Guia de Implementação da SES GO - CORE
1.2.6 - draft Brazil flag

Guia de Implementação da SES GO - CORE - Downloaded Version 1.2.6 See the Directory of published versions

Resource Profile: PrescricaoMedicamentoSumarioAlta - Detailed Descriptions

Draft as of 2026-03-07

Definitions for the prescricao-medicamento-sumario-alta resource profile.

Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

0. MedicationRequest
Definição

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.

CurtoOrdering of medication for patient or group
Controlo0..*
É modificadorfalse
Resumofalse
Nomes alternativosPrescription, Order
Invariantesdom-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())
2. MedicationRequest.implicitRules
Definição

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.

CurtoA set of rules under which this content was created
Comentários

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.

Controlo0..1
Tipouri
É modificadortrue porque 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
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.modifierExtension
Definição

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).

CurtoExtensions that cannot be ignored
Comentários

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.

Controlo0..*
TipoExtension
É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Resumofalse
Requisitos

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.

Nomes alternativosextensions, user content
Invariantesele-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())
6. MedicationRequest.status
Definição

A code specifying the current state of the order. Generally, this will be active or completed state.

Curtoactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Comentários

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de 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.

Tipocode
É modificadortrue porque 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
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Valor do padrãoactive
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationRequest.intent
Definição

Whether the request is a proposal, plan, or an original order.

Curtoproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Comentários

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.

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de 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.

Tipocode
É modificadortrue porque 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
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Valor do padrãoplan
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationRequest.doNotPerform
Definição

If true indicates that the provider is asking for the medication request not to occur.

CurtoTrue if request is prohibiting action
Comentários

If do not perform is not specified, the request is a positive request e.g. "do perform".

Controlo0..1
Tipoboolean
É modificadortrue porque 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)
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MedicationRequest.medication[x]
Definição

Descrição da prescrição de medicamentos de forma livre, em texto, podendo ter vários medicamentos no mesmo texto. O profissional prescritor deverá descrever todos os campos necessários a uma prescrição, entre outros elementos relevantes.


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.

CurtoPrescrição não estruturadaMedication to be taken
Comentários

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.

Controlo1..1
VínculoPara exemplos de códigos, ver 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.

TipoCodeableConcept, Reference(Medication)
[x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. MedicationRequest.medication[x].text
Definição

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

CurtoPlain text representation of the concept
Comentários

Very often the text is the same as a displayName of one of the codings.

Controlo10..1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MedicationRequest.subject
Definição

Identificação inequívoca da pessoa assistida.


A link to a resource representing the person or set of individuals to whom the medication will be given.

CurtoIdentificação do IndivíduoWho or group medication request is for
Comentários

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.

Controlo1..1
TipoReference(Cidadão Identificado, Patient, Group)
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. MedicationRequest.encounter
Definição

The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

CurtoEncounter created as part of encounter/admission/stay
Comentários

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.

Controlo10..1
TipoReference(Contato Assistencial do Sumário de Alta, Encounter)
É modificadorfalse
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. MedicationRequest.authoredOn
Definição

Data e hora da alta do paciente


The date (and perhaps time) when the prescription was initially written or authored on.

CurtoData e hora da saída da internaçãoWhen request was initially authored
Controlo10..1
TipodateTime
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. MedicationRequest.requester
Definição

Identificação unívoca do estabelecimento de atendimento, mediante número único válido em todo o território nacional, sendo: - Cadastro Nacional de Estabelecimentos de Saúde (CNES).


The individual, organization, or device that initiated the request and has responsibility for its activation.

CurtoIdentificador do Estabelecimento de SaúdeWho/What requested the Request
Controlo10..1
TipoReference(Estabelecimento de Saúde, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

0. MedicationRequest
2. MedicationRequest.status
Valor do padrãoactive
4. MedicationRequest.intent
Valor do padrãoplan
6. MedicationRequest.medication[x]
Definição

Descrição da prescrição de medicamentos de forma livre, em texto, podendo ter vários medicamentos no mesmo texto. O profissional prescritor deverá descrever todos os campos necessários a uma prescrição, entre outros elementos relevantes.

CurtoPrescrição não estruturada
TipoCodeableConcept, Reference(Medication)
[x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
8. MedicationRequest.medication[x].text
Controlo1..?
10. MedicationRequest.subject
Definição

Identificação inequívoca da pessoa assistida.

CurtoIdentificação do Indivíduo
TipoReference(Cidadão Identificado)
12. MedicationRequest.encounter
Controlo1..?
TipoReference(Contato Assistencial do Sumário de Alta)
14. MedicationRequest.authoredOn
Definição

Data e hora da alta do paciente

CurtoData e hora da saída da internação
Controlo1..?
16. MedicationRequest.requester
Definição

Identificação unívoca do estabelecimento de atendimento, mediante número único válido em todo o território nacional, sendo: - Cadastro Nacional de Estabelecimentos de Saúde (CNES).

CurtoIdentificador do Estabelecimento de Saúde
Controlo1..?
TipoReference(Estabelecimento de Saúde)
18. MedicationRequest.dosageInstruction
20. MedicationRequest.dosageInstruction.timing
22. MedicationRequest.dosageInstruction.timing.repeat
24. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
[x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
  • type @ $this
  • 26. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod
    Nome da fatiaboundsPeriod
    Controlo0..1
    TipoPeriod
    [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
    28. MedicationRequest.dosageInstruction.route
    30. MedicationRequest.dosageInstruction.route.coding
    32. MedicationRequest.dosageInstruction.route.coding.system
    Valor do padrãohttp://www.saude.gov.br/fhir/r4/CodeSystem/BRViaAdministracao
    34. MedicationRequest.dosageInstruction.doseAndRate
    36. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
    [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
    SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.doseAndRate.dose[x]. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
    • type @ $this
    • 38. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
      Nome da fatiadoseQuantity
      Controlo0..1
      TipoQuantity(SimpleQuantity)
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      40. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system
      Valor do padrãohttp://www.saude.gov.br/fhir/r4/CodeSystem/BRUnidadeMedida
      42. MedicationRequest.dispenseRequest
      44. MedicationRequest.dispenseRequest.quantity
      46. MedicationRequest.dispenseRequest.quantity.system
      Valor do padrãohttp://www.saude.gov.br/fhir/r4/CodeSystem/BRUnidadeMedida

      Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

      0. MedicationRequest
      Definição

      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.

