MedicationOrder

Overview

The Medication Order resource provides orders for all medications along with administration instructions for a patient in both the inpatient and outpatient setting (orders/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 patient, significant other or another provider.

If the Medication Order represents a prescription (something the patient takes at home), the start, stop, and other data 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:

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}

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

Search for MedicationOrders that meet supplied query parameters:

GET /MedicationOrder?:parameters

Implementation Notes

Authorization Types

Parameters

Name Required? Type Description
patient Y reference The identity of a patient to list orders for. Example: 12345
status N token The status of the medication order, may be a list separated by commas. Example: active,draft
-timing-boundsPeriod N date The date-time which should fall within the period the medication should be given to the patient. Must be prefixed by ‘ge’. Example: ge2014-05-19T20:54:02.000Z
_count N number The maximum number of results to include in a page. Example: 50

Headers

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

Example

Request

GET https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/MedicationOrder?patient=4342010 

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "c9c3f145-c744-490f-8cc6-4faac8a060e1",
  "type": "searchset",
  "total": 4,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/MedicationOrder?patient=4342010&_count=25"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/MedicationOrder/21389901",
      "resource": {
        "resourceType": "MedicationOrder",
        "id": "21389901",
        "meta": {
          "versionId": "0",
          "lastUpdated": "2016-06-27T15:00:00.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Medication Order</b></p><p><b>Patient Name</b>: Smart, Joe</p><p><b>Medication Name</b>: acebutolol (Sectral)</p><p><b>Dosage Instructions</b>: 200 mg, 1 caps, Oral, Daily</p><p><b>Status</b>: Active</p></div>"
        },
        "dateWritten": "2016-06-27T09:57:32.000-05:00",
        "status": "active",
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "prescriber": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "encounter": {
          "reference": "Encounter/4027918"
        },
        "medicationCodeableConcept": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "9631",
              "display": "Sectral",
              "userSelected": false
            }
          ],
          "text": "acebutolol (Sectral)"
        },
        "dosageInstruction": [
          {
            "text": "200 mg, 1 caps, Oral, Daily",
            "_text": {
              "extension": [
                {
                  "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
                  "valueString": "200 Milligram Oral every day. Refills: 0."
                }
              ]
            },
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2016-06-27T09:00:00.000-07:00"
                }
              },
              "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": "C38288",
                  "display": "ORAL",
                  "userSelected": false
                }
              ],
              "text": "Oral"
            },
            "doseQuantity": {
              "value": 200.0,
              "unit": "mg",
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            }
          }
        ],
        "dispenseRequest": {
          "validityPeriod": {
            "start": "2016-06-27T09:57:32.000-05:00"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/MedicationOrder/21389899",
      "resource": {
        "resourceType": "MedicationOrder",
        "id": "21389899",
        "meta": {
          "versionId": "0",
          "lastUpdated": "2016-06-27T14:59:58.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Medication Order</b></p><p><b>Patient Name</b>: Smart, Joe</p><p><b>Medication Name</b>: furosemide (Lasix)</p><p><b>Dosage Instructions</b>: 80 mg, 1 tabs, Oral, Daily</p><p><b>Status</b>: Active</p></div>"
        },
        "dateWritten": "2016-06-27T09:56:37.000-05:00",
        "status": "active",
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "prescriber": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "encounter": {
          "reference": "Encounter/4027918"
        },
        "medicationCodeableConcept": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "202991",
              "display": "Lasix",
              "userSelected": false
            }
          ],
          "text": "furosemide (Lasix)"
        },
        "dosageInstruction": [
          {
            "text": "80 mg, 1 tabs, Oral, Daily",
            "_text": {
              "extension": [
                {
                  "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
                  "valueString": "80 Milligram Oral every day. Refills: 0."
                }
              ]
            },
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2016-06-27T09:00:00.000-07:00"
                }
              },
              "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": "C38288",
                  "display": "ORAL",
                  "userSelected": false
                }
              ],
              "text": "Oral"
            },
            "doseQuantity": {
              "value": 80.0,
              "unit": "mg",
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            }
          }
        ],
        "dispenseRequest": {
          "validityPeriod": {
            "start": "2016-06-27T09:56:37.000-05:00"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/MedicationOrder/22298109",
      "resource": {
        "resourceType": "MedicationOrder",
        "id": "22298109",
        "meta": {
          "versionId": "0",
          "lastUpdated": "2017-02-09T16:31:47.000Z"
        },
        "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>: 1 g, IV, q12hr</p><p><b>Status</b>: Active</p></div>"
        },
        "dateWritten": "2017-02-09T10:31:00.000-06:00",
        "status": "active",
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "prescriber": {
          "reference": "Practitioner/4474007",
