Bangladesh Core FHIR Implementation Guide
0.4.2 - Published by DGHS, MoHFW

Bangladesh Core FHIR Implementation Guide - Published by Ministry of Health and Family Welfare. See the Directory of published versions

## Resource Profile: Medication Request Profile for Bangladesh

Official URL: https://fhir.dghs.gov.bd/core/StructureDefinition/bd-medication-request | Version: 0.4.2
Standards status: Informative | Maturity Level: 1 | Computable Name: BDMedicationRequest

Profile of the MedicationRequest resource for the Bangladesh National Health Information Exchange (HIE). Prescriptions must reference a BDMedication resource coded against the DGDA Drug Registry, ensuring all prescribed medications are traceable to DGDA-registered drug products.

This profile constrains medication references to BDMedication only. Inline medicationCodeableConcept is not permitted — all medication data must be carried in a referenced BDMedication resource to support ingredient coding for IPS and cross-border data exchange.

Route of administration is coded using HL7 v3 RouteOfAdministration served via the national OCL terminology server.

Usages:

- Refer to this Profile: Medication Request Profile for Bangladesh
- Examples for this Profile: MedicationRequest/BDMedicationRequestExample

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 1..* | Identifier | Prescription identifier
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
reported[x]:reportedReference | Σ | 0..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh | Patient Profile for Bangladesh) | Reported rather than primary record
medication[x] | S Σ | 1..1 | Reference(Medication Profile for Bangladesh) | Reference to DGDA-registered medication
subject | S Σ | 1..1 | Reference(Patient Profile for Bangladesh) | Patient for whom the medication is prescribed
encounter | S | 0..1 | Reference(Encounter Profile for Bangladesh) | Encounter during which this prescription was created
authoredOn | S Σ | 1..1 | dateTime | Date and time the prescription was authored
requester | S Σ | 1..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh) | Practitioner or organisation that authored the prescription
basedOn | Σ | 0..* | Reference(Medication Request Profile for Bangladesh | ServiceRequest | CarePlan | ImmunizationRecommendation) | Plan or request this prescription is based on
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
route | S Σ | 0..1 | CodeableConcept | Route of administration coded using HL7 v3 RouteOfAdministration Binding: Route of Administration Value Set (required)
priorPrescription |  | 0..1 | Reference(Medication Request Profile for Bangladesh) | Reference to a prior prescription this replaces
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | required | Route of Administration Value Set | 📦0.4.2 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | 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 | error | MedicationRequest | 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 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
identifier | S | 1..* | Identifier | Prescription identifier
Slices for reported[x] |  | 0..1 | boolean, Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | Reported rather than primary record Slice: Unordered, Open by type:$this
reported[x]:reportedReference |  | 0..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh | Patient Profile for Bangladesh) | Reported rather than primary record
medication[x] | S | 1..1 | Reference(Medication Profile for Bangladesh) | Reference to DGDA-registered medication
subject | S | 1..1 | Reference(Patient Profile for Bangladesh) | Patient for whom the medication is prescribed
encounter | S | 0..1 | Reference(Encounter Profile for Bangladesh) | Encounter during which this prescription was created
authoredOn | S | 1..1 | dateTime | Date and time the prescription was authored
requester | S | 1..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh) | Practitioner or organisation that authored the prescription
basedOn |  | 0..* | Reference(Medication Request Profile for Bangladesh | ServiceRequest | CarePlan | ImmunizationRecommendation) | Plan or request this prescription is based on
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
route | S | 0..1 | CodeableConcept | Route of administration coded using HL7 v3 RouteOfAdministration Binding: Route of Administration Value Set (required)
priorPrescription |  | 0..1 | Reference(Medication Request Profile for Bangladesh) | Reference to a prior prescription this replaces
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.dosageInstruction.​route | Base | required | Route of Administration Value Set | 📦0.4.2 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 1..* | Identifier | Prescription identifier
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): 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.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
reported[x]:reportedReference | Σ | 0..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh | Patient Profile for Bangladesh) | Reported rather than primary record
medication[x] | S Σ | 1..1 | Reference(Medication Profile for Bangladesh) | Reference to DGDA-registered medication
subject | S Σ | 1..1 | Reference(Patient Profile for Bangladesh) | Patient for whom the medication is prescribed
encounter | S | 0..1 | Reference(Encounter Profile for Bangladesh) | Encounter during which this prescription was created
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | Date and time the prescription was authored
requester | S Σ | 1..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh) | Practitioner or organisation that authored the prescription
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(Medication Request Profile for Bangladesh | ServiceRequest | CarePlan | ImmunizationRecommendation) | Plan or request this prescription is based on
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): 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.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | S Σ | 0..1 | CodeableConcept | Route of administration coded using HL7 v3 RouteOfAdministration Binding: Route of Administration Value Set (required)
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription |  | 0..1 | Reference(Medication Request Profile for Bangladesh) | Reference to a prior prescription this replaces
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | required | Route of Administration Value Set | 📦0.4.2 | This IG
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | 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 | error | MedicationRequest | 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 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequest

