Concepts/Medication Request

conceptmedicationsCARE 3.0+

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 medication dispense, giving it to the patient is a medication administration, and what the patient reports actually taking is a 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:

draft → active → (on_hold) → completed / stopped / ended / cancelled

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 proposal, to a plan, to a true order. This separates "we're thinking about this drug" from "give this drug."
Category — the care setting the order applies to: inpatient, outpatient, community, or discharge. 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.

Permission	Description	System Roles
`can_write_encounter_clinical_data`	Author, update, or discontinue a medication request on an encounter	Admin, Doctor, Nurse, Facility Admin
`is_pharmacist`	Pharmacist-wide access to read every medication request in a facility (and create dispenses)	Facility Admin, Admin, Pharmacist
`can_view_clinical_data`	Read the medication requests recorded for a patient	Staff, Doctor, Nurse, Admin, Facility Admin
`can_read_encounter_clinical_data`	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 [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 on_hold, original_order) rather than the hyphenated FHIR spellings.

Pages that link here:

Concepts/Response Template

Concept: Concepts/Patient
Reference: References/Medication Request