      CurtoOrdering of medication for patient or group
      Controlo0..*
      É modificadorfalse
      Resumofalse
      Nomes alternativosPrescription, Order
      Invariantesdom-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())
      2. MedicationRequest.id
      Definição

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      CurtoLogical id of this artifact
      Comentários

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Controlo0..1
      Tipoid
      É modificadorfalse
      Resumotrue
      4. MedicationRequest.meta
      Definição

      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.

      CurtoMetadata about the resource
      Controlo0..1
      TipoMeta
      É modificadorfalse
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MedicationRequest.implicitRules
      Definição

      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.

      CurtoA set of rules under which this content was created
      Comentários

      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.

      Controlo0..1
      Tipouri
      É modificadortrue porque 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
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. MedicationRequest.language
      Definição

      The base language in which the resource is written.

      CurtoLanguage of the resource content
      Comentários

      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).

      Controlo0..1
      VínculoOs códigos DEVERÃO ser retirados de CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

      A human language.

      Vínculos adicionaisObjetivo
      AllLanguagesVínculo máximo
      Tipocode
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. MedicationRequest.text
      Definição

      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.

      CurtoText summary of the resource, for human interpretation
      Comentários

      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.

      Controlo0..1
      TipoNarrative
      É modificadorfalse
      Resumofalse
      Nomes alternativosnarrative, html, xhtml, display
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. MedicationRequest.contained
      Definição

      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.

      CurtoContained, inline Resources
      Comentários

      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.

      Controlo0..*
      TipoResource
      É modificadorfalse
      Resumofalse
      Nomes alternativosinline resources, anonymous resources, contained resources
      14. MedicationRequest.extension
      Definição

      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.

      CurtoAdditional content defined by implementations
      Comentários

      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.

      Controlo0..*
      TipoExtension
      É modificadorfalse
      Resumofalse
      Nomes alternativosextensions, user content
      Invariantesele-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
      Definição

      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).

      CurtoExtensions that cannot be ignored
      Comentários

      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.

      Controlo0..*
      TipoExtension
      É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Resumofalse
      Requisitos

      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.

      Nomes alternativosextensions, user content
      Invariantesele-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
      Definição

      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.

      CurtoExternal ids for this request
      Comentários

      This is a business identifier, not a resource identifier.

      NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
      Controlo0..*
      TipoIdentifier
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. MedicationRequest.status
      Definição

      A code specifying the current state of the order. Generally, this will be active or completed state.

      Curtoactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
      Comentários

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Controlo1..1
      VínculoOs códigos DEVERÃO ser retirados de 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.

      Tipocode
      É modificadortrue porque 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
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Valor do padrãoactive
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. MedicationRequest.statusReason
      Definição

      Captures the reason for the current state of the MedicationRequest.

      CurtoReason for current status
      Comentários

      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.

      Controlo0..1
      VínculoPara exemplos de códigos, ver medicationRequest Status Reason Codes
      (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1)

      Identifies the reasons for a given status.

      TipoCodeableConcept
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. MedicationRequest.intent
      Definição

      Whether the request is a proposal, plan, or an original order.

      Curtoproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
      Comentários

      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.

      Controlo1..1
      VínculoOs códigos DEVERÃO ser retirados de medicationRequest Intent
      (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

      The kind of medication order.

      Tipocode
      É modificadortrue porque 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
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Valor do padrãoplan
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. MedicationRequest.category
      Definição

      Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

      CurtoType of medication usage
      Comentários

      The category can be used to include where the medication is expected to be consumed or other types of requests.

      Controlo0..*
      VínculoPara exemplos de códigos, ver 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.

      TipoCodeableConcept
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. MedicationRequest.priority
      Definição

      Indicates how quickly the Medication Request should be addressed with respect to other requests.

      Curtoroutine | urgent | asap | stat
      Controlo0..1
      VínculoOs códigos DEVERÃO ser retirados de 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.

      Tipocode
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. MedicationRequest.doNotPerform
      Definição

      If true indicates that the provider is asking for the medication request not to occur.

      CurtoTrue if request is prohibiting action
      Comentários

      If do not perform is not specified, the request is a positive request e.g. "do perform".

      Controlo0..1
      Tipoboolean
      É modificadortrue porque 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)
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MedicationRequest.reported[x]
      Definição

      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.

      CurtoReported rather than primary record
      Controlo0..1
      TipoEscolha de: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationRequest.medication[x]
      Definição

      Descrição da prescrição de medicamentos de forma livre, em texto, podendo ter vários medicamentos no mesmo texto. O profissional prescritor deverá descrever todos os campos necessários a uma prescrição, entre outros elementos relevantes.

      CurtoPrescrição não estruturada
      Comentários

      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.

      Controlo1..1
      VínculoPara exemplos de códigos, ver SNOMEDCTMedicationCodes
      (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

      A coded concept identifying substance or product that can be ordered.

      TipoCodeableConcept
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      É modificadorfalse
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MedicationRequest.medication[x].id
      Definição

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      CurtoUnique id for inter-element referencing
      Controlo0..1
      Tipostring
      É modificadorfalse
      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
      Resumofalse
      38. MedicationRequest.medication[x].extension
      Definição

      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.