Summary

Mandatory: 3 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- Practitioner for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-practitioner)
- Organization for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-organization)
- Patient Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-patient)
- Medication Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-medication)
- Encounter Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-encounter)
- Medication Request Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-medication-request)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.reported[x]

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 1..* | Identifier | Prescription identifier
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
reported[x]:reportedReference | Σ | 0..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh | Patient Profile for Bangladesh) | Reported rather than primary record
medication[x] | S Σ | 1..1 | Reference(Medication Profile for Bangladesh) | Reference to DGDA-registered medication
subject | S Σ | 1..1 | Reference(Patient Profile for Bangladesh) | Patient for whom the medication is prescribed
encounter | S | 0..1 | Reference(Encounter Profile for Bangladesh) | Encounter during which this prescription was created
authoredOn | S Σ | 1..1 | dateTime | Date and time the prescription was authored
requester | S Σ | 1..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh) | Practitioner or organisation that authored the prescription
basedOn | Σ | 0..* | Reference(Medication Request Profile for Bangladesh | ServiceRequest | CarePlan | ImmunizationRecommendation) | Plan or request this prescription is based on
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
route | S Σ | 0..1 | CodeableConcept | Route of administration coded using HL7 v3 RouteOfAdministration Binding: Route of Administration Value Set (required)
priorPrescription |  | 0..1 | Reference(Medication Request Profile for Bangladesh) | Reference to a prior prescription this replaces
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | required | Route of Administration Value Set | 📦0.4.2 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | 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 | error | MedicationRequest | 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 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
identifier | S | 1..* | Identifier | Prescription identifier
Slices for reported[x] |  | 0..1 | boolean, Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | Reported rather than primary record Slice: Unordered, Open by type:$this
reported[x]:reportedReference |  | 0..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh | Patient Profile for Bangladesh) | Reported rather than primary record
medication[x] | S | 1..1 | Reference(Medication Profile for Bangladesh) | Reference to DGDA-registered medication
subject | S | 1..1 | Reference(Patient Profile for Bangladesh) | Patient for whom the medication is prescribed
encounter | S | 0..1 | Reference(Encounter Profile for Bangladesh) | Encounter during which this prescription was created
authoredOn | S | 1..1 | dateTime | Date and time the prescription was authored
requester | S | 1..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh) | Practitioner or organisation that authored the prescription
basedOn |  | 0..* | Reference(Medication Request Profile for Bangladesh | ServiceRequest | CarePlan | ImmunizationRecommendation) | Plan or request this prescription is based on
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
route | S | 0..1 | CodeableConcept | Route of administration coded using HL7 v3 RouteOfAdministration Binding: Route of Administration Value Set (required)
priorPrescription |  | 0..1 | Reference(Medication Request Profile for Bangladesh) | Reference to a prior prescription this replaces
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.dosageInstruction.​route | Base | required | Route of Administration Value Set | 📦0.4.2 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 1..* | Identifier | Prescription identifier
status | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): 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.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
Slices for reported[x] | Σ | 0..1 |  | Reported rather than primary record Slice: Unordered, Open by type:$this
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
reported[x]:reportedReference | Σ | 0..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh | Patient Profile for Bangladesh) | Reported rather than primary record
medication[x] | S Σ | 1..1 | Reference(Medication Profile for Bangladesh) | Reference to DGDA-registered medication
subject | S Σ | 1..1 | Reference(Patient Profile for Bangladesh) | Patient for whom the medication is prescribed
encounter | S | 0..1 | Reference(Encounter Profile for Bangladesh) | Encounter during which this prescription was created
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | Date and time the prescription was authored
requester | S Σ | 1..1 | Reference(Practitioner for Bangladesh | Organization for Bangladesh) | Practitioner or organisation that authored the prescription
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(Medication Request Profile for Bangladesh | ServiceRequest | CarePlan | ImmunizationRecommendation) | Plan or request this prescription is based on
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): 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.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | S Σ | 0..1 | CodeableConcept | Route of administration coded using HL7 v3 RouteOfAdministration Binding: Route of Administration Value Set (required)
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription |  | 0..1 | Reference(Medication Request Profile for Bangladesh) | Reference to a prior prescription this replaces
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | required | Route of Administration Value Set | 📦0.4.2 | This IG
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | 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 | error | MedicationRequest | 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 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequest

Summary

Mandatory: 3 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- Practitioner for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-practitioner)
- Organization for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-organization)
- Patient Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-patient)
- Medication Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-medication)
- Encounter Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-encounter)
- Medication Request Profile for Bangladesh (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-medication-request)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.reported[x]

Maturity: 1

Other representations of profile: CSV, Excel, Schematron