Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide
0.10.0 - Draft for Community Review
Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide - Draft for Community Review (v0.10.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft tại thời điểm 2026-08-21 |
Các định nghĩa cho vn-core-cancer-pain-narcotic-prescription hồ sơ tài nguyên
Guidance on how to interpret the contents of this table can be foundhere
| 0. MedicationRequest | |
| Definition | An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. |
| Short | Ordering of medication for patient or group |
| Control | 0..* |
| Is Modifier | false |
| Summary | false |
| Alternate Names | Prescription, Order |
| Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) vn-rx-narcotic-course-numbering: Đơn phải có đúng ba đợt điều trị, đánh số 1, 2 và 3, mỗi số xuất hiện đúng một lần. The prescription SHALL carry exactly three courses numbered 1, 2 and 3. ( extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').count() = 3 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).count() = 1 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).count() = 1 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).count() = 1)vn-rx-narcotic-course-duration: Mỗi đợt điều trị không vượt quá 10 ngày, tính cả ngày bắt đầu và ngày kết thúc. Each course SHALL NOT exceed 10 days inclusive of both boundaries. ( extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').all(extension.where(url = 'period').value.ofType(Period).start.exists() and extension.where(url = 'period').value.ofType(Period).end.exists() and extension.where(url = 'period').value.ofType(Period).end >= extension.where(url = 'period').value.ofType(Period).start and extension.where(url = 'period').value.ofType(Period).end <= extension.where(url = 'period').value.ofType(Period).start + 9 days))vn-rx-narcotic-course-consecutive: Ba đợt phải liên tiếp — đợt sau bắt đầu ngay ngày kế tiếp đợt trước — và tổng thời gian không quá 30 ngày. The three courses SHALL be consecutive and SHALL NOT exceed 30 days in total. ( (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).exists() and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).exists() and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).exists()) implies (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).start = extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).end + 1 day and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).start = extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).end + 1 day and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).end <= extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).start + 29 days)) |
| 2. MedicationRequest.implicitRules | |
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
| Short | A set of rules under which this content was created |
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
| Control | 0..1 |
| Type | uri |
| Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 4. MedicationRequest.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 30..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. MedicationRequest.extension:registrationNumber | |
| Slice Name | registrationNumber |
| Definition | Số đăng ký lưu hành thuốc (Visa) do Cục Quản lý Dược — Bộ Y tế cấp. Trường SO_DANG_KY theo QĐ 3176/QĐ-BYT (29/10/2024). Bắt buộc khi gửi dữ liệu chi phí thuốc cho BHXH. Căn cứ bổ sung:
|
| Short | Số đăng ký thuốc (SO_DANG_KY) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Số đăng ký thuốc (Visa) — Medication Registration Number) (Extension Type: string) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 8. MedicationRequest.extension:paymentSource | |
| Slice Name | paymentSource |
| Definition | Nguồn chi trả cho dòng chi phí KCB, đặc biệt dùng cho XML2 thuốc (NGUON_CTRA) theo QĐ 3176/QĐ-BYT. Biểu diễn nguồn chi trả ở mức item thay vì gán vào Coverage.type hoặc payment method tổng thể. Nguồn thiết kế: QĐ 3176/QĐ-BYT và terminology VNPaymentSourceCS/VS. |
| Short | Nguồn chi trả cho dòng thuốc (NGUON_CTRA) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Nguồn chi trả — Payment Source Extension) (Extension Type: CodeableConcept) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 10. MedicationRequest.extension:tenderInfo | |
| Slice Name | tenderInfo |
| Definition | Thông tin thầu của dòng thuốc/vật tư/thiết bị trong dữ liệu KCB/BHYT, đặc biệt dùng cho XML2/XML3 trường TT_THAU theo QĐ 130/QĐ-BYT và QĐ 3176/QĐ-BYT. Đây là chuỗi nghiệp vụ phục vụ thanh toán/gateway, không phải procurement package đầy đủ và không thay thế hồ sơ đấu thầu riêng. |
| Short | Thông tin thầu (TT_THAU) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Thông tin thầu — Tender Information Extension) (Extension Type: string) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 12. MedicationRequest.extension:processingMethod | |
| Slice Name | processingMethod |
| Definition | Phương pháp chế biến vị thuốc, dược liệu hoặc thuốc y học cổ truyền — mang trường |
| Short | Phương pháp chế biến YHCT (MA_PP_CHEBIEN) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Phương pháp chế biến YHCT — Traditional Medicine Processing Method) (Extension Type: Choice of: string, CodeableConcept) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 14. MedicationRequest.extension:treatmentCourse | |
| Slice Name | treatmentCourse |
| Definition | Một đợt điều trị của đơn thuốc gây nghiện giảm đau cho người bệnh ung thư: số thứ tự đợt và khoảng ngày bắt đầu–kết thúc.
Căn cứ TT 26/2025/TT-BYT Điều 8 khoản 1: mỗi lần kê đơn tối đa 30 ngày, phải ghi cụ thể 03 đợt điều trị liên tiếp trên một đơn, mỗi đợt không vượt quá 10 ngày, ghi rõ ngày bắt đầu và kết thúc.