          "display": "Song, River"
        },
        "encounter": {
          "reference": "Encounter/4027918"
        },
        "medicationCodeableConcept": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "11124",
              "display": "Vancomycin",
              "userSelected": false
            }
          ],
          "text": "vancomycin"
        },
        "dosageInstruction": [
          {
            "text": "1 g, IV, q12hr",
            "_text": {
              "extension": [
                {
                  "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
                  "valueString": "1 Gram Intravenous every 12 hours. Refills: 0."
                }
              ]
            },
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2017-02-09T09:00:00.000-08:00"
                }
              },
              "code": {
                "text": "q12hr"
              }
            },
            "route": {
              "coding": [
                {
                  "system": "http://ncimeta.nci.nih.gov",
                  "code": "C38276",
                  "display": "INTRAVENOUS",
                  "userSelected": false
                }
              ],
              "text": "IV"
            },
            "doseQuantity": {
              "value": 1.0,
              "unit": "g",
              "system": "http://unitsofmeasure.org",
              "code": "g"
            }
          }
        ],
        "dispenseRequest": {
          "validityPeriod": {
            "start": "2017-02-09T10:31:00.000-06:00"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/MedicationOrder/22298077",
      "resource": {
        "resourceType": "MedicationOrder",
        "id": "22298077",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2017-02-09T16:30:45.000Z"
        },
        "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 + Dextrose 5% in Water 100 mL</p><p><b>Dosage Instructions</b>: 100 mg, IV, q12hr</p><p><b>Status</b>: Entered In Error</p></div>"
        },
        "contained": [
          {
            "resourceType": "Medication",
            "id": "2770945",
            "code": {
              "text": "vancomycin + Dextrose 5% in Water 100 mL"
            },
            "product": {
              "ingredient": [
                {
                  "item": {
                    "reference": "#2770945-1",
                    "display": "vancomycin"
                  },
                  "amount": {
                    "numerator": {
                      "value": 100.0,
                      "unit": "mg",
                      "system": "http://unitsofmeasure.org",
                      "code": "mg"
                    },
                    "denominator": {
                      "value": 100.0,
                      "unit": "mL",
                      "system": "http://unitsofmeasure.org",
                      "code": "mL"
                    }
                  }
                },
                {
                  "item": {
                    "reference": "#2778758-2",
                    "display": "Dextrose 5% in Water"
                  },
                  "amount": {
                    "numerator": {
                      "value": 100.0,
                      "unit": "mL",
                      "system": "http://unitsofmeasure.org",
                      "code": "mL"
                    },
                    "denominator": {
                      "value": 100.0,
                      "unit": "mL",
                      "system": "http://unitsofmeasure.org",
                      "code": "mL"
                    }
                  }
                }
              ]
            }
          },
          {
            "resourceType": "Medication",
            "id": "2770945-1",
            "code": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "code": "11124",
                  "display": "Vancomycin",
                  "userSelected": false
                }
              ],
              "text": "vancomycin"
            }
          },
          {
            "resourceType": "Medication",
            "id": "2778758-2",
            "code": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "code": "309778",
                  "display": "Glucose 50 MG/ML Injectable Solution",
                  "userSelected": false
                }
              ],
              "text": "Dextrose 5% in Water"
            }
          }
        ],
        "dateWritten": "2017-02-09T09:29:09.000-06:00",
        "status": "entered-in-error",
        "dateEnded": "2017-02-09T08:30:45.000-08:00",
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "prescriber": {
          "reference": "Practitioner/4474007",
          "display": "Song, River"
        },
        "encounter": {
          "reference": "Encounter/4027918"
        },
        "medicationReference": {
          "reference": "#2770945",
          "display": "vancomycin + Dextrose 5% in Water 100 mL"
        },
        "dosageInstruction": [
          {
            "text": "100 mg, IV, q12hr",
            "_text": {
              "extension": [
                {
                  "url": "https://fhir-ehr.cerner.com/dstu2/StructureDefinition/patient-friendly-display",
                  "valueString": "Intravenous every 12 hours for 6 Days. Refills: 0."
                }
              ]
            },
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2017-02-09T08:00:00.000-08:00",
                  "end": "2017-02-09T08:30:45.000-08:00"
                }
              },
              "code": {
                "text": "q12hr"
              }
            },
            "route": {
              "coding": [
                {
                  "system": "http://ncimeta.nci.nih.gov",
                  "code": "C38276",
                  "display": "INTRAVENOUS",
                  "userSelected": false
                }
              ],
              "text": "IV"
            },
            "doseQuantity": {
              "value": 100.0,
              "unit": "mL",
              "system": "http://unitsofmeasure.org",
              "code": "mL"
            }
          }
        ],
        "dispenseRequest": {
          "validityPeriod": {
            "start": "2017-02-09T09:29:09.000-06:00"
          }
        }
      }
    }
  ]
}

Errors

The common errors may be returned.