      CurtoAdditional content defined by implementations
      Comentários

      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.

      Controlo0..*
      TipoExtension
      É modificadorfalse
      Resumofalse
      Nomes alternativosextensions, user content
      Invariantesele-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())
      SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.medication[x].extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
      • value @ url
      • 40. MedicationRequest.medication[x].coding
        Definição

        A reference to a code defined by a terminology system.

        CurtoCode defined by a terminology system
        Comentários

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Controlo0..*
        TipoCoding
        É modificadorfalse
        Resumotrue
        Requisitos

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationRequest.medication[x].text
        Definição

        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        CurtoPlain text representation of the concept
        Comentários

        Very often the text is the same as a displayName of one of the codings.

        Controlo1..1
        Tipostring
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Requisitos

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MedicationRequest.subject
        Definição

        Identificação inequívoca da pessoa assistida.

        CurtoIdentificação do Indivíduo
        Comentários

        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.

        Controlo1..1
        TipoReference(Cidadão Identificado)
        É modificadorfalse
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. MedicationRequest.encounter
        Definição

        The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

        CurtoEncounter created as part of encounter/admission/stay
        Comentários

        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.

        Controlo1..1
        TipoReference(Contato Assistencial do Sumário de Alta)
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationRequest.supportingInformation
        Definição

        Include additional information (for example, patient height and weight) that supports the ordering of the medication.

        CurtoInformation to support ordering of the medication
        Controlo0..*
        TipoReference(Resource)
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. MedicationRequest.authoredOn
        Definição

        Data e hora da alta do paciente

        CurtoData e hora da saída da internação
        Controlo1..1
        TipodateTime
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. MedicationRequest.requester
        Definição

        Identificação unívoca do estabelecimento de atendimento, mediante número único válido em todo o território nacional, sendo: - Cadastro Nacional de Estabelecimentos de Saúde (CNES).

        CurtoIdentificador do Estabelecimento de Saúde
        Controlo1..1
        TipoReference(Estabelecimento de Saúde)
        É modificadorfalse
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. MedicationRequest.performer
        Definição

        The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

        CurtoIntended performer of administration
        Controlo0..1
        TipoReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. MedicationRequest.performerType
        Definição

        Indicates the type of performer of the administration of the medication.

        CurtoDesired kind of performer of the medication administration
        Comentários

        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.

        Controlo0..1
        VínculoPara exemplos de códigos, ver 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.

        TipoCodeableConcept
        É modificadorfalse
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. MedicationRequest.recorder
        Definição

        The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

        CurtoPerson who entered the request
        Controlo0..1
        TipoReference(Practitioner, PractitionerRole)
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. MedicationRequest.reasonCode
        Definição

        The reason or the indication for ordering or not ordering the medication.

        CurtoReason or indication for ordering or not ordering the medication
        Comentários

        This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

        Controlo0..*
        VínculoPara exemplos de códigos, ver Condition/Problem/DiagnosisCodes
        (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

        A coded concept indicating why the medication was ordered.

        TipoCodeableConcept
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. MedicationRequest.reasonReference
        Definição

        Condition or observation that supports why the medication was ordered.

        CurtoCondition or observation that supports why the prescription is being written
        Comentários

        This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

        Controlo0..*
        TipoReference(Condition, Observation)
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. MedicationRequest.instantiatesCanonical
        Definição

        The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

        CurtoInstantiates FHIR protocol or definition
        Controlo0..*
        Tipocanonical
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. MedicationRequest.instantiatesUri
        Definição

        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.

        CurtoInstantiates external protocol or definition
        Controlo0..*
        Tipouri
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. MedicationRequest.basedOn
        Definição

        A plan or request that is fulfilled in whole or in part by this medication request.

        CurtoWhat request fulfills
        Controlo0..*
        TipoReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
        É modificadorfalse
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. MedicationRequest.groupIdentifier
        Definição

        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.

        CurtoComposite request this is part of
        Controlo0..1
        TipoIdentifier
        É modificadorfalse
        Resumotrue
        Requisitos

        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.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. MedicationRequest.courseOfTherapyType
        Definição

        The description of the overall patte3rn of the administration of the medication to the patient.

        CurtoOverall pattern of medication administration
        Comentários

        This attribute should not be confused with the protocol of the medication.

        Controlo0..1
        VínculoPara exemplos de códigos, ver 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.

        TipoCodeableConcept
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. MedicationRequest.insurance
        Definição

        Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

        CurtoAssociated insurance coverage
        Controlo0..*
        TipoReference(Coverage, ClaimResponse)
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. MedicationRequest.note
        Definição

        Extra information about the prescription that could not be conveyed by the other attributes.

        CurtoInformation about the prescription
        Controlo0..*
        TipoAnnotation
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. MedicationRequest.dosageInstruction
        Definição

        Indicates how the medication is to be used by the patient.

        CurtoHow the medication should be taken
        Comentários

        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.

        Controlo0..*
        TipoDosage
        É modificadorfalse
        Resumofalse
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. MedicationRequest.dosageInstruction.id
        Definição

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        CurtoUnique id for inter-element referencing
        Controlo0..1
        Tipostring
        É modificadorfalse
        Formato XMLNo formato XML, esta propriedade é representada como um atributo.
        Resumofalse
        82. MedicationRequest.dosageInstruction.extension
        Definição

        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.

        CurtoAdditional content defined by implementations
        Comentários

        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.

        Controlo0..*
        TipoExtension
        É modificadorfalse
        Resumofalse
        Nomes alternativosextensions, user content
        Invariantesele-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())
        SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
        • value @ url
        • 84. MedicationRequest.dosageInstruction.modifierExtension
          Definição

          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).