Extension đặt trên |
| Short | Đúng ba đợt điều trị liên tiếp (TT 26/2025/TT-BYT Điều 8 khoản 1) |
| Control | 3..3 |
| Type | Extension(Đợt điều trị thuốc gây nghiện — Narcotic Treatment Course Extension) (Complex Extension) |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 16. MedicationRequest.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
| Summary | false |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 18. MedicationRequest.identifier | |
| Definition | Định danh của riêng dòng thuốc này, thường là mã nội bộ do phần mềm cơ sở KCB sinh. Mã đơn thuốc quốc gia đặt ở 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. |
| Short | Mã dòng thuốc trong đơn (mã nội bộ của cơ sở kê đơn) — KHÔNG dùng cho mã đơn quốc giaExternal ids for this request |
| Comments | This is a business identifier, not a resource identifier. |
| Note | This is a business identifier, not a resource identifier (see discussion) |
| Control | 0..* |
| Type | Identifier |
| Is Modifier | false |
| Must Support | true |
| Obligations | |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 20. MedicationRequest.status | |
| Definition | Đơn ngoại trú liên thông chỉ mang trạng thái của đơn ĐÃ PHÁT HÀNH: A code specifying the current state of the order. Generally, this will be active or completed state. |
| Short | Trạng thái đơn thuốcactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown |
| Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
| Control | 1..1 |
| Binding | The codes SHALL be taken from medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. |
| Type | code |
| Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Obligations | |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) vn-rx-outpatient-issued-only: Đơn ngoại trú liên thông phải là đơn đã phát hành: status không được là draft. ( $this != 'draft') |
| 22. MedicationRequest.intent | |
| Definition | Whether the request is a proposal, plan, or an original order. |
| Short | Ý định: order (kê đơn) | proposal | planproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option |
| Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. |
| Control | 1..1 |
| Binding | The codes SHALL be taken from medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)The kind of medication order. |
| Type | code |
| Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Obligations | |
| Summary | true |
| Fixed Value | order |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 24. MedicationRequest.category | |
| Definition | Phân loại bối cảnh kê đơn. Đơn thuốc ngoại trú và đơn thuốc điện tử tham chiếu TT 26/2025/TT-BYT; đơn nội trú/cấp cứu gắn với bệnh án điện tử theo TT 13/2025/TT-BYT. Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). |
| Short | Bối cảnh kê đơn: outpatient (ngoại trú) hoặc discharge (cấp khi ra viện)Type of medication usage |
| Comments | The category can be used to include where the medication is expected to be consumed or other types of requests. |
| Control | 10..* |
| Binding | For example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1 (example to http://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1)A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. |
| Type | CodeableConcept |
| Is Modifier | false |
| Must Support | true |
| Obligations | |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) vn-rx-outpatient-category: Đơn ngoại trú phải mang ít nhất một category là outpatient hoặc discharge theo hệ mã medicationrequest-category của HL7. ( coding.where(system = 'http://terminology.hl7.org/CodeSystem/medicationrequest-category' and (code = 'outpatient' or code = 'discharge')).exists()) |
| 26. MedicationRequest.doNotPerform | |
| Definition | If true indicates that the provider is asking for the medication request not to occur. |
| Short | True if request is prohibiting action |
| Comments | If do not perform is not specified, the request is a positive request e.g. "do perform". |
| Control | 0..1 |
| Type | boolean |
| Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc) |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 28. MedicationRequest.medication[x] | |
| Definition | Thuốc được kê đơn. Ưu tiên mã hoá bằng ATC (WHO) hoặc SNOMED CT. Nếu chưa có mã, sử dụng text (tên thương mại hoặc tên hoạt chất). Với bài thuốc YHCT: dùng mã từ VNYHCTPrescriptionCS (522 bài thuốc theo QĐ 3080/QĐ-BYT, PL VI). Lưu ý: VN chưa có bộ mã thuốc quốc gia dạng FHIR — sẽ bổ sung khi BYT/Dược điển VN publish. 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. |
| Short | Thuốc được kê (ATC/SNOMED CT/tên thuốc / bài thuốc YHCT)Medication to be taken |
| Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. |
| Control | 1..1 |
| Binding | For example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1 (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)A coded concept identifying substance or product that can be ordered. |
| Type | Choice of: CodeableConcept, Reference(Medication) |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Must Support | true |
| Must Support Types | No must-support rules about the choice of types/profiles |
| Obligations | |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 30. MedicationRequest.subject | |
| Definition | A link to a resource representing the person or set of individuals to whom the medication will be given. |
| Short | Bệnh nhân được kê đơnWho or group medication request is for |
| Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. |
| Control | 1..1 |
| Type | Reference(Bệnh nhân VN Core — VN Core Patient Profile, Patient, Group) |
| Is Modifier | false |
| Must Support | true |
| Obligations | |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 32. MedicationRequest.authoredOn | |
| Definition | The date (and perhaps time) when the prescription was initially written or authored on. |
| Short | Ngày kê đơnWhen request was initially authored |
| Control | 10..1 |
| Type | dateTime |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Obligations | |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 34. MedicationRequest.requester | |
| Definition | The individual, organization, or device that initiated the request and has responsibility for its activation. |
| Short | Người kê đơn — bắt buộc theo TT 26/2025/TT-BYTWho/What requested the Request |
| Control | 10..1 |
| Type | Reference(Nhân viên y tế VN Core — VN Core Practitioner Profile, Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device) |
| Is Modifier | false |
| Must Support | true |
| Must Support Types | No must-support rules about the choice of types/profiles |
| Obligations | |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 36. MedicationRequest.groupIdentifier | |
| Definition | Mã đơn thuốc điện tử do Hệ thống đơn thuốc quốc gia (donthuocquocgia.vn) sinh, theo Phụ lục I TT 26/2025/TT-BYT. Mọi MedicationRequest thuộc cùng một đơn mang cùng giá trị này, kể cả đơn chỉ có một thuốc — nhờ đó nhà thuốc và Hệ thống đơn thuốc quốc gia gom đúng đơn khi bán và báo cáo. Ràng buộc định dạng đặt ở các profile dẫn xuất (đơn ngoại trú, đơn y học cổ truyền) vì cấu trúc hậu tố khác nhau theo loại đơn. A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription. |
| Short | Mã đơn thuốc quốc gia (bắt buộc với đơn ngoại trú)Composite request this is part of |
| Control | 10..1 |
| Type | Identifier |
| Is Modifier | false |
| Must Support | true |
| Obligations | |
| Summary | true |
| Requirements | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) vn-rx-outpatient-code-format: Mã đơn thuốc quốc gia gồm 14 ký tự theo Phụ lục I TT 26/2025/TT-BYT: 5 chữ số mã cơ sở khám bệnh, chữa bệnh + 7 ký tự chữ thường hoặc số + dấu gạch nối + 1 ký tự loại đơn (N, H hoặc C). Đơn thuốc cổ truyền dùng hậu tố T và thuộc profile VNCoreYHCTOutpatientPrescription. ( value.matches('^[0-9]{5}[0-9a-z]{7}-[NHC]$'))vn-rx-narcotic-code-suffix: Mã đơn thuốc gây nghiện phải kết thúc bằng hậu tố N theo Phụ lục I TT 26/2025/TT-BYT. A narcotic prescription code SHALL end with the N suffix. ( value.exists() implies value.matches('-N$')) |
| 38. MedicationRequest.groupIdentifier.use | |
| Definition | The purpose of this identifier. |
| Short | usual | official | temp | secondary | old (If known) |
| Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
| Control | 0..1 |
| Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)Identifies the purpose for this identifier, if known . |
| Type | code |
| Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 40. MedicationRequest.groupIdentifier.system | |
| Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
| Short | The namespace for the identifier value |
| Comments | Identifier.system is always case sensitive. |
| Control | 10..1 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
| Fixed Value | http://fhir.hl7.org.vn/core/sid/don-thuoc-quoc-gia |
| Example | General: http://www.acme.com/identifiers/patient |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 42. MedicationRequest.groupIdentifier.value | |
| Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
| Short | The value that is unique |
| Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
| Control | 10..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Example | General: 123456 |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 44. MedicationRequest.dosageInstruction | |
| Definition | Indicates how the medication is to be used by the patient. |
| Short | Hướng dẫn liều dùngHow the medication should be taken |
| Comments | There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. |
| Control | 10..* |
| Type | Dosage |
| Is Modifier | false |
| Must Support | true |
| Obligations | |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 46. MedicationRequest.dosageInstruction.modifierExtension | |
| Definition | 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 48. MedicationRequest.dosageInstruction.text | |
| Definition | Free text dosage instructions e.g. SIG. |
| Short | Hướng dẫn dạng text (VD: Uống 500mg, 3 lần/ngày, sau ăn)Free text dosage instructions e.g. SIG |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Free text dosage instructions 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. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 50. MedicationRequest.dosageInstruction.timing | |
| Definition | When medication should be administered. |
| Short | Lịch dùng thuốc (tần suất, thời điểm)When medication should be administered |
| Comments | 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. |
| Control | 0..1 |
| Type | Timing |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | 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. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 52. MedicationRequest.dosageInstruction.route | |
| Definition | How drug should enter body. |
| Short | Đường dùng (uống, tiêm, bôi...) — 56 mã theo Dược điển VNHow drug should enter body |
| Control | 0..1 |
| Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Đường dùng thuốc — Vietnam Medication Route ValueSethttp://hl7.org/fhir/ValueSet/route-codes|4.0.1 (extensible to http://fhir.hl7.org.vn/core/ValueSet/vn-medication-route-vs) |
| Type | CodeableConcept |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 54. MedicationRequest.dosageInstruction.doseAndRate | |
| Definition | The amount of medication administered. |
| Short | Liều lượng và tốc độAmount of medication administered |
| Control | 0..* |
| Type | Element |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 56. MedicationRequest.dispenseRequest | |
| Definition | Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. |
| Short | Yêu cầu cấp phátMedication supply authorization |
| Control | 0..1 |
| Type | BackboneElement |
| Is Modifier | false |
| Must Support | true |
| Obligations | |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 58. MedicationRequest.dispenseRequest.modifierExtension | |
| Definition | 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 60. MedicationRequest.dispenseRequest.quantity | |
| Definition | The amount that is to be dispensed for one fill. |
| Short | Tổng số lượng cấp phátAmount of medication to supply per dispense |
| Control | 0..1 |
| Type | Quantity(SimpleQuantity) |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 62. MedicationRequest.dispenseRequest.expectedSupplyDuration | |
| Definition | Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. |
| Short | Số ngày sử dụng thuốc — TT 26/2025/TT-BYT Điều 6 khoản 6Number of days supply per dispense |
| Comments | Điều 6 khoản 8 đặt trần: tối đa 30 ngày cho mỗi thuốc, trừ trường hợp tại Điều 7, 8 và 9; riêng bệnh thuộc Phụ lục VII của thông tư thì người kê đơn quyết định theo tình trạng lâm sàng, tối đa 90 ngày. In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors. |
| Control | 0..1 |
| Type | Duration |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. MedicationRequest | |
| Invariants | vn-rx-narcotic-course-numbering: Đơn phải có đúng ba đợt điều trị, đánh số 1, 2 và 3, mỗi số xuất hiện đúng một lần. The prescription SHALL carry exactly three courses numbered 1, 2 and 3. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').count() = 3 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).count() = 1 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).count() = 1 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).count() = 1)vn-rx-narcotic-course-duration: Mỗi đợt điều trị không vượt quá 10 ngày, tính cả ngày bắt đầu và ngày kết thúc. Each course SHALL NOT exceed 10 days inclusive of both boundaries. ( extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').all(extension.where(url = 'period').value.ofType(Period).start.exists() and extension.where(url = 'period').value.ofType(Period).end.exists() and extension.where(url = 'period').value.ofType(Period).end >= extension.where(url = 'period').value.ofType(Period).start and extension.where(url = 'period').value.ofType(Period).end <= extension.where(url = 'period').value.ofType(Period).start + 9 days))vn-rx-narcotic-course-consecutive: Ba đợt phải liên tiếp — đợt sau bắt đầu ngay ngày kế tiếp đợt trước — và tổng thời gian không quá 30 ngày. The three courses SHALL be consecutive and SHALL NOT exceed 30 days in total. ( (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).exists() and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).exists() and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).exists()) implies (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).start = extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).end + 1 day and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).start = extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).end + 1 day and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).end <= extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).start + 29 days)) |
| 2. MedicationRequest.extension | |
| Control | 3..? |
| 4. MedicationRequest.extension:treatmentCourse | |
| Slice Name | treatmentCourse |
| Short | Đúng ba đợt điều trị liên tiếp (TT 26/2025/TT-BYT Điều 8 khoản 1) |
| Control | 3..3 |
| Type | Extension(Đợt điều trị thuốc gây nghiện — Narcotic Treatment Course Extension) (Complex Extension) |
| 6. MedicationRequest.groupIdentifier | |
| Invariants | vn-rx-narcotic-code-suffix: Mã đơn thuốc gây nghiện phải kết thúc bằng hậu tố N theo Phụ lục I TT 26/2025/TT-BYT. A narcotic prescription code SHALL end with the N suffix. (value.exists() implies value.matches('-N$')) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. MedicationRequest | |||||
| Definition | An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns. | ||||
| Short | Ordering of medication for patient or group | ||||
| Control | 0..* | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | Prescription, Order | ||||
| Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource ( contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated ( contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())dom-5: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty())dom-6: A resource should have narrative for robust management ( text.`div`.exists())vn-rx-narcotic-course-numbering: Đơn phải có đúng ba đợt điều trị, đánh số 1, 2 và 3, mỗi số xuất hiện đúng một lần. The prescription SHALL carry exactly three courses numbered 1, 2 and 3. ( extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').count() = 3 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).count() = 1 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).count() = 1 and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).count() = 1)vn-rx-narcotic-course-duration: Mỗi đợt điều trị không vượt quá 10 ngày, tính cả ngày bắt đầu và ngày kết thúc. Each course SHALL NOT exceed 10 days inclusive of both boundaries. ( extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').all(extension.where(url = 'period').value.ofType(Period).start.exists() and extension.where(url = 'period').value.ofType(Period).end.exists() and extension.where(url = 'period').value.ofType(Period).end >= extension.where(url = 'period').value.ofType(Period).start and extension.where(url = 'period').value.ofType(Period).end <= extension.where(url = 'period').value.ofType(Period).start + 9 days))vn-rx-narcotic-course-consecutive: Ba đợt phải liên tiếp — đợt sau bắt đầu ngay ngày kế tiếp đợt trước — và tổng thời gian không quá 30 ngày. The three courses SHALL be consecutive and SHALL NOT exceed 30 days in total. ( (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).exists() and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).exists() and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).exists()) implies (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).start = extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).end + 1 day and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).start = extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 2).extension.where(url = 'period').value.ofType(Period).end + 1 day and extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 3).extension.where(url = 'period').value.ofType(Period).end <= extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-narcotic-treatment-course').where(extension.where(url = 'sequence').value = 1).extension.where(url = 'period').value.ofType(Period).start + 29 days)) | ||||
| 2. MedicationRequest.id | |||||
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
| Short | Logical id of this artifact | ||||
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
| Control | 0..1 | ||||
| Type | id | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| 4. MedicationRequest.meta | |||||
| Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
| Short | Metadata about the resource | ||||
| Control | 0..1 | ||||
| Type | Meta | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 6. MedicationRequest.implicitRules | |||||
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
| Short | A set of rules under which this content was created | ||||
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
| Control | 0..1 | ||||
| Type | uri | ||||
| Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 8. MedicationRequest.language | |||||
| Definition | The base language in which the resource is written. | ||||
| Short | Language of the resource content | ||||
| Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)A human language.
| ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 10. MedicationRequest.text | |||||
| Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
| Short | Text summary of the resource, for human interpretation | ||||
| Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
| Control | 0..1 | ||||
| Type | Narrative | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | narrative, html, xhtml, display | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 12. MedicationRequest.contained | |||||
| Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
| Short | Contained, inline Resources | ||||
| Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
| Control | 0..* | ||||
| Type | Resource | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | inline resources, anonymous resources, contained resources | ||||
| 14. MedicationRequest.extension | |||||
| Definition | An Extension | ||||
| Short | Extension | ||||
| Control | 3..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 16. MedicationRequest.extension:registrationNumber | |||||
| Slice Name | registrationNumber | ||||
| Definition | Số đăng ký lưu hành thuốc (Visa) do Cục Quản lý Dược — Bộ Y tế cấp. Trường SO_DANG_KY theo QĐ 3176/QĐ-BYT (29/10/2024). Bắt buộc khi gửi dữ liệu chi phí thuốc cho BHXH. Căn cứ bổ sung:
| ||||
| Short | Số đăng ký thuốc (SO_DANG_KY) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(Số đăng ký thuốc (Visa) — Medication Registration Number) (Extension Type: string) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 18. MedicationRequest.extension:paymentSource | |||||
| Slice Name | paymentSource | ||||
| Definition | Nguồn chi trả cho dòng chi phí KCB, đặc biệt dùng cho XML2 thuốc (NGUON_CTRA) theo QĐ 3176/QĐ-BYT. Biểu diễn nguồn chi trả ở mức item thay vì gán vào Coverage.type hoặc payment method tổng thể. Nguồn thiết kế: QĐ 3176/QĐ-BYT và terminology VNPaymentSourceCS/VS. | ||||
| Short | Nguồn chi trả cho dòng thuốc (NGUON_CTRA) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(Nguồn chi trả — Payment Source Extension) (Extension Type: CodeableConcept) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 20. MedicationRequest.extension:tenderInfo | |||||
| Slice Name | tenderInfo | ||||
| Definition | Thông tin thầu của dòng thuốc/vật tư/thiết bị trong dữ liệu KCB/BHYT, đặc biệt dùng cho XML2/XML3 trường TT_THAU theo QĐ 130/QĐ-BYT và QĐ 3176/QĐ-BYT. Đây là chuỗi nghiệp vụ phục vụ thanh toán/gateway, không phải procurement package đầy đủ và không thay thế hồ sơ đấu thầu riêng. | ||||
| Short | Thông tin thầu (TT_THAU) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(Thông tin thầu — Tender Information Extension) (Extension Type: string) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 22. MedicationRequest.extension:processingMethod | |||||
| Slice Name | processingMethod | ||||
| Definition | Phương pháp chế biến vị thuốc, dược liệu hoặc thuốc y học cổ truyền — mang trường | ||||
| Short | Phương pháp chế biến YHCT (MA_PP_CHEBIEN) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(Phương pháp chế biến YHCT — Traditional Medicine Processing Method) (Extension Type: Choice of: string, CodeableConcept) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 24. MedicationRequest.extension:treatmentCourse | |||||
| Slice Name | treatmentCourse | ||||
| Definition | Một đợt điều trị của đơn thuốc gây nghiện giảm đau cho người bệnh ung thư: số thứ tự đợt và khoảng ngày bắt đầu–kết thúc.
