Generated Narrative: StructureDefinition IHEMultilineOrder Name Flags Card. Type Description & Constraints IHEMultilineOrder 0..* Base Medication order - multiline (model) Instances of this logical model can be the target of a Reference identifier 1..* Identifier Business identifier(s) for the prescription group patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date. medicationLine 1..* BackboneElement Medication line in the prescription status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc). basedOn 0..1 Reference(Medication order - multiline (model)) What this order is based on medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure) indicationText 0..1 string Reason for the prescription in textual form. This might not be allowed by some implementations. indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc. treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.) quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets). dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions preparationInstructions 0..1 string Additional instructions about preparation or dispense substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution). allowedBoolean boolean allowedCodeableConcept CodeableConcept reason[x] 0..1 Reason for the substitution requirement reasonCodeableConcept CodeableConcept reasonString string offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product. isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided. reason[x] 0..* Reason or related clarification for off-label use. reasonCodeableConcept CodeableConcept reasonString string repeatsAllowed 0..1 integer Number of refills authorized minimumDispenseInterval 0..1 Duration Minimum Dispense Interval comment 0..* string Additional information or comments Documentation for this format
Integrating the Healthcare Enterprise (IHE)
Logical model for multiline medication prescription
IHE http://www.ihe.net/Governance/#Intellectual_Property
Business identifier(s) for the prescription group
The person for whom the medication is prescribed/ordered
Question: would we want to add basic Patient model?
The person who made the prescription, and who takes the responsibility of the treatment
Question: would we want to add basic Practicioner model?
Time of issuing (signing) the prescription by health care practicioner
The recorder of the prescription/draft in the information system
Time of authoring the prescription/draft in the information system
Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
The validity period end date. The prescription is not dispensable after this date.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Must have either extensions or value[x], not both
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Status of the prescription, this should not be status of treatment
Reason for the current status of prescription, for example the reason why the prescription was made invalid
Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
This is a reference to the order that this order is based on. For example, a prescription for a medication may be based on a proposal, and an administration request may be based on a prescription.
Prescribed product, branded, generic, virtual, extemporal, etc
Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
Reason for the prescription in textual form. This might not be allowed by some implementations.
Reason for the prescription - as a reference to a problem, result, etc.
Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
Overall quantity of prescribed product (e.g number of packages or number of tablets).
Dosaging and administration instructions
Additional instructions about preparation or dispense
Whether and which type of substitution is allowed for this medication treatment line
Whether substitution is allowed or not (or type of substitution).
Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
Indicates off-label use. Must be 'true' when .reason is provided.
Reason or related clarification for off-label use.
How many times the prescription item can be dispensed in addition to the original dispense.
If a prescription allows for repeated dispensations, the interval between dispensations shall be stated here.