MedicationOrder

Overview

The MedicationOrder resource provides orders for all medications with administration instructions for a patient in both the inpatient and outpatient settings (orders or prescriptions filled by a pharmacy and discharge medication orders). This resource does not include historical or home medications documented or reported to have been taken by the patient, significant other, or another provider.

If the medication order represents a prescription the patient takes at home, then the start, stop, and other information may not be a representation of when the medication was taken. For example, the system may not know if the patient ever filled or took the prescribed medication, or when the prescription was filled.

The following fields are returned if valued:

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Terminology Bindings

MedicationOrder.reasonCodeableConcept
  • Description
    • The reason or indication for writing the prescription.
  • Details: SNOMED CT
    System: http://snomed.info/sct

  • Details: ICD-9-CM
    System: http://hl7.org/fhir/sid/icd-9-cm

  • Details: ICD-10-CM
    System: http://hl7.org/fhir/sid/icd-10-cm

MedicationOrder.medicationCodeableConcept
  • Description
    • Identifies the medication being administered.
  • Details: RxNorm
    System: http://www.nlm.nih.gov/research/umls/rxnorm

MedicationOrder.dosageInstruction.additionalInstructions
  • Description
    • Supplemental instructions.
  • Note
    • Currently not bound to any terminology. The value would always be returned as a free-text value.
MedicationOrder.dosageInstruction.timing.code
  • Description
    • Code for a known / defined timing pattern.
  • Details: TimingAbbreviation
    System: http://hl7.org/fhir/timing-abbreviation

  • Details: SNOMED CT
    System: http://snomed.info/sct

MedicationOrder.dosageInstruction.asNeeded[x]
  • Description
    • Indicates whether the Medication is only taken when needed or the preconditions for taking the medication.
  • Details: SNOMED CT
    System: http://snomed.info/sct

MedicationOrder.dosageInstruction.siteCodeableConcept
  • Description
    • The anatomic site where the medication first enters the body.
  • Details: SNOMED CT
    System: http://snomed.info/sct

MedicationOrder.dosageInstruction.route
  • Description
    • A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject.
  • Details: SNOMED CT
    System: http://snomed.info/sct

  • Details: NCI Metathesaurus
    System: http://ncimeta.nci.nih.gov

Contained Medication Bindings

Medication.code
  • Description
    • A code that defines the type of medication.
  • Details: RxNorm
    System: http://www.nlm.nih.gov/research/umls/rxnorm

Medication.product.form
  • Description
    • Describes the form of the item.
  • Details: NCI Metathesaurus
    System: http://ncimeta.nci.nih.gov

Extensions

Custom Extensions

All URLs for custom extensions are defined as https://fhir-ehr.cerner.com/dstu2/StructureDefinition/{id}

For more information, see the StructureDefinition resource.

ID Value[x] Type Description
patient-friendly-display string Extension to MedicationRequest.dosageInstruction. The display name that can be used for this field when producing a view suitable for a patient.

Search for medication orders that meet supplied query parameters.

GET /MedicationOrder?:parameters

Authorization Types

Parameters

Name Required? Type Description
_id Conditionally token The logical resource ID associated with the resource. It may be a list separated by commas. This parameter is required if the patient parameter is not used. Example: _id=1234
patient Conditionally reference The specific patient to return orders for. This parameter is required if the _id parameter is not used. Example: patient=5678
status No token The status of the medication order. It may be a list separated by commas. Example: status=active,draft
-timing-boundsPeriod No date The date and time that should fall within the period when the medication should be given to the patient. This parameter cannot be provided at the same time as the _lastUpdated parameter. Example: -timing-boundsPeriod=ge2014-05-19T20:54:02.000Z
_lastUpdated No date An explicit or implied date and time range within which the most recent clinically relevant update was made to the medication. This parameter cannot be provided at the same time as the -timing-boundsPeriod parameter. Example: _lastUpdated=ge2014-05-19T20:54:02.000Z
_count No number The maximum number of results to include on a page. Example: _count=50

Notes

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/MedicationOrder?patient=12724067

