--- type: "resource" title: "VisionPrescription" resource: "VisionPrescription" --- # VisionPrescription ## Introduction ## Scope and Usage > **Note to Balloters:** To ensure this resource is ready for Normative status, we are seeking ballot comment on the substantive content. The key changes made since R5 include: > > - Added the following elements to align with the Request workflow pattern > > - VisionPrescription.basedOn > - VisionPrescription.groupIdentifier > - VisionPrescription.priority > > - Added a product search parameter The VisionPrescription resource represents an authorization for corrective optical lenses to be provided to a patient. Eye glasses and contact lenses usually require a prescription for patient-specific lenses. Details about the fulfillment of the authorization are handled by the [Task](task) resource. For further information about this separation of responsibilities, refer to the link [Fulfillment/Execution](request#fulfillment) section of the Request pattern. Vision prescriptions may only be issued by providers who have optical diagnosis within their scope of practice, typically ophthalmologists and optometrists. The prescription is a time-limited, typically two years, authorization for the provision of an unlimited number of lenses, glasses or contacts, which conform to the authorized specification by providers which have lens provision within their scope of practice, typically ophthalmologists , optometrists and opticians. Health insurers typically require a copy of the prescription to ensure that a vision professional has examined the patient and that the power of the lenses exceeds some minimum, such as +- 0.75 diopters, to qualify for reimbursement under the insurance coverage. ### Additional Information Additional information regarding resources conveying electronic claims content and usage may be found at: - [Financial Resource Status Lifecycle](financial-module#resource-status): how .status is used in the financial resources. ## Boundaries and Relationships The VisionPrescription resource is used to provide the authorized specification of lenses for glasses and contacts which have well known and internationally consistent requirements, which is distinct from other types of health care authorizations detailed below. **The health care domain includes a number of related resources** | VisionPrescription (this resource) | This resource is used to prescribe, authorize, and request provision of lenses for glasses or contacts. | | --- | --- | | [DeviceRequest](devicerequest) | This resource is used to prescribe, authorize, and request provision of a health care device such as a halter monitor or a wheelchair services. | | [MedicationRequest](medicationrequest) | This resource is used to prescribe, authorize, and request provision of medications such a pharmaceuticals and vaccines. | | [ServiceRequest](servicerequest) | This resource is used to prescribe, authorize, and request provision of health care services such as consultative or rehabilitative services. | | [SupplyRequest](https://build.fhir.org/ig/HL7/oo-incubator/StructureDefinition-SupplyRequest.html) | This resource is used for inventory management of a supply item (which may include a medication, substance or device). | ## StructureDefinition ### Elements (Simplified) - **[VisionPrescription](/visionprescription-definitions#VisionPrescription)** [0..*]: - Prescription for vision correction products for a patient - **[VisionPrescription.identifier](/visionprescription-definitions#VisionPrescription.identifier)** [0..*]: [Identifier](/Identifier) Business Identifier for vision prescription - **[VisionPrescription.basedOn](/visionprescription-definitions#VisionPrescription.basedOn)** [0..*]: [Reference(CarePlan](/Reference(CarePlan), [RequestOrchestration](/RequestOrchestration), [NutritionOrder](/NutritionOrder), [ServiceRequest)](/ServiceRequest)) What prescription fulfills - **[VisionPrescription.groupIdentifier](/visionprescription-definitions#VisionPrescription.groupIdentifier)** [0..1]: [Identifier](/Identifier) Composite request identifier - **[VisionPrescription.status](/visionprescription-definitions#VisionPrescription.status)** [1..1]: [code](/code) required:[fm-status](/valueset-fm-status) active | cancelled | draft | entered-in-error - **[VisionPrescription.priority](/visionprescription-definitions#VisionPrescription.priority)** [0..1]: [code](/code) required:[request-priority](/valueset-request-priority) routine | urgent | asap | stat - **[VisionPrescription.created](/visionprescription-definitions#VisionPrescription.created)** [1..1]: [dateTime](/dateTime) Response creation date - **[VisionPrescription.patient](/visionprescription-definitions#VisionPrescription.patient)** [1..1]: Reference([Patient](/Patient)) Who prescription is for - **[VisionPrescription.encounter](/visionprescription-definitions#VisionPrescription.encounter)** [0..1]: Reference([Encounter](/Encounter)) Created during encounter / admission / stay - **[VisionPrescription.dateWritten](/visionprescription-definitions#VisionPrescription.dateWritten)** [1..1]: [dateTime](/dateTime) When prescription was authorized - **[VisionPrescription.prescriber](/visionprescription-definitions#VisionPrescription.prescriber)** [1..1]: [Reference(Practitioner](/Reference(Practitioner), [PractitionerRole)](/PractitionerRole)) Who authorized the vision prescription - **[VisionPrescription.lensSpecification](/visionprescription-definitions#VisionPrescription.lensSpecification)** [1..