого кода. Обратите внимание, что для хорошо поддерживаемой системы кодирования не требуется указывать версию, поскольку значение кодов в разных версиях одинаково. Однако это не может быть гарантировано последовательно, и если нет гарантии, что значение будет непротиворечивым, следует заменить версию.

В тех случаях, когда терминология четко не определяет, какую строку следует использовать для идентификации версий системы кодирования, рекомендуется использовать в качестве даты версии дату (выраженную в формате даты FHIR), когда эта версия была официально опубликована.

Код.

Необходимо обратиться к определенному коду в системе.

Представление значения кода в системе в соответствии с правилами системы.

Необходимо иметь возможность передавать значение кода, понятное человеку, для читателей, которые не знакомы с системой.

Указывает на то, что данная кодировка была выбрана непосредственно пользователем - например, из списка доступных сущностей(кодов или отображений)..

Из множества альтернативных вариантов код, выбранный непосредственно, является наиболее подходящей отправной точкой для новых переводов. Существует некоторая неясность в отношении того, что именно подразумевается под "прямым выбором", и может потребоваться соглашение с торговым партнером, чтобы более полно разъяснить использование этого элемента и его последствия (коды или отображения).

Это было определено как критерий клинической безопасности - то, что именно эта пара система/код была выбрана явно, а не выведена системой на основе каких-либо правил или языковой обработки.

Представление концепции на человеческом языке, увиденное/выбранное/произнесенное пользователем, который ввел данные, и/или представляющее предполагаемый смысл пользователя.

Очень часто текст совпадает с отображаемым именем одной из кодировок.

Коды из терминологии не всегда отражают правильное значение со всеми нюансами, присущими человеку, который их использует, а иногда вообще не содержат соответствующего кода. В этих случаях используется текст, чтобы полностью передать значение источника.

Ссылка на ресурс, который содержит точные сведения об информации, на которую ссылаются.

The individual or group for whom the medication has been requested.

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.

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

An Extension

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Ресурс (или, для логических моделей, URI логической модели).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

The person or organization who provided the information about this request, if the source is someone other than the requestor. This is often used when the MedicationRequest is reported by another person.

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

An Extension

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Ресурс (или, для логических моделей, URI логической модели).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

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.

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

An Extension

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Ресурс (или, для логических моделей, URI логической модели).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Information to support fulfilling (i.e. dispensing or administering) of the medication, for example, patient height and weight, a MedicationStatement for the patient).

This attribute can be used to reference a MedicationStatement about the patients' medication use.

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

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

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

An Extension

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Ресурс (или, для логических моделей, URI логической модели).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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.

If not populated, then assume that this is the original record and not reported

Indicates the type of performer of the administration of the medication.

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.

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

The specified desired performer of the medication treatment (e.g. the performer of the medication administration). For devices, this is the device that is intended to perform the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers.

The intended type of device that is to be used for the administration of the medication (for example, PCA Pump).

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

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

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

Закодированная концепция, указывающая, почему было заказано данное лекарство.

The description of the overall pattern of the administration of the medication to the patient.

This attribute should not be confused with the protocol of the medication.

Identifies the overall pattern of medication administratio.

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

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

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

An Extension

The individual responsible for making the annotation.

Organization is used when there's no need for specific attribution as to who made the comment.

Indicates when this particular annotation was made.

The text of the annotation in markdown format.

The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

The period over which the medication is to be taken. Where there are multiple dosageInstruction lines (for example, tapering doses), this is the earliest date and the latest end date of the dosageInstructions.

Specific instructions for how the medication is to be used by the patient.

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. In general, each prescribed drug will be a separate Medication Request.

When drug orders are grouped together at the time of order entry, but each of the drugs can be manipulated independently e.g. changing the status of one order to "completed" or "cancelled", changing another order status to "on-hold", the method to "group" all of the medication requests together is to use MedicationRequest.groupIdentifier element. All of the orders grouped together in this manner will have the same groupIdentifier, and separately, each order in the group may have a unique identifier.

There are cases that require grouping of Medication orders together when it is necessary to specify optionality e.g. order two drugs at one time, but stating either of these drugs may be used to treat the patient. The use of a RequestOrchestration should be used as a parent for the Medication orders that require this type of grouping. An example when it may be necessary to group medication orders together is when you specify timing relationships e.g. order drug "xyz" with dose 123, then taper the same drug to a different dose after some interval of time precedence: e.g. give drug "abc" followed by drug "def" e.g. give drug 30 minutes before some procedure was performed more generically this supports - hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group. Note that one should NOT use the List or Composition resource to accomplish the above requirements. You may use List or Composition for other business requirements, but not to address the specific requirements of grouping medication orders.

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

An Extension

An Extension

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

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

Инструкции по дозировке в виде свободного текста e.g. SIG.

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

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or take "immediately following drug x") should be populated in dosage.text.

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Instructions in terms that are understood by the patient or consumer.

When medication should be administered.

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

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

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option).

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated.

Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept).

Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed".

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

Часть тела.

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Закодированное понятие, описывающее местоположение участка, в который поступает лекарство или на который попадает организм.

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

Как препарат должен поступать в организм.

Закодированная концепция, описывающая способ или физиологический путь введения терапевтического средства в организм субъекта.

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

Способ введения лекарственного средства.

Terminologies used often pre-coordinate this term with the route and or form of administration.

Закодированная концепция, описывающая технику введения лекарственного средства.

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Depending on the resource,this is the amount of medication administered, to be administered or typical amount to be administered.

Upper limit on medication per unit of time.

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

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

Upper limit on medication per administration.

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

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

Upper limit on medication per lifetime of the patient.

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

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.

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.

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.

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.).