 ANSI/HL7 V3 RXMEDORDER, R1-2009 HL7 Version 3 Standard: Pharmacy; Medication Order, Release 1 9/10/2009 |
Content Last Edited: 2012-03-06T13:34:34
2.2 Application Roles
2.3 Trigger Events
2.4 Refined Message Information Models
2.5 Hierarchical Message Descriptions
2.6 Interactions
This topic deals with all content related to the ordering of medications, both for dispensing (supply) and for administration. It is intended to cover community prescribing, discharge prescriptions and institutional medication orders. The models are intended to support the requirements of all jurisdictions.
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For details on the interpretation of this section, see the discussion of application roles and their relationships in the Version 3 Guide.
This is a system which supports a care provider with dispensing authority. This role specifically captures those interactions pertaining to the fulfillment of medication orders.
This is a system which supports a request to another system for review of a proposed medication order.
This is a system which supports a request for the recording of a medication order.
This is a system which supports a care provider with prescribing authority. This role specifically captures those interactions pertaining to the creation/management of medication orders.
This is a system which tracks the creation of medication order but does not necessarily fulfill the order.
This is a system which supports requests from another system for the review of a proposed medication order.
This is a system which fulfills requests for the recording of a medication order.
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For details on the interpretation of this section, see the discussion of trigger events in the Version 3 Guide.
| Type: | User request |
User attempts to identify any contraindications or other issues that would be associated with creating a specific medication prescription for a patient.
| Type: | User request |
There are contraindications associated with the possibility of prescribing a proposed medication prescription to a patient.
| Type: |
There are no known issues with prescribing the proposed draft medication prescription to the identified patient.
| Type: | User request |
A user attempts to record a new medication prescription for storage in a central repository.
| Type: | User request |
A user or system requests a fulfiller to perform a fulfill against a medication order.
| Type: | User request |
The request to record a new medication prescription in a central repository has been refused. For example, un-recognized drug code, unmanaged contraindications, lack of permission, etc.
| Type: |
A new medication prescription has been recorded.
| Type: |
Requests that a medication prescription be recorded against the patient's record and that the previous order identified in the request have its status changed to obsolete.
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For details on the interpretation of this section, see the description of RMIMs in the Version 3 Guide.
| Parent: | Pharmacy (PORX_DM000000UV) |
This message model represents data and associations involved in the creation and storage of a patient's medication order. The order process includes content/concepts related to ordering, dispensing (supply) and administration of prescribed items.
The core classes in the Medication Order Model are the: * Combined Medication Request * Dispense Request * Substance administration Request
The combined medication request is the medication order entry point. Associated with the combine medication request are acts and participations capturing the parties involved in the ordering of a medication, the reasons for, and other order related parameters.
The dispense request is a component of the medication request and provides details concerning the dispensing of the medication. Dispensing parameters instructions to the pharmacy regarding the dispensing of the medication, time parameters associated with the dispense function, the quantity dispensed, the number of refills, who performed the dispense, who received the dispensed medication, where the medication was dispensed to, and other related parameters.
The ordered medication is the direct target of the combined medication request, the product within the dispense request and the consumable in the substance administration request.
The substance administration request is a component of the combined medication request providing information on how, when, where, how much and under what conditions the medication should be administered.
Combine Medication Request Related entities Review The act of examining and evaluating the subject, usually another act Working List The work list is used to group orders together Substance Administration Definition The act of introducing or otherwise applying a substance to the subject. A_Supporting Clinical Information Additional information relevant to the order.
Substitution Permission Used to specify "allowed" substitution when creating orders, "actual" susbstitution when sending events, as well as the reason for the substitution and who was responsible for it. A_Coverage Used to reference insurance or other coverage.
A_Annotation Observation or other notations entered on the order. Substitution Administration Intent States that the order is 'X of Y orders".
A_Detected Medication issue Provides details about potential problems or warnings associated with a medication. Prior Combined Medication Request A order that has become obsolete as a result
Prior Combined Medication Request2 An order that is related to another order.
Verification Event Criterion An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details.
Supply Request A_Annotation Observation or other notations entered on the dispense. Substance Administration Request Procedure Event Criterion Linking the order and administration based on a procedure. Subs Admin Event Criterion Linking the order and administration based on another order.
Observation Event Criterion Linking the order and administration based on an clinical observation of the patient.
Further breakdown of the model attributes are listed in the attributes table
| MedicationOrder | PORX_HD010120UV01 |
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For details on the interpretation of this section, see the description of HMDs in the Version 3 Guide.
Used when communicating full drug prescription requests
| A_EncounterUniversal | COCT_MT010000UV01 |
| R_PatientUniversal | COCT_MT050000UV01 |
| R_AssignedEntityUniversal | COCT_MT090000UV01 |
| R_AssignedPersonUniversal | COCT_MT090100UV01 |
| R_AssignedOrganizationUniversal | COCT_MT090200UV01 |
| R_AssignedDeviceUniversal | COCT_MT090300UV01 |
| A_CoverageDeprecated | COCT_MT180000UV04 |
| R_OrderableMedicationUniversal | COCT_MT220100UV |
| R_AdministerableMedicationUniversal | COCT_MT220200UV |
| R_AdministerableMedicationUniversal | COCT_MT220200UV |
| R_ServiceDeliveryLocationUniversal | COCT_MT240000UV01 |
| R_ServiceDeliveryLocationUniversal | COCT_MT240000UV01 |
| R_ServiceDeliveryLocationUniversal | COCT_MT240000UV01 |
| A_DetectedMedicationIssueUniversal | COCT_MT260003UV |
| A_SupportingClinicalStatementMinimal | COCT_MT530004UV |
| A_AnnotationUniversal | COCT_MT590000UV |
| A_AnnotationUniversal | COCT_MT590000UV |
| A_AnnotationUniversal | COCT_MT590000UV |
| Medication Order | PORX_MT010120UV01 |  |
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For details on the interpretation of this section, see the definition of Interactions in the Version 3 Guide.
Requests the proposed medication order be reviewed and any detected issues be identified. This is not a request for order fulfillment.
| Trigger Event | Request to evaluate proposed medication order | PORX_TE010720UV01 |
| Transmission Wrapper | Send Message Payload | MCCI_MT000100UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Message Type | Medication Order | PORX_MT010120UV01 |
| Reason | Trigger Event | Interaction |
| Medication Prescription problems found | PORX_TE010690UV01 | PORX_IN010630UV01 |
| No medication prescription problems found | PORX_TE010670UV01 | PORX_IN010640UV01 |
| Sender | Medication Order Predetermination Placer | PORX_AR990703UV01 |
| Receiver | Medication Order Predeterminiation Fulfiller | PORX_AR990704UV01 |
Indicates that the proposed medication order was reviewed and no issues were detected.
| Trigger Event | No medication order problems found | PORX_TE010670UV01 |
| Transmission Wrapper | Application Level Acknowledgement | MCCI_MT000300UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Sender | Medication Order Predeterminiation Fulfiller | PORX_AR990704UV01 |
| Receiver | Medication Order Predetermination Placer | PORX_AR990703UV01 |
Indicates that issues were found in reviewing the proposed medication order.
| Trigger Event | Medication order problems found | PORX_TE010690UV01 |
| Transmission Wrapper | Application Level Acknowledgement | MCCI_MT000300UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Sender | Medication Order Predeterminiation Fulfiller | PORX_AR990704UV01 |
| Receiver | Medication Order Predetermination Placer | PORX_AR990703UV01 |
Indicates that a medication order has been created. This is not a request for order fulfillment.
| Trigger Event | New medication order recorded | PORX_TE010660UV01 |
| Transmission Wrapper | Send Message Payload | MCCI_MT000100UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Message Type | Medication Order | PORX_MT010120UV01 |
| Reason | Trigger Event | Interaction |
| PORX_IN010370UV01 |
| Sender | Prescribing System | PORX_AR990701UV01 |
| Receiver | Dispensing System | PORX_AR990702UV01 |
Requests that a medication prescription be recorded against the patient's record. This may be an interaction between a provider and a repository.
| Trigger Event | Request to record medication order | PORX_TE010730UV01 |
| Transmission Wrapper | Send Message Payload | MCCI_MT000100UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Message Type | Medication Order | PORX_MT010120UV01 |
| Reason | Trigger Event | Interaction |
| Decision to not record a medication prescription | PORX_TE010700UV01 | PORX_IN010400UV01 |
| Sender | Medication Order Record Request Placer | PORX_AR990705UV01 |
| Receiver | Medication Order Record Request Fulfiller | PORX_AR990706UV01 |
Requests that the specified facility dispense the medication prescription transmitted by this interaction. This may be the interaction between a provider and a pharmacy or between a repository and a pharmacy.
| Trigger Event | Send medication order to pharmacy | PORX_TE010770UV01 |
| Transmission Wrapper | Send Message Payload | MCCI_MT000100UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Message Type | Medication Order | PORX_MT010120UV01 |
| Reason | Trigger Event | Interaction |
| Sender | Prescribing System | PORX_AR990701UV01 |
| Receiver | Dispensing System | PORX_AR990702UV01 |
Requests that the specified facility dispense the medication prescription transmitted by this interaction and does not expect a response interaction
| Trigger Event | Send medication order to pharmacy | PORX_TE010770UV01 |
| Transmission Wrapper | Send Message Payload | MCCI_MT000100UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Message Type | Medication Order | PORX_MT010120UV01 |
| Sender | Prescribing System | PORX_AR990701UV01 |
| Receiver | Dispensing System | PORX_AR990702UV01 |
Indicates that the request to record a medication prescription against the patient's record as been refused.
| Trigger Event | Decision to not record medication order | PORX_TE010700UV01 |
| Transmission Wrapper | Application Level Acknowledgement | MCCI_MT000300UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Sender | Medication Order Record Request Fulfiller | PORX_AR990706UV01 |
| Receiver | Medication Order Record Request Placer | PORX_AR990705UV01 |
Requests that a medication prescription be recorded against the patient's record and that the previous order identified in the request have its status changed to obsolete. This may be an interaction between a provider and a repository.
| Trigger Event | Medication Order Record Obsolte Request | PORX_TE010410UV01 |
| Transmission Wrapper | Send Message Payload | MCCI_MT000100UV01 |
| Control Act Wrapper | Trigger Event Control Act | MCAI_MT700201UV01 |
| Reason | Trigger Event | Interaction |
| PORX_IN010400UV01 |
| Sender | Medication Order Record Request Placer | PORX_AR990705UV01 |
| Receiver | Medication Order Record Request Fulfiller | PORX_AR990706UV01 |
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