          CurtoExtensions that cannot be ignored even if unrecognized
          Comentários

          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.

          Controlo0..*
          TipoExtension
          É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Resumotrue
          Requisitos

          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.

          Nomes alternativosextensions, user content, modifiers
          Invariantesele-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())
          86. MedicationRequest.dosageInstruction.sequence
          Definição

          Indicates the order in which the dosage instructions should be applied or interpreted.

          CurtoThe order of the dosage instructions
          Controlo0..1
          Tipointeger
          É modificadorfalse
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumotrue
          Requisitos

          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.

          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. MedicationRequest.dosageInstruction.text
          Definição

          Free text dosage instructions e.g. SIG.

          CurtoFree text dosage instructions e.g. SIG
          Controlo0..1
          Tipostring
          É modificadorfalse
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumotrue
          Requisitos

          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.

          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. MedicationRequest.dosageInstruction.additionalInstruction
          Definição

          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").

          CurtoSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
          Comentários

          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.

          Controlo0..*
          VínculoPara exemplos de códigos, ver 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".

          TipoCodeableConcept
          É modificadorfalse
          Resumotrue
          Requisitos

          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.

          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. MedicationRequest.dosageInstruction.patientInstruction
          Definição

          Instructions in terms that are understood by the patient or consumer.

          CurtoPatient or consumer oriented instructions
          Controlo0..1
          Tipostring
          É modificadorfalse
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. MedicationRequest.dosageInstruction.timing
          Definição

          When medication should be administered.

          CurtoWhen medication should be administered
          Comentários

          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.

          Controlo0..1
          TipoTiming
          É modificadorfalse
          Resumotrue
          Requisitos

          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.

          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. MedicationRequest.dosageInstruction.timing.id
          Definição

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          CurtoUnique id for inter-element referencing
          Controlo0..1
          Tipostring
          É modificadorfalse
          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
          Resumofalse
          98. MedicationRequest.dosageInstruction.timing.extension
          Definição

          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.

          CurtoAdditional content defined by implementations
          Comentários

          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.

          Controlo0..*
          TipoExtension
          É modificadorfalse
          Resumofalse
          Nomes alternativosextensions, user content
          Invariantesele-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())
          SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.timing.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
          • value @ url
          • 100. MedicationRequest.dosageInstruction.timing.modifierExtension
            Definição

            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).

            CurtoExtensions that cannot be ignored even if unrecognized
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Resumotrue
            Requisitos

            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.

            Nomes alternativosextensions, user content, modifiers
            Invariantesele-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())
            102. MedicationRequest.dosageInstruction.timing.event
            Definição

            Identifies specific times when the event occurs.

            CurtoWhen the event occurs
            Controlo0..*
            TipodateTime
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumotrue
            Requisitos

            In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. MedicationRequest.dosageInstruction.timing.repeat
            Definição

            A set of rules that describe when the event is scheduled.

            CurtoWhen the event is to occur
            Controlo0..1
            TipoElement
            É modificadorfalse
            Resumotrue
            Requisitos

            Many timing schedules are determined by regular repetitions.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
            tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
            tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
            tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
            tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
            tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
            tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
            tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
            tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
            106. MedicationRequest.dosageInstruction.timing.repeat.id
            Definição

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            CurtoUnique id for inter-element referencing
            Controlo0..1
            Tipostring
            É modificadorfalse
            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
            Resumofalse
            108. MedicationRequest.dosageInstruction.timing.repeat.extension
            Definição

            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.

            CurtoAdditional content defined by implementations
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadorfalse
            Resumofalse
            Nomes alternativosextensions, user content
            Invariantesele-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())
            SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.timing.repeat.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
            • value @ url
            • 110. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
              Definição

              Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

              CurtoLength/Range of lengths, or (Start and/or end) limits
              Controlo0..1
              TipoEscolha de: Duration, Range, Period
              [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
              É modificadorfalse
              Resumotrue
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
              • type @ $this
              • 112. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod
                Nome da fatiaboundsPeriod
                Definição

                Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                CurtoLength/Range of lengths, or (Start and/or end) limits
                Controlo0..1
                TipoPeriod
                [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                É modificadorfalse
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                114. MedicationRequest.dosageInstruction.timing.repeat.count
                Definição

                A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

                CurtoNumber of times to repeat
                Comentários

                If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                Controlo0..1
                TipopositiveInt
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Requisitos

                Repetitions may be limited by end time or total occurrences.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                116. MedicationRequest.dosageInstruction.timing.repeat.countMax
                Definição

                If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                CurtoMaximum number of times to repeat
                Controlo0..1
                TipopositiveInt
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. MedicationRequest.dosageInstruction.timing.repeat.duration
                Definição

                How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                CurtoHow long when it happens
                Comentários

                For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                Controlo0..1
                Tipodecimal
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Requisitos

                Some activities are not instantaneous and need to be maintained for a period of time.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. MedicationRequest.dosageInstruction.timing.repeat.durationMax
                Definição

                If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                CurtoHow long when it happens (Max)
                Comentários

                For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                Controlo0..1
                Tipodecimal
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Requisitos

                Some activities are not instantaneous and need to be maintained for a period of time.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. MedicationRequest.dosageInstruction.timing.repeat.durationUnit
                Definição

                The units of time for the duration, in UCUM units.

                Curtos | min | h | d | wk | mo | a - unit of time (UCUM)
                Controlo0..1
                VínculoOs códigos DEVERÃO ser retirados de UnitsOfTime
                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                A unit of time (units from UCUM).

                Tipocode
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. MedicationRequest.dosageInstruction.timing.repeat.frequency
                Definição

                The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

                CurtoEvent occurs frequency times per period
                Controlo0..1
                TipopositiveInt
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Significado em caso de faltaIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                126. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
                Definição

                If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                CurtoEvent occurs up to frequencyMax times per period
                Controlo0..1
                TipopositiveInt
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                128. MedicationRequest.dosageInstruction.timing.repeat.period
                Definição

                Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

                CurtoEvent occurs frequency times per period
                Controlo0..1
                Tipodecimal
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                130. MedicationRequest.dosageInstruction.timing.repeat.periodMax
                Definição

                If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                CurtoUpper limit of period (3-4 hours)
                Controlo0..1
                Tipodecimal
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                132. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
                Definição

                The units of time for the period in UCUM units.

                Curtos | min | h | d | wk | mo | a - unit of time (UCUM)
                Controlo0..1
                VínculoOs códigos DEVERÃO ser retirados de UnitsOfTime
                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                A unit of time (units from UCUM).

                Tipocode
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                134. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
                Definição

                If one or more days of week is provided, then the action happens only on the specified day(s).

                Curtomon | tue | wed | thu | fri | sat | sun
                Comentários

                If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

                Controlo0..*
                VínculoOs códigos DEVERÃO ser retirados de DaysOfWeek
                (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                Tipocode
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
                Definição

                Specified time of day for action to take place.

                CurtoTime of day for action
                Comentários

                When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

                Controlo0..*
                Tipotime
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. MedicationRequest.dosageInstruction.timing.repeat.when
                Definição

                An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

                CurtoCode for time period of occurrence
                Comentários

                When more than one event is listed, the event is tied to the union of the specified events.

                Controlo0..*
                VínculoOs códigos DEVERÃO ser retirados de EventTiming
                (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                Real world event relating to the schedule.

                Tipocode
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Requisitos

                Timings are frequently determined by occurrences such as waking, eating and sleep.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                140. MedicationRequest.dosageInstruction.timing.repeat.offset
                Definição

                The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

                CurtoMinutes from event (before or after)
                Controlo0..1
                TipounsignedInt
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                142. MedicationRequest.dosageInstruction.timing.code
                Definição

                A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                CurtoBID | TID | QID | AM | PM | QD | QOD | +
                Comentários

                BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                Controlo0..1
                VínculoOs códigos DEVERÃO ser retirados de TimingAbbreviation
                (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1)

                Code for a known / defined timing pattern.

                TipoCodeableConcept
                É modificadorfalse
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                144. MedicationRequest.dosageInstruction.asNeeded[x]
                Definição

                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).

                CurtoTake "as needed" (for x)
                Comentários

                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".

                Controlo0..1
                VínculoPara exemplos de códigos, ver 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.

                TipoEscolha de: boolean, CodeableConcept
                [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                É modificadorfalse
                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                Resumotrue
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                146. MedicationRequest.dosageInstruction.site
                Definição

                Body site to administer to.

                CurtoBody site to administer to
                Comentários

                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.

                Controlo0..1
                VínculoPara exemplos de códigos, ver 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.

                TipoCodeableConcept
                É modificadorfalse
                Resumotrue
                Requisitos

                A coded specification of the anatomic site where the medication first enters the body.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                148. MedicationRequest.dosageInstruction.route
                Definição

                How drug should enter body.

                CurtoHow drug should enter body
                Controlo0..1
                VínculoPara exemplos de códigos, ver SNOMEDCTRouteCodes
                (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                TipoCodeableConcept
                É modificadorfalse
                Resumotrue
                Requisitos

                A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                150. MedicationRequest.dosageInstruction.route.id
                Definição

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                CurtoUnique id for inter-element referencing
                Controlo0..1
                Tipostring
                É modificadorfalse
                Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                Resumofalse
                152. MedicationRequest.dosageInstruction.route.extension
                Definição

                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.

                CurtoAdditional content defined by implementations
                Comentários

                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.

                Controlo0..*
                TipoExtension
                É modificadorfalse
                Resumofalse
                Nomes alternativosextensions, user content
                Invariantesele-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())
                SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.route.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                • value @ url
                • 154. MedicationRequest.dosageInstruction.route.coding
                  Definição

                  A reference to a code defined by a terminology system.

                  CurtoCode defined by a terminology system
                  Comentários

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Controlo0..*
                  TipoCoding
                  É modificadorfalse
                  Resumotrue
                  Requisitos

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  156. MedicationRequest.dosageInstruction.route.coding.id
                  Definição

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  CurtoUnique id for inter-element referencing
                  Controlo0..1
                  Tipostring
                  É modificadorfalse
                  Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                  Resumofalse
                  158. MedicationRequest.dosageInstruction.route.coding.extension
                  Definição

                  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.

                  CurtoAdditional content defined by implementations
                  Comentários

                  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.

                  Controlo0..*
                  TipoExtension
                  É modificadorfalse
                  Resumofalse
                  Nomes alternativosextensions, user content
                  Invariantesele-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())
                  SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.route.coding.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                  • value @ url
                  • 160. MedicationRequest.dosageInstruction.route.coding.system
                    Definição

                    The identification of the code system that defines the meaning of the symbol in the code.

                    CurtoIdentity of the terminology system
                    Comentários

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                    Controlo0..1
                    Tipouri
                    É modificadorfalse
                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                    Resumotrue
                    Requisitos

                    Need to be unambiguous about the source of the definition of the symbol.

                    Valor do padrãohttp://www.saude.gov.br/fhir/r4/CodeSystem/BRViaAdministracao
                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    162. MedicationRequest.dosageInstruction.route.coding.version
                    Definição

                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                    CurtoVersion of the system - if relevant
                    Comentários

                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                    NotaEste é um ID de versão comercial, não um ID de versão de recurso (ver discussão)
                    Controlo0..1
                    Tipostring
                    É modificadorfalse
                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                    Resumotrue
                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    164. MedicationRequest.dosageInstruction.route.coding.code
                    Definição

                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                    CurtoSymbol in syntax defined by the system
                    Controlo0..1
                    Tipocode
                    É modificadorfalse
                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                    Resumotrue
                    Requisitos

                    Need to refer to a particular code in the system.

                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    166. MedicationRequest.dosageInstruction.route.coding.display
                    Definição

                    A representation of the meaning of the code in the system, following the rules of the system.

                    CurtoRepresentation defined by the system
                    Controlo0..1
                    Tipostring
                    É modificadorfalse
                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                    Resumotrue
                    Requisitos

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    168. MedicationRequest.dosageInstruction.route.coding.userSelected
                    Definição

                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                    CurtoIf this coding was chosen directly by the user
                    Comentários

                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                    Controlo0..1
                    Tipoboolean
                    É modificadorfalse
                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                    Resumotrue
                    Requisitos

                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    170. MedicationRequest.dosageInstruction.route.text
                    Definição

                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                    CurtoPlain text representation of the concept
                    Comentários

                    Very often the text is the same as a displayName of one of the codings.

                    Controlo0..1
                    Tipostring
                    É modificadorfalse
                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                    Resumotrue
                    Requisitos

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    172. MedicationRequest.dosageInstruction.method
                    Definição

                    Technique for administering medication.

                    CurtoTechnique for administering medication
                    Comentários

                    Terminologies used often pre-coordinate this term with the route and or form of administration.

                    Controlo0..1
                    VínculoPara exemplos de códigos, ver 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.

                    TipoCodeableConcept
                    É modificadorfalse
                    Resumotrue
                    Requisitos

                    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.

                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    174. MedicationRequest.dosageInstruction.doseAndRate
                    Definição

                    The amount of medication administered.

                    CurtoAmount of medication administered
                    Controlo0..*
                    TipoElement
                    É modificadorfalse
                    Resumotrue
                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    176. MedicationRequest.dosageInstruction.doseAndRate.id
                    Definição

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    CurtoUnique id for inter-element referencing
                    Controlo0..1
                    Tipostring
                    É modificadorfalse
                    Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                    Resumofalse
                    178. MedicationRequest.dosageInstruction.doseAndRate.extension
                    Definição

                    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.

                    CurtoAdditional content defined by implementations
                    Comentários

                    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.

                    Controlo0..*
                    TipoExtension
                    É modificadorfalse
                    Resumofalse
                    Nomes alternativosextensions, user content
                    Invariantesele-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())
                    SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.doseAndRate.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                    • value @ url
                    • 180. MedicationRequest.dosageInstruction.doseAndRate.type
                      Definição

                      The kind of dose or rate specified, for example, ordered or calculated.

                      CurtoThe kind of dose or rate specified
                      Controlo0..1
                      VínculoPara exemplos de códigos, ver DoseAndRateType
                      (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                      The kind of dose or rate specified.

                      TipoCodeableConcept
                      É modificadorfalse
                      Resumotrue
                      Requisitos

                      If the type is not populated, assume to be "ordered".

                      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      182. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                      Definição

                      Amount of medication per dose.

                      CurtoAmount of medication per dose
                      Comentários

                      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.

                      Controlo0..1
                      TipoEscolha de: Range, Quantity(SimpleQuantity)
                      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                      É modificadorfalse
                      Resumotrue
                      Requisitos

                      The amount of therapeutic or other substance given at one administration event.

                      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.doseAndRate.dose[x]. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                      • type @ $this
                      • 184. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                        Nome da fatiadoseQuantity
                        Definição

                        Amount of medication per dose.

                        CurtoAmount of medication per dose
                        Comentários

                        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.

                        Controlo0..1
                        TipoQuantity(SimpleQuantity)
                        [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                        É modificadorfalse
                        Resumotrue
                        Requisitos

                        The amount of therapeutic or other substance given at one administration event.

                        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        186. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id
                        Definição

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        CurtoUnique id for inter-element referencing
                        Controlo0..1
                        Tipostring
                        É modificadorfalse
                        Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                        Resumofalse
                        188. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension
                        Definição

                        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.

                        CurtoAdditional content defined by implementations
                        Comentários

                        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.

                        Controlo0..*
                        TipoExtension
                        É modificadorfalse
                        Resumofalse
                        Nomes alternativosextensions, user content
                        Invariantesele-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())
                        SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dosageInstruction.doseAndRate.dose[x].extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                        • value @ url
                        • 190. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
                          Definição

                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                          CurtoNumerical value (with implicit precision)
                          Comentários

                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                          Controlo0..1
                          Tipodecimal
                          É modificadorfalse
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumotrue
                          Requisitos

                          Precision is handled implicitly in almost all cases of measurement.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          192. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator
                          Definição

                          Not allowed to be used in this context

                          Curto< | <= | >= | > - how to understand the value
                          Controlo0..0
                          VínculoOs códigos DEVERÃO ser retirados de QuantityComparator
                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                          How the Quantity should be understood and represented.

                          Tipocode
                          É modificadortrue porque This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumotrue
                          Requisitos

                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                          Significado em caso de faltaIf there is no comparator, then there is no modification of the value
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          194. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
                          Definição

                          A human-readable form of the unit.

                          CurtoUnit representation
                          Controlo0..1
                          Tipostring
                          É modificadorfalse
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumotrue
                          Requisitos

                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          196. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system
                          Definição

                          The identification of the system that provides the coded form of the unit.

                          CurtoSystem that defines coded unit form
                          Controlo0..1
                          Este elemento é afetado pelas seguintes invariantes: qty-3
                          Tipouri
                          É modificadorfalse
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumotrue
                          Requisitos

                          Need to know the system that defines the coded form of the unit.

                          Valor do padrãohttp://www.saude.gov.br/fhir/r4/CodeSystem/BRUnidadeMedida
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          198. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code
                          Definição

                          A computer processable form of the unit in some unit representation system.

                          CurtoCoded form of the unit
                          Comentários

                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                          Controlo0..1
                          Tipocode
                          É modificadorfalse
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumotrue
                          Requisitos

                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          200. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
                          Definição

                          Amount of medication per unit of time.

                          CurtoAmount of medication per unit of time
                          Comentários

                          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.

                          Controlo0..1
                          TipoEscolha de: Ratio, Range, Quantity(SimpleQuantity)
                          [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                          É modificadorfalse
                          Resumotrue
                          Requisitos

                          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.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          202. MedicationRequest.dosageInstruction.maxDosePerPeriod
                          Definição

                          Upper limit on medication per unit of time.

                          CurtoUpper limit on medication per unit of time
                          Comentários

                          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".

                          Controlo0..1
                          TipoRatio
                          É modificadorfalse
                          Resumotrue
                          Requisitos

                          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.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          204. MedicationRequest.dosageInstruction.maxDosePerAdministration
                          Definição

                          Upper limit on medication per administration.

                          CurtoUpper limit on medication per administration
                          Comentários

                          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.

                          Controlo0..1
                          TipoQuantity(SimpleQuantity)
                          É modificadorfalse
                          Resumotrue
                          Requisitos

                          The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          206. MedicationRequest.dosageInstruction.maxDosePerLifetime
                          Definição

                          Upper limit on medication per lifetime of the patient.

                          CurtoUpper limit on medication per lifetime of the patient
                          Controlo0..1
                          TipoQuantity(SimpleQuantity)
                          É modificadorfalse
                          Resumotrue
                          Requisitos

                          The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          208. MedicationRequest.dispenseRequest
                          Definição

                          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.

                          CurtoMedication supply authorization
                          Controlo0..1
                          TipoBackboneElement
                          É modificadorfalse
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          210. MedicationRequest.dispenseRequest.id
                          Definição

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          CurtoUnique id for inter-element referencing
                          Controlo0..1
                          Tipostring
                          É modificadorfalse
                          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                          Resumofalse
                          212. MedicationRequest.dispenseRequest.extension
                          Definição

                          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.

                          CurtoAdditional content defined by implementations
                          Comentários

                          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.

                          Controlo0..*
                          TipoExtension
                          É modificadorfalse
                          Resumofalse
                          Nomes alternativosextensions, user content
                          Invariantesele-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())
                          214. MedicationRequest.dispenseRequest.modifierExtension
                          Definição

                          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).

                          CurtoExtensions that cannot be ignored even if unrecognized
                          Comentários

                          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.

                          Controlo0..*
                          TipoExtension
                          É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Resumotrue
                          Requisitos

                          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.

                          Nomes alternativosextensions, user content, modifiers
                          Invariantesele-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())
                          216. MedicationRequest.dispenseRequest.initialFill
                          Definição

                          Indicates the quantity or duration for the first dispense of the medication.

                          CurtoFirst fill details
                          Comentários

                          If populating this element, either the quantity or the duration must be included.

                          Controlo0..1
                          TipoBackboneElement
                          É modificadorfalse
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          218. MedicationRequest.dispenseRequest.initialFill.id
                          Definição

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          CurtoUnique id for inter-element referencing
                          Controlo0..1
                          Tipostring
                          É modificadorfalse
                          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                          Resumofalse
                          220. MedicationRequest.dispenseRequest.initialFill.extension
                          Definição

                          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.

                          CurtoAdditional content defined by implementations
                          Comentários

                          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.

                          Controlo0..*
                          TipoExtension
                          É modificadorfalse
                          Resumofalse
                          Nomes alternativosextensions, user content
                          Invariantesele-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())
                          222. MedicationRequest.dispenseRequest.initialFill.modifierExtension
                          Definição

                          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).

                          CurtoExtensions that cannot be ignored even if unrecognized
                          Comentários

                          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.

                          Controlo0..*
                          TipoExtension
                          É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Resumotrue
                          Requisitos

                          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.

                          Nomes alternativosextensions, user content, modifiers
                          Invariantesele-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())
                          224. MedicationRequest.dispenseRequest.initialFill.quantity
                          Definição

                          The amount or quantity to provide as part of the first dispense.

                          CurtoFirst fill quantity
                          Controlo0..1
                          TipoQuantity(SimpleQuantity)
                          É modificadorfalse
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          226. MedicationRequest.dispenseRequest.initialFill.duration
                          Definição

                          The length of time that the first dispense is expected to last.

                          CurtoFirst fill duration
                          Controlo0..1
                          TipoDuration
                          É modificadorfalse
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          228. MedicationRequest.dispenseRequest.dispenseInterval
                          Definição

                          The minimum period of time that must occur between dispenses of the medication.

                          CurtoMinimum period of time between dispenses
                          Controlo0..1
                          TipoDuration
                          É modificadorfalse
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          230. MedicationRequest.dispenseRequest.validityPeriod
                          Definição

                          This indicates the validity period of a prescription (stale dating the Prescription).

                          CurtoTime period supply is authorized for
                          Comentários

                          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.

                          Controlo0..1
                          TipoPeriod
                          É modificadorfalse
                          Resumofalse
                          Requisitos

                          Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          232. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                          Definição

                          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.

                          CurtoNumber of refills authorized
                          Comentários

                          If displaying "number of authorized fills", add 1 to this number.

                          Controlo0..1
                          TipounsignedInt
                          É modificadorfalse
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          234. MedicationRequest.dispenseRequest.quantity
                          Definição

                          The amount that is to be dispensed for one fill.