Căn cứ TT 26/2025/TT-BYT Điều 8 khoản 1: mỗi lần kê đơn tối đa 30 ngày, phải ghi cụ thể 03 đợt điều trị liên tiếp trên một đơn, mỗi đợt không vượt quá 10 ngày, ghi rõ ngày bắt đầu và kết thúc.
Extension đặt trên | ||||
| Short | Đúng ba đợt điều trị liên tiếp (TT 26/2025/TT-BYT Điều 8 khoản 1) | ||||
| Control | 3..3 | ||||
| Type | Extension(Đợt điều trị thuốc gây nghiện — Narcotic Treatment Course Extension) (Complex Extension) | ||||
| Is Modifier | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 26. MedicationRequest.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
| Summary | false | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 28. MedicationRequest.identifier | |||||
| Definition | Định danh của riêng dòng thuốc này, thường là mã nội bộ do phần mềm cơ sở KCB sinh. Mã đơn thuốc quốc gia đặt ở | ||||
| Short | Mã dòng thuốc trong đơn (mã nội bộ của cơ sở kê đơn) — KHÔNG dùng cho mã đơn quốc gia | ||||
| Comments | This is a business identifier, not a resource identifier. | ||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||
| Control | 0..* | ||||
| Type | Identifier | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 30. MedicationRequest.status | |||||
| Definition | Đơn ngoại trú liên thông chỉ mang trạng thái của đơn ĐÃ PHÁT HÀNH: | ||||
| Short | Trạng thái đơn thuốc | ||||
| Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||||
| Control | 1..1 | ||||
| Binding | The codes SHALL be taken from medicationrequest Status (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||
| Type | code | ||||
| Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))vn-rx-outpatient-issued-only: Đơn ngoại trú liên thông phải là đơn đã phát hành: status không được là draft. ( $this != 'draft') | ||||
| 32. MedicationRequest.statusReason | |||||
| Definition | Captures the reason for the current state of the MedicationRequest. | ||||
| Short | Reason for current status | ||||
| Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here. | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see medicationRequest Status Reason Codes (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1)Identifies the reasons for a given status. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 34. MedicationRequest.intent | |||||
| Definition | Whether the request is a proposal, plan, or an original order. | ||||
| Short | Ý định: order (kê đơn) | proposal | plan | ||||
| Comments | It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. | ||||
| Control | 1..1 | ||||
| Binding | The codes SHALL be taken from medicationRequest Intent (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)The kind of medication order. | ||||
| Type | code | ||||
| Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | true | ||||
| Fixed Value | order | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 36. MedicationRequest.category | |||||
| Definition | Phân loại bối cảnh kê đơn. Đơn thuốc ngoại trú và đơn thuốc điện tử tham chiếu TT 26/2025/TT-BYT; đơn nội trú/cấp cứu gắn với bệnh án điện tử theo TT 13/2025/TT-BYT. | ||||
| Short | Bối cảnh kê đơn: outpatient (ngoại trú) hoặc discharge (cấp khi ra viện) | ||||
| Comments | The category can be used to include where the medication is expected to be consumed or other types of requests. | ||||
| Control | 1..* | ||||
| Binding | For example codes, see medicationRequest Category Codes (example to http://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1)A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))vn-rx-outpatient-category: Đơn ngoại trú phải mang ít nhất một category là outpatient hoặc discharge theo hệ mã medicationrequest-category của HL7. ( coding.where(system = 'http://terminology.hl7.org/CodeSystem/medicationrequest-category' and (code = 'outpatient' or code = 'discharge')).exists()) | ||||
| 38. MedicationRequest.priority | |||||
| Definition | Indicates how quickly the Medication Request should be addressed with respect to other requests. | ||||
| Short | routine | urgent | asap | stat | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from RequestPriority (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)Identifies the level of importance to be assigned to actioning the request. | ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 40. MedicationRequest.doNotPerform | |||||
| Definition | If true indicates that the provider is asking for the medication request not to occur. | ||||
| Short | True if request is prohibiting action | ||||
| Comments | If do not perform is not specified, the request is a positive request e.g. "do perform". | ||||
| Control | 0..1 | ||||
| Type | boolean | ||||
| Is Modifier | true because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc) | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 42. MedicationRequest.reported[x] | |||||
| Definition | Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report. | ||||
| Short | Reported rather than primary record | ||||
| Control | 0..1 | ||||
| Type | Choice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization) | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 44. MedicationRequest.medication[x] | |||||
| Definition | Thuốc được kê đơn. Ưu tiên mã hoá bằng ATC (WHO) hoặc SNOMED CT. Nếu chưa có mã, sử dụng text (tên thương mại hoặc tên hoạt chất). Với bài thuốc YHCT: dùng mã từ VNYHCTPrescriptionCS (522 bài thuốc theo QĐ 3080/QĐ-BYT, PL VI). Lưu ý: VN chưa có bộ mã thuốc quốc gia dạng FHIR — sẽ bổ sung khi BYT/Dược điển VN publish. | ||||
| Short | Thuốc được kê (ATC/SNOMED CT/tên thuốc / bài thuốc YHCT) | ||||
| Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. | ||||
| Control | 1..1 | ||||
| Binding | For example codes, see SNOMEDCTMedicationCodes (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)A coded concept identifying substance or product that can be ordered. | ||||
| Type | Choice of: CodeableConcept, Reference(Medication) | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Must Support Types | No must-support rules about the choice of types/profiles | ||||
| Obligations | |||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 46. MedicationRequest.subject | |||||
| Definition | A link to a resource representing the person or set of individuals to whom the medication will be given. | ||||
| Short | Bệnh nhân được kê đơn | ||||
| Comments | The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. | ||||
| Control | 1..1 | ||||
| Type | Reference(Bệnh nhân VN Core — VN Core Patient Profile) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 48. MedicationRequest.encounter | |||||
| Definition | The Encounter during which this [x] was created or to which the creation of this record is tightly associated. | ||||
| Short | Lượt khám liên quan | ||||
| Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension. | ||||
| Control | 0..1 | ||||
| Type | Reference(Lượt khám/nhập viện VN Core — VN Core Encounter Profile) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 50. MedicationRequest.supportingInformation | |||||
| Definition | Include additional information (for example, patient height and weight) that supports the ordering of the medication. | ||||
| Short | Information to support ordering of the medication | ||||
| Control | 0..* | ||||
| Type | Reference(Resource) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 52. MedicationRequest.authoredOn | |||||
| Definition | The date (and perhaps time) when the prescription was initially written or authored on. | ||||
| Short | Ngày kê đơn | ||||
| Control | 1..1 | ||||
| Type | dateTime | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 54. MedicationRequest.requester | |||||
| Definition | The individual, organization, or device that initiated the request and has responsibility for its activation. | ||||
| Short | Người kê đơn — bắt buộc theo TT 26/2025/TT-BYT | ||||
| Control | 1..1 | ||||
| Type | Reference(Nhân viên y tế VN Core — VN Core Practitioner Profile, Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Must Support Types | No must-support rules about the choice of types/profiles | ||||
| Obligations | |||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 56. MedicationRequest.performer | |||||
| Definition | The specified desired performer of the medication treatment (e.g. the performer of the medication administration). | ||||
| Short | Intended performer of administration | ||||
| Control | 0..1 | ||||
| Type | Reference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 58. MedicationRequest.performerType | |||||
| Definition | Indicates the type of performer of the administration of the medication. | ||||
| Short | Desired kind of performer of the medication administration | ||||
| Comments | If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available. | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see ProcedurePerformerRoleCodes (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)Identifies the type of individual that is desired to administer the medication. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 60. MedicationRequest.recorder | |||||
| Definition | The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. | ||||
| Short | Person who entered the request | ||||
| Control | 0..1 | ||||
| Type | Reference(Practitioner, PractitionerRole) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 62. MedicationRequest.reasonCode | |||||
| Definition | The reason or the indication for ordering or not ordering the medication. | ||||
| Short | Lý do kê đơn (mã ICD-10) | ||||
| Comments | This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference. | ||||
| Control | 0..* | ||||
| Binding | Unless not suitable, these codes SHALL be taken from Mã chẩn đoán — VN Core Condition Code ValueSet (extensible to http://fhir.hl7.org.vn/core/ValueSet/vn-condition-code-vs) | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 64. MedicationRequest.reasonReference | |||||
| Definition | Condition or observation that supports why the medication was ordered. | ||||
| Short | Condition or observation that supports why the prescription is being written | ||||
| Comments | This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. | ||||
| Control | 0..* | ||||
| Type | Reference(Condition, Observation) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 66. MedicationRequest.instantiatesCanonical | |||||
| Definition | The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest. | ||||
| Short | Instantiates FHIR protocol or definition | ||||
| Control | 0..* | ||||
| Type | canonical | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 68. MedicationRequest.instantiatesUri | |||||
| Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest. | ||||
| Short | Instantiates external protocol or definition | ||||
| Control | 0..* | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 70. MedicationRequest.basedOn | |||||
| Definition | A plan or request that is fulfilled in whole or in part by this medication request. | ||||
| Short | What request fulfills | ||||
| Control | 0..* | ||||
| Type | Reference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation) | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 72. MedicationRequest.groupIdentifier | |||||
| Definition | Mã đơn thuốc điện tử do Hệ thống đơn thuốc quốc gia (donthuocquocgia.vn) sinh, theo Phụ lục I TT 26/2025/TT-BYT. Mọi MedicationRequest thuộc cùng một đơn mang cùng giá trị này, kể cả đơn chỉ có một thuốc — nhờ đó nhà thuốc và Hệ thống đơn thuốc quốc gia gom đúng đơn khi bán và báo cáo. Ràng buộc định dạng đặt ở các profile dẫn xuất (đơn ngoại trú, đơn y học cổ truyền) vì cấu trúc hậu tố khác nhau theo loại đơn. | ||||
| Short | Mã đơn thuốc quốc gia (bắt buộc với đơn ngoại trú) | ||||
| Control | 1..1 | ||||
| Type | Identifier | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | true | ||||
| Requirements | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))vn-rx-outpatient-code-format: Mã đơn thuốc quốc gia gồm 14 ký tự theo Phụ lục I TT 26/2025/TT-BYT: 5 chữ số mã cơ sở khám bệnh, chữa bệnh + 7 ký tự chữ thường hoặc số + dấu gạch nối + 1 ký tự loại đơn (N, H hoặc C). Đơn thuốc cổ truyền dùng hậu tố T và thuộc profile VNCoreYHCTOutpatientPrescription. ( value.matches('^[0-9]{5}[0-9a-z]{7}-[NHC]$'))vn-rx-narcotic-code-suffix: Mã đơn thuốc gây nghiện phải kết thúc bằng hậu tố N theo Phụ lục I TT 26/2025/TT-BYT. A narcotic prescription code SHALL end with the N suffix. ( value.exists() implies value.matches('-N$')) | ||||
| 74. MedicationRequest.groupIdentifier.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 76. MedicationRequest.groupIdentifier.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on MedicationRequest.groupIdentifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 78. MedicationRequest.groupIdentifier.use | |||||
| Definition | The purpose of this identifier. | ||||
| Short | usual | official | temp | secondary | old (If known) | ||||
| Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)Identifies the purpose for this identifier, if known . | ||||
| Type | code | ||||
| Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 80. MedicationRequest.groupIdentifier.type | |||||
| Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
| Short | Description of identifier | ||||
| Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||||
| Control | 0..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 82. MedicationRequest.groupIdentifier.system | |||||
| Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
| Short | The namespace for the identifier value | ||||
| Comments | Identifier.system is always case sensitive. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||||
| Fixed Value | http://fhir.hl7.org.vn/core/sid/don-thuoc-quoc-gia | ||||
| Example | General: http://www.acme.com/identifiers/patient | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 84. MedicationRequest.groupIdentifier.value | |||||
| Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||||
| Short | The value that is unique | ||||
| Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Example | General: 123456 | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 86. MedicationRequest.groupIdentifier.period | |||||
| Definition | Time period during which identifier is/was valid for use. | ||||
| Short | Time period when id is/was valid for use | ||||
| Control | 0..1 | ||||
| Type | Period | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 88. MedicationRequest.groupIdentifier.assigner | |||||
| Definition | Organization that issued/manages the identifier. | ||||
| Short | Organization that issued id (may be just text) | ||||
| Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. | ||||
| Control | 0..1 | ||||
| Type | Reference(Organization) | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 90. MedicationRequest.courseOfTherapyType | |||||
| Definition | The description of the overall patte3rn of the administration of the medication to the patient. | ||||
| Short | Overall pattern of medication administration | ||||
| Comments | This attribute should not be confused with the protocol of the medication. | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see medicationRequest Course of Therapy Codes (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1)Identifies the overall pattern of medication administratio. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 92. MedicationRequest.insurance | |||||
| Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. | ||||
| Short | Thẻ BHYT (nếu đơn BHYT) | ||||
| Control | 0..* | ||||
| Type | Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 94. MedicationRequest.note | |||||
| Definition | Extra information about the prescription that could not be conveyed by the other attributes. | ||||
| Short | Ghi chú bổ sung | ||||
| Control | 0..* | ||||
| Type | Annotation | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 96. MedicationRequest.dosageInstruction | |||||
| Definition | Indicates how the medication is to be used by the patient. | ||||
| Short | Hướng dẫn liều dùng | ||||
| Comments | There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed. | ||||
| Control | 1..* | ||||
| Type | Dosage | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 98. MedicationRequest.dosageInstruction.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 100. MedicationRequest.dosageInstruction.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on MedicationRequest.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 102. MedicationRequest.dosageInstruction.modifierExtension | |||||
| Definition | 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 104. MedicationRequest.dosageInstruction.sequence | |||||
| Definition | Indicates the order in which the dosage instructions should be applied or interpreted. | ||||
| Short | The order of the dosage instructions | ||||
| Control | 0..1 | ||||
| Type | integer | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 106. MedicationRequest.dosageInstruction.text | |||||
| Definition | Free text dosage instructions e.g. SIG. | ||||
| Short | Hướng dẫn dạng text (VD: Uống 500mg, 3 lần/ngày, sau ăn) | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Free text dosage instructions 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 108. MedicationRequest.dosageInstruction.additionalInstruction | |||||
| Definition | 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"). | ||||
| Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" | ||||
| Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. | ||||
| Control | 0..* | ||||
| Binding | For example codes, see SNOMEDCTAdditionalDosageInstructions (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 110. MedicationRequest.dosageInstruction.patientInstruction | |||||
| Definition | Instructions in terms that are understood by the patient or consumer. | ||||
| Short | Patient or consumer oriented instructions | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 112. MedicationRequest.dosageInstruction.timing | |||||
| Definition | When medication should be administered. | ||||
| Short | Lịch dùng thuốc (tần suất, thời điểm) | ||||
| Comments | 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. | ||||
| Control | 0..1 | ||||
| Type | Timing | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 114. MedicationRequest.dosageInstruction.asNeeded[x] | |||||
| Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). | ||||
| Short | Take "as needed" (for x) | ||||
| Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)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. | ||||
| Type | Choice of: boolean, CodeableConcept | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 116. MedicationRequest.dosageInstruction.site | |||||
| Definition | Body site to administer to. | ||||
| Short | Body site to administer to | ||||
| Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)A coded concept describing the site location the medicine enters into or onto the body. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | A coded specification of the anatomic site where the medication first enters the body. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 118. MedicationRequest.dosageInstruction.route | |||||
| Definition | How drug should enter body. | ||||
| Short | Đường dùng (uống, tiêm, bôi...) — 56 mã theo Dược điển VN | ||||
| Control | 0..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from Đường dùng thuốc — Vietnam Medication Route ValueSet (extensible to http://fhir.hl7.org.vn/core/ValueSet/vn-medication-route-vs) | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 120. MedicationRequest.dosageInstruction.method | |||||
| Definition | Technique for administering medication. | ||||
| Short | Technique for administering medication | ||||
| Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see SNOMEDCTAdministrationMethodCodes (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)A coded concept describing the technique by which the medicine is administered. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 122. MedicationRequest.dosageInstruction.doseAndRate | |||||
| Definition | The amount of medication administered. | ||||
| Short | Liều lượng và tốc độ | ||||
| Control | 0..* | ||||
| Type | Element | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 124. MedicationRequest.dosageInstruction.doseAndRate.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 126. MedicationRequest.dosageInstruction.doseAndRate.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 128. MedicationRequest.dosageInstruction.doseAndRate.type | |||||
| Definition | The kind of dose or rate specified, for example, ordered or calculated. | ||||
| Short | The kind of dose or rate specified | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see DoseAndRateType (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)The kind of dose or rate specified. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | If the type is not populated, assume to be "ordered". | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 130. MedicationRequest.dosageInstruction.doseAndRate.dose[x] | |||||
| Definition | Amount of medication per dose. | ||||
| Short | Amount of medication per dose | ||||
| Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. | ||||
| Control | 0..1 | ||||
| Type | Choice of: Range, Quantity(SimpleQuantity) | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | The amount of therapeutic or other substance given at one administration event. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 132. MedicationRequest.dosageInstruction.doseAndRate.rate[x] | |||||
| Definition | Amount of medication per unit of time. | ||||
| Short | Amount of medication per unit of time | ||||
| Comments | It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. | ||||
| Control | 0..1 | ||||
| Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 134. MedicationRequest.dosageInstruction.maxDosePerPeriod | |||||
| Definition | Upper limit on medication per unit of time. | ||||
| Short | Upper limit on medication per unit of time | ||||
| Comments | 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". | ||||
| Control | 0..1 | ||||
| Type | Ratio | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | 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. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 136. MedicationRequest.dosageInstruction.maxDosePerAdministration | |||||
