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	This concept aligns with the HL7 FHIR [<nowiki/>https://hl7.org/fhir/medicationrequest.html MedicationRequest] resource, which represents an order or instruction for a medication for a patient. Care uses underscored status and intent values (for example <code>on_hold</code>, <code>original_order</code>) rather than the hyphenated FHIR spellings.		This concept aligns with the HL7 FHIR [<nowiki/>https://hl7.org/fhir/medicationrequest.html MedicationRequest] resource, which represents an order or instruction for a medication for a patient. Care uses underscored status and intent values (for example <code>on_hold</code>, <code>original_order</code>) rather than the hyphenated FHIR spellings.

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{{Doc header
|type=concept
|domain=medications
|title=Medication Request
|order=1
|introduced=3.0
|concept=Concepts/Patient
|reference=References/Medication Request
}}

A '''medication request''' is a prescriber's instruction to supply and/or administer a medication to a patient. It is the starting point of the medication journey in Care — the order that everything downstream (dispensing, administration, the patient's medication history) refers back to.

== What it represents ==

In Care's FHIR-aligned model, a medication request maps to the '''MedicationRequest''' resource. It captures:

* '''What to give''' — a coded drug from a managed list, or a specific product from your facility's catalogue
* '''How to give it''' — structured dosage instructions: dose, route, body site, timing and frequency, and whether the medication is taken only as needed (PRN)
* '''Why and how urgently''' — the intent (a proposal, a plan, or a firm order), the care setting (inpatient, outpatient, community, or discharge), and the priority (routine through stat)
* '''Who and where''' — the patient, the encounter it was written during, the prescriber, and when it was authored

A medication request records the ''intent'' to medicate — it is not proof that the drug was handed over or taken. Handing the drug out is a [[Concepts/Medication Dispense|medication dispense]], giving it to the patient is a [[Concepts/Medication Administration|medication administration]], and what the patient reports actually taking is a [[Concepts/Medication Statement|medication statement]]. The request is the order; the others are the follow-through.

== How it connects ==

A medication request never stands alone. It is always tied to a clinical context:

* '''Patient''' — every request belongs to one patient. The patient is taken from the encounter, never supplied directly, so a request can never point at someone who wasn't actually seen.
* '''Encounter''' — the visit or admission the order was written during. This anchors the order in time and place and decides who is allowed to touch it.
* '''Prescription''' — requests authored together in one sitting are grouped under a single '''prescription''' for the encounter. Think of the prescription as the sheet of paper and each medication request as one line on it.
* '''Requester''' — the clinician who authored the order.

Grouping by prescription is what lets a pharmacist review or act on a whole prescribing event at once, rather than one drug at a time.

== Lifecycle ==

A medication request moves through a status that reflects where the order stands:

<syntaxhighlight lang="text">draft → active → (on_hold) → completed / stopped / ended / cancelled</syntaxhighlight>
* '''draft''' — written but not yet finalised or acted on
* '''active''' — the live order; this is the default for a real prescription
* '''on_hold''' — temporarily suspended (for example, paused before surgery), expected to resume
* '''completed''' — the course has run as intended
* '''stopped''' — deliberately discontinued before completion (for example, an adverse reaction)
* '''ended''' — the order's validity period has lapsed
* '''cancelled''' — withdrawn before it took effect
* '''entered_in_error''' — recorded by mistake and retracted; kept for audit, not treatment
* '''unknown''' — status cannot be determined

When a request is stopped or changed, a '''status reason''' can record ''why'' — for example an allergy, a suspected drug interaction, a duplicate therapy, or the patient being scheduled for surgery. Once a request is created, only a narrow set of things can change: its status, its note, and its dispensing progress. The clinical substance of the order — the drug and the dosage — is fixed at authoring.

== Classification ==

Two coded fields shape how a request is read and routed:

* '''Intent''' — how firm the order is, from a loose <code>proposal</code>, to a <code>plan</code>, to a true <code>order</code>. This separates "we're thinking about this drug" from "give this drug."
* '''Category''' — the care setting the order applies to: <code>inpatient</code>, <code>outpatient</code>, <code>community</code>, or <code>discharge</code>. Discharge medications, for instance, are what the patient goes home with.

A request can also be marked '''do not perform''' — an explicit instruction that a medication must ''not'' be given, which is a clinical statement in its own right, not merely the absence of an order.

== Permissions ==

Access to a medication request follows the encounter it belongs to, with one addition: pharmacists get a facility-wide grant so they can fill orders across the floor. Authoring an order requires write access on the encounter; reading one requires clinical-data access for the patient, or read access on the specific encounter.

{| class="wikitable"
|-
! Permission
! Description
! System Roles
|-
| <code>can_write_encounter_clinical_data</code>
| Author, update, or discontinue a medication request on an encounter
| Admin, Doctor, Nurse, Facility Admin
|-
| <code>is_pharmacist</code>
| Pharmacist-wide access to read every medication request in a facility (and create dispenses)
| Facility Admin, Admin, Pharmacist
|-
| <code>can_view_clinical_data</code>
| Read the medication requests recorded for a patient
| Staff, Doctor, Nurse, Admin, Facility Admin
|-
| <code>can_read_encounter_clinical_data</code>
| Read the medication requests on a specific encounter (when scoped by encounter)
| Admin, Doctor, Nurse, Facility Admin
|}

Roles are granted to a user through their membership in an organization, facility, or patient's care team; permissions cascade down the organization tree, so access granted higher up flows to the facilities and encounters beneath it.

== FHIR reference ==

This concept aligns with the HL7 FHIR [<nowiki/>https://hl7.org/fhir/medicationrequest.html MedicationRequest] resource, which represents an order or instruction for a medication for a patient. Care uses underscored status and intent values (for example <code>on_hold</code>, <code>original_order</code>) rather than the hyphenated FHIR spellings.

{{Related}}

Concepts/Medication Request - Revision history

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