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "b4a46440-d23a-4161-9456-1587475fc314",
  "type": "searchset",
  "total": 2,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/MedicationOrder?patient=12724067"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/MedicationOrder/309799821",
      "resource": {
        "resourceType": "MedicationOrder",
        "id": "309799821",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2020-03-20T01:00:37.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Medication Order</b></p><p><b>Patient Name</b>: SMART, JOE</p><p><b>Medication Name</b>: levoFLOXacin</p><p><b>Dosage Instructions</b>: 728 mg = 145.6 mL, IV Piggyback, Daily</p><p><b>Status</b>: Active</p></div>"
        },
        "dateWritten": "2020-03-05T11:26:02.000-06:00",
        "status": "active",
        "patient": {
          "reference": "Patient/12724067",
          "display": "SMART, JOE"
        },
        "prescriber": {
          "reference": "Practitioner/4122622",
          "display": "Cerner Test, Physician - Hospitalist Cerner"
        },
        "encounter": {
          "reference": "Encounter/97953480"
        },
        "medicationCodeableConcept": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "82122",
              "display": "Levofloxacin",
              "userSelected": false
            }
          ],
          "text": "levoFLOXacin"
        },
        "dosageInstruction": [
          {
            "text": "728 mg = 145.6 mL, IV Piggyback, Daily",
            "_text": {
              "extension": [
                {
                  "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
                  "valueString": "IV Piggyback every day. Refills: 0."
                }
              ]
            },
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2020-03-05T11:26:00.000-06:00"
                }
              },
              "code": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/timing-abbreviation",
                    "code": "QD",
                    "display": "QD",
                    "userSelected": false
                  }
                ],
                "text": "Daily"
              }
            },
            "route": {
              "coding": [
                {
                  "system": "http://ncimeta.nci.nih.gov",
                  "code": "C38279",
                  "display": "INTRAVENOUS DRIP",
                  "userSelected": false
                },
                {
                  "system": "http://snomed.info/sct",
                  "code": "47625008",
                  "display": "Intravenous route (qualifier value)",
                  "userSelected": false
                }
              ],
              "text": "IV Piggyback"
            },
            "doseQuantity": {
              "value": 728.0,
              "unit": "mg",
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            }
          }
        ],
        "dispenseRequest": {
          "validityPeriod": {
            "start": "2020-03-05T11:26:02.000-06:00"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/MedicationOrder/309799757",
      "resource": {
        "resourceType": "MedicationOrder",
        "id": "309799757",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2020-03-20T01:00:37.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Medication Order</b></p><p><b>Patient Name</b>: SMART, JOE</p><p><b>Medication Name</b>: vancomycin</p><p><b>Dosage Instructions</b>: 2,275 mg, IV Piggyback, Once</p><p><b>Status</b>: Active</p></div>"
        },
        "dateWritten": "2020-03-05T11:26:02.000-06:00",
        "status": "active",
        "dateEnded": "2020-03-05T11:26:00.000-06:00",
        "patient": {
          "reference": "Patient/12724067",
          "display": "SMART, JOE"
        },
        "prescriber": {
          "reference": "Practitioner/4122622",
          "display": "Cerner Test, Physician - Hospitalist Cerner"
        },
        "encounter": {
          "reference": "Encounter/97953480"
        },
        "medicationCodeableConcept": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "11124",
              "display": "Vancomycin",
              "userSelected": false
            }
          ],
          "text": "vancomycin"
        },
        "dosageInstruction": [
          {
            "text": "2,275 mg, IV Piggyback, Once",
            "_text": {
              "extension": [
                {
                  "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
                  "valueString": "IV Piggyback once. Refills: 0."
                }
              ]
            },
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2020-03-05T11:26:00.000-06:00",
                  "end": "2020-03-05T11:26:00.000-06:00"
                }
              },
              "code": {
                "text": "Once"
              }
            },
            "route": {
              "coding": [
                {
                  "system": "http://ncimeta.nci.nih.gov",
                  "code": "C38279",
                  "display": "INTRAVENOUS DRIP",
                  "userSelected": false
                },
                {
                  "system": "http://snomed.info/sct",
                  "code": "47625008",
                  "display": "Intravenous route (qualifier value)",
                  "userSelected": false
                }
              ],
              "text": "IV Piggyback"
            },
            "doseQuantity": {
              "value": 2275.0,
              "unit": "mg",
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            }
          }
        ],
        "dispenseRequest": {
          "validityPeriod": {
            "start": "2020-03-05T11:26:02.000-06:00"
          }
        }
      }
    }
  ]
}

Retrieve by ID

List an individual medication order by its ID.

GET /MedicationOrder/:id

Authorization Types

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/MedicationOrder/309799821

Response

Status: 200 OK
{
  "resourceType": "MedicationOrder",
  "id": "309799821",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2020-03-20T01:00:37.000Z"
  },
  "text": {
    "status": "generated",
    "div": "<div><p><b>Medication Order</b></p><p><b>Patient Name</b>: SMART, JOE</p><p><b>Medication Name</b>: levoFLOXacin</p><p><b>Dosage Instructions</b>: 728 mg = 145.6 mL, IV Piggyback, Daily</p><p><b>Status</b>: Active</p></div>"
  },
  "dateWritten": "2020-03-05T11:26:02.000-06:00",
  "status": "active",
  "patient": {
    "reference": "Patient/12724067",
    "display": "SMART, JOE"
  },
  "prescriber": {
    "reference": "Practitioner/4122622",
    "display": "Cerner Test, Physician - Hospitalist Cerner"
  },
  "encounter": {
    "reference": "Encounter/97953480"
  },
  "medicationCodeableConcept": {
    "coding": [
      {
        "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code": "82122",
        "display": "Levofloxacin",
        "userSelected": false
      }
    ],
    "text": "levoFLOXacin"
  },
  "dosageInstruction": [
    {
      "text": "728 mg = 145.6 mL, IV Piggyback, Daily",
      "_text": {
        "extension": [
          {
            "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
            "valueString": "IV Piggyback every day. Refills: 0."
          }
        ]
      },
      "timing": {
        "repeat": {
          "boundsPeriod": {
            "start": "2020-03-05T11:26:00.000-06:00"
          }
        },
        "code": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/timing-abbreviation",
              "code": "QD",
              "display": "QD",
              "userSelected": false
            }
          ],
          "text": "Daily"
        }
      },
      "route": {
        "coding": [
          {
            "system": "http://ncimeta.nci.nih.gov",
            "code": "C38279",
            "display": "INTRAVENOUS DRIP",
            "userSelected": false
          },
          {
            "system": "http://snomed.info/sct",
            "code": "47625008",
            "display": "Intravenous route (qualifier value)",
            "userSelected": false
          }
        ],
        "text": "IV Piggyback"
      },
      "doseQuantity": {
        "value": 728.0,
        "unit": "mg",
        "system": "http://unitsofmeasure.org",
        "code": "mg"
      }
    }
  ],
  "dispenseRequest": {
    "validityPeriod": {
      "start": "2020-03-05T11:26:02.000-06:00"
    }
  }
}