| Definition | Upper limit on medication per administration. | ||||
| Short | Upper limit on medication per administration | ||||
| Comments | 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. | ||||
| Control | 0..1 | ||||
| Type | Quantity(SimpleQuantity) | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 138. MedicationRequest.dosageInstruction.maxDosePerLifetime | |||||
| Definition | Upper limit on medication per lifetime of the patient. | ||||
| Short | Upper limit on medication per lifetime of the patient | ||||
| Control | 0..1 | ||||
| Type | Quantity(SimpleQuantity) | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 140. MedicationRequest.dispenseRequest | |||||
| Definition | Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department. | ||||
| Short | Yêu cầu cấp phát | ||||
| Control | 0..1 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Obligations | |||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 142. MedicationRequest.dispenseRequest.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 144. MedicationRequest.dispenseRequest.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 146. MedicationRequest.dispenseRequest.modifierExtension | |||||
| Definition | 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 148. MedicationRequest.dispenseRequest.initialFill | |||||
| Definition | Indicates the quantity or duration for the first dispense of the medication. | ||||
| Short | First fill details | ||||
| Comments | If populating this element, either the quantity or the duration must be included. | ||||
| Control | 0..1 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 150. MedicationRequest.dispenseRequest.initialFill.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 152. MedicationRequest.dispenseRequest.initialFill.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 154. MedicationRequest.dispenseRequest.initialFill.modifierExtension | |||||
| Definition | 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 156. MedicationRequest.dispenseRequest.initialFill.quantity | |||||
| Definition | The amount or quantity to provide as part of the first dispense. | ||||
| Short | First fill quantity | ||||
| Control | 0..1 | ||||
| Type | Quantity(SimpleQuantity) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 158. MedicationRequest.dispenseRequest.initialFill.duration | |||||
| Definition | The length of time that the first dispense is expected to last. | ||||
| Short | First fill duration | ||||
| Control | 0..1 | ||||
| Type | Duration | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 160. MedicationRequest.dispenseRequest.dispenseInterval | |||||
| Definition | The minimum period of time that must occur between dispenses of the medication. | ||||
| Short | Minimum period of time between dispenses | ||||
| Control | 0..1 | ||||
| Type | Duration | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 162. MedicationRequest.dispenseRequest.validityPeriod | |||||
| Definition | This indicates the validity period of a prescription (stale dating the Prescription). | ||||
| Short | Time period supply is authorized for | ||||
| Comments | It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations. | ||||
| Control | 0..1 | ||||
| Type | Period | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Requirements | Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 164. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed | |||||
| Definition | An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense. | ||||
| Short | Number of refills authorized | ||||
| Comments | If displaying "number of authorized fills", add 1 to this number. | ||||
| Control | 0..1 | ||||
| Type | unsignedInt | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 166. MedicationRequest.dispenseRequest.quantity | |||||
| Definition | The amount that is to be dispensed for one fill. | ||||
| Short | Tổng số lượng cấp phát | ||||
| Control | 0..1 | ||||
| Type | Quantity(SimpleQuantity) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 168. MedicationRequest.dispenseRequest.expectedSupplyDuration | |||||
| Definition | Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. | ||||
| Short | Số ngày sử dụng thuốc — TT 26/2025/TT-BYT Điều 6 khoản 6 | ||||
| Comments | Điều 6 khoản 8 đặt trần: tối đa 30 ngày cho mỗi thuốc, trừ trường hợp tại Điều 7, 8 và 9; riêng bệnh thuộc Phụ lục VII của thông tư thì người kê đơn quyết định theo tình trạng lâm sàng, tối đa 90 ngày. | ||||
| Control | 0..1 | ||||
| Type | Duration | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 170. MedicationRequest.dispenseRequest.performer | |||||
| Definition | Indicates the intended dispensing Organization specified by the prescriber. | ||||
| Short | Intended dispenser | ||||
| Control | 0..1 | ||||
| Type | Reference(Organization) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 172. MedicationRequest.substitution | |||||
| Definition | Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done. | ||||
| Short | Thay thế thuốc | ||||
| Control | 0..1 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 174. MedicationRequest.substitution.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 176. MedicationRequest.substitution.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 178. MedicationRequest.substitution.modifierExtension | |||||
| Definition | 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 180. MedicationRequest.substitution.allowed[x] | |||||
| Definition | True if the prescriber allows a different drug to be dispensed from what was prescribed. | ||||
| Short | Whether substitution is allowed or not | ||||
| Comments | This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored. | ||||
| Control | 1..1 | ||||
| Binding | For example codes, see ActSubstanceAdminSubstitutionCode (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)Identifies the type of substitution allowed. | ||||
| Type | Choice of: boolean, CodeableConcept | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 182. MedicationRequest.substitution.reason | |||||
| Definition | Indicates the reason for the substitution, or why substitution must or must not be performed. | ||||
| Short | Why should (not) substitution be made | ||||
| Control | 0..1 | ||||
| Binding | For example codes, see SubstanceAdminSubstitutionReason (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 184. MedicationRequest.priorPrescription | |||||
| Definition | A link to a resource representing an earlier order related order or prescription. | ||||
| Short | An order/prescription that is being replaced | ||||
| Control | 0..1 | ||||
| Type | Reference(MedicationRequest) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 186. MedicationRequest.detectedIssue | |||||
| Definition | Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. | ||||
| Short | Clinical Issue with action | ||||
| Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. | ||||
| Control | 0..* | ||||
| Type | Reference(DetectedIssue) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 188. MedicationRequest.eventHistory | |||||
| Definition | Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. | ||||
| Short | A list of events of interest in the lifecycle | ||||
| Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). | ||||
| Control | 0..* | ||||
| Type | Reference(Provenance) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