                          CurtoAmount of medication to supply per dispense
                          Controlo0..1
                          TipoQuantity(SimpleQuantity)
                          É modificadorfalse
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          236. MedicationRequest.dispenseRequest.quantity.id
                          Definição

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          CurtoUnique id for inter-element referencing
                          Controlo0..1
                          Tipostring
                          É modificadorfalse
                          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                          Resumofalse
                          238. MedicationRequest.dispenseRequest.quantity.extension
                          Definição

                          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.

                          CurtoAdditional content defined by implementations
                          Comentários

                          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.

                          Controlo0..*
                          TipoExtension
                          É modificadorfalse
                          Resumofalse
                          Nomes alternativosextensions, user content
                          Invariantesele-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())
                          SlicingEste elemento introduz um conjunto de fatias em MedicationRequest.dispenseRequest.quantity.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                          • value @ url
                          • 240. MedicationRequest.dispenseRequest.quantity.value
                            Definição

                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                            CurtoNumerical value (with implicit precision)
                            Comentários

                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                            Controlo0..1
                            Tipodecimal
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Requisitos

                            Precision is handled implicitly in almost all cases of measurement.

                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            242. MedicationRequest.dispenseRequest.quantity.comparator
                            Definição

                            Not allowed to be used in this context

                            Curto< | <= | >= | > - how to understand the value
                            Controlo0..0
                            VínculoOs códigos DEVERÃO ser retirados de QuantityComparator
                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                            How the Quantity should be understood and represented.

                            Tipocode
                            É modificadortrue porque This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Requisitos

                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                            Significado em caso de faltaIf there is no comparator, then there is no modification of the value
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            244. MedicationRequest.dispenseRequest.quantity.unit
                            Definição

                            A human-readable form of the unit.

                            CurtoUnit representation
                            Controlo0..1
                            Tipostring
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Requisitos

                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            246. MedicationRequest.dispenseRequest.quantity.system
                            Definição

                            The identification of the system that provides the coded form of the unit.

                            CurtoSystem that defines coded unit form
                            Controlo0..1
                            Este elemento é afetado pelas seguintes invariantes: qty-3
                            Tipouri
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Requisitos

                            Need to know the system that defines the coded form of the unit.

                            Valor do padrãohttp://www.saude.gov.br/fhir/r4/CodeSystem/BRUnidadeMedida
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            248. MedicationRequest.dispenseRequest.quantity.code
                            Definição

                            A computer processable form of the unit in some unit representation system.

                            CurtoCoded form of the unit
                            Comentários

                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                            Controlo0..1
                            Tipocode
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Requisitos

                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            250. MedicationRequest.dispenseRequest.expectedSupplyDuration
                            Definição

                            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.

                            CurtoNumber of days supply per dispense
                            Comentários

                            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.

                            Controlo0..1
                            TipoDuration
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            252. MedicationRequest.dispenseRequest.performer
                            Definição

                            Indicates the intended dispensing Organization specified by the prescriber.

                            CurtoIntended dispenser
                            Controlo0..1
                            TipoReference(Organization)
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            254. MedicationRequest.substitution
                            Definição

                            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.

                            CurtoAny restrictions on medication substitution
                            Controlo0..1
                            TipoBackboneElement
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            256. MedicationRequest.substitution.id
                            Definição

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            CurtoUnique id for inter-element referencing
                            Controlo0..1
                            Tipostring
                            É modificadorfalse
                            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                            Resumofalse
                            258. MedicationRequest.substitution.extension
                            Definição

                            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.

                            CurtoAdditional content defined by implementations
                            Comentários

                            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.

                            Controlo0..*
                            TipoExtension
                            É modificadorfalse
                            Resumofalse
                            Nomes alternativosextensions, user content
                            Invariantesele-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())
                            260. MedicationRequest.substitution.modifierExtension
                            Definição

                            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).

                            CurtoExtensions that cannot be ignored even if unrecognized
                            Comentários

                            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.

                            Controlo0..*
                            TipoExtension
                            É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Resumotrue
                            Requisitos

                            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.

                            Nomes alternativosextensions, user content, modifiers
                            Invariantesele-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())
                            262. MedicationRequest.substitution.allowed[x]
                            Definição

                            True if the prescriber allows a different drug to be dispensed from what was prescribed.

                            CurtoWhether substitution is allowed or not
                            Comentários

                            This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                            Controlo1..1
                            VínculoPara exemplos de códigos, ver ActSubstanceAdminSubstitutionCode
                            (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                            Identifies the type of substitution allowed.

                            TipoEscolha de: boolean, CodeableConcept
                            [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            264. MedicationRequest.substitution.reason
                            Definição

                            Indicates the reason for the substitution, or why substitution must or must not be performed.

                            CurtoWhy should (not) substitution be made
                            Controlo0..1
                            VínculoPara exemplos de códigos, ver 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.

                            TipoCodeableConcept
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            266. MedicationRequest.priorPrescription
                            Definição

                            A link to a resource representing an earlier order related order or prescription.

                            CurtoAn order/prescription that is being replaced
                            Controlo0..1
                            TipoReference(MedicationRequest)
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            268. MedicationRequest.detectedIssue
                            Definição

                            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.

                            CurtoClinical Issue with action
                            Comentários

                            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.

                            Controlo0..*
                            TipoReference(DetectedIssue)
                            É modificadorfalse
                            Resumofalse
                            Nomes alternativosContraindication, Drug Utilization Review (DUR), Alert
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            270. MedicationRequest.eventHistory
                            Definição

                            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.

                            CurtoA list of events of interest in the lifecycle
                            Comentários

                            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.).

                            Controlo0..*
                            TipoReference(Provenance)
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))