*]: [BackboneElement](/BackboneElement) Vision lens authorization - **[VisionPrescription.lensSpecification.product](/visionprescription-definitions#VisionPrescription.lensSpecification.product)** [1..1]: [CodeableConcept](/CodeableConcept) example:[vision-product](/valueset-vision-product) Product to be supplied - **[VisionPrescription.lensSpecification.eye](/visionprescription-definitions#VisionPrescription.lensSpecification.eye)** [1..1]: [code](/code) required:[vision-eye-codes](/valueset-vision-eye-codes) right | left - **[VisionPrescription.lensSpecification.sphere](/visionprescription-definitions#VisionPrescription.lensSpecification.sphere)** [0..1]: [decimal](/decimal) Power of the lens - **[VisionPrescription.lensSpecification.cylinder](/visionprescription-definitions#VisionPrescription.lensSpecification.cylinder)** [0..1]: [decimal](/decimal) Lens power for astigmatism - **[VisionPrescription.lensSpecification.axis](/visionprescription-definitions#VisionPrescription.lensSpecification.axis)** [0..1]: [integer](/integer) Lens meridian which contain no power for astigmatism - **[VisionPrescription.lensSpecification.prism](/visionprescription-definitions#VisionPrescription.lensSpecification.prism)** [0..*]: [BackboneElement](/BackboneElement) Eye alignment compensation - **[VisionPrescription.lensSpecification.prism.amount](/visionprescription-definitions#VisionPrescription.lensSpecification.prism.amount)** [1..1]: [decimal](/decimal) Amount of adjustment - **[VisionPrescription.lensSpecification.prism.base](/visionprescription-definitions#VisionPrescription.lensSpecification.prism.base)** [1..1]: [code](/code) required:[vision-base-codes](/valueset-vision-base-codes) up | down | in | out - **[VisionPrescription.lensSpecification.add](/visionprescription-definitions#VisionPrescription.lensSpecification.add)** [0..1]: [decimal](/decimal) Added power for multifocal levels - **[VisionPrescription.lensSpecification.power](/visionprescription-definitions#VisionPrescription.lensSpecification.power)** [0..1]: [decimal](/decimal) Contact lens power - **[VisionPrescription.lensSpecification.backCurve](/visionprescription-definitions#VisionPrescription.lensSpecification.backCurve)** [0..1]: [decimal](/decimal) Contact lens back curvature - **[VisionPrescription.lensSpecification.diameter](/visionprescription-definitions#VisionPrescription.lensSpecification.diameter)** [0..1]: [decimal](/decimal) Contact lens diameter - **[VisionPrescription.lensSpecification.duration](/visionprescription-definitions#VisionPrescription.lensSpecification.duration)** [0..1]: [Quantity](/Quantity)([SimpleQuantity](/SimpleQuantity)) Lens wear duration - **[VisionPrescription.lensSpecification.color](/visionprescription-definitions#VisionPrescription.lensSpecification.color)** [0..1]: [string](/string) Color required - **[VisionPrescription.lensSpecification.brand](/visionprescription-definitions#VisionPrescription.lensSpecification.brand)** [0..1]: [string](/string) Brand required - **[VisionPrescription.lensSpecification.note](/visionprescription-definitions#VisionPrescription.lensSpecification.note)** [0..*]: [Annotation](/Annotation) Notes for coatings ## Mappings - [VisionPrescription Mappings](/visionprescription-mappings) — 48 mapping entries ## Resource Packs ### list-VisionPrescription-packs.xml ```xml ``` ## Search Parameters - [datewritten](/visionprescription-search#datewritten) — **date** — Return prescriptions written on this date — `VisionPrescription.dateWritten` - [encounter](/visionprescription-search#encounter) — **reference** — Return prescriptions with this encounter identifier — `VisionPrescription.encounter` - [identifier](/visionprescription-search#identifier) — **token** — Return prescriptions with this external identifier — `VisionPrescription.identifier` - [patient](/visionprescription-search#patient) — **reference** — The identity of a patient to list dispenses for — `VisionPrescription.patient` - [prescriber](/visionprescription-search#prescriber) — **reference** — Who authorized the vision prescription — `VisionPrescription.prescriber` - [status](/visionprescription-search#status) — **token** — The status of the vision prescription — `VisionPrescription.status` - [product](/visionprescription-search#product) — **token** — The type of product being prescribed — `VisionPrescription.lensSpecification.product` [Full Search Parameters](/visionprescription-search) ## Examples - [33123](/visionprescription-example-33123) — visionprescription-example — General Glasses Example - [33124](/visionprescription-example-33124) — visionprescription-example-1 — General Contacts Example - [visionprescription-example](/visionprescription-example-visionprescription-example) — visionprescription-example - [visionprescription-example-1](/visionprescription-example-visionprescription-example-1) — visionprescription-example-1 - [visionprescription-examples-header](/visionprescription-example-visionprescription-examples-header) — visionprescription-examples-header [Full Examples](/visionprescription-examples) ## Mapping Exceptions ### visionprescription-fivews-mapping-exceptions.xml ### Unmapped Elements - **FiveWs.what** — Unknown - **FiveWs.actor** — Unknown - **FiveWs.cause** — Unknown - **FiveWs.version** — Unknown - **FiveWs.witness** — Unknown - **FiveWs.class** — Unknown - **FiveWs.where** — Unknown - **FiveWs.init** — Unknown - **FiveWs.why** — Unknown - **FiveWs.source** — Unknown - **FiveWs.who** — Unknown - **FiveWs.planned** — Unknown - **FiveWs.done** — Unknown ### visionprescription-request-mapping-exceptions.xml ### Divergent Elements - **Request.identifier** → **VisionPrescription.identifier** - summary | reason=Unknown | pattern=true - definitionUnmatched | reason=Unknown | pattern=Business identifiers assigned to this vision prescription by the author and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server. | resource=A unique identifier assigned to this vision prescription. - commentsUnmatched | reason=Unknown | pattern=The identifier.type element is used to distinguish between the identifiers assigned by the requester/placer and the performer/filler. Note: This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. - requirementsUnmatched | reason=Unknown | pattern=Allows identification of the vision prescription as it is known by various participating systems and in a way that remains consistent across servers. | resource=Allows vision prescriptions to be distinguished and referenced. - **Request.basedOn** → **VisionPrescription.basedOn** - missingTypes | reason=Unknown | pattern=Reference(Request) - extraTypes | reason=Unknown - shortUnmatched | reason=Unknown | pattern=Fulfills plan, proposal or order | resource=What prescription fulfills - definitionUnmatched | reason=Unknown | pattern=A higher-level request resource (i.e. a plan, proposal or order) that is fulfilled in whole or in part by this vision prescription. Authorization from the 'basedOn' request flows through to the referencing vision prescription. | resource=Plan/proposal/order/request fulfilled by this prescription. - commentsUnmatched | reason=Unknown | pattern=basedOn represents the 'authorization' chain for an action, not the 'reason for action'. For example, an order might be placed on hold under the authorization for a surgery. However the 'reason' for placing the hold is "to avoid interaction with anesthesia medications" . - requirementsUnmatched | reason=Unknown | pattern=Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon. - **Request.groupIdentifier** → **VisionPrescription.groupIdentifier** - shortUnmatched | reason=Unknown | pattern=Composite request this is part of | resource=Composite request identifier - definitionUnmatched | reason=Unknown | pattern=A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form. | resource=A shared identifier common to all Vision Prescriptions that were authorized more or less simultaneously by a single author, representing the composite or group identifier. - commentsUnmatched | reason=Unknown | pattern=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. - requirementsUnmatched | reason=Unknown | pattern=Some business processes need to know if multiple items were ordered as part of the same "prescription" or "requisition" for billing or other purposes. - **Request.status** → **VisionPrescription.status** - shortUnmatched | reason=Unknown | pattern=draft | active | on-hold | revoked | completed | entered-in-error | unknown | resource=active | cancelled | draft | entered-in-error - definitionUnmatched | reason=Unknown | pattern=The current state of the vision prescription. | resource=The status of the resource instance. - commentsUnmatched | reason=Unknown | pattern=The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, completed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding]](s) or using the]] resource. A nominal state-transition diagram can be found in the] documentation Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. A status of 'active' when doNotPerform is true means that the request to not perform is currently in force. A status of completed for a "doNotPerform" request indicates that the period of non-performance is now satisfied and the request no longer holds. | resource=This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. - **Request.subject** → **VisionPrescription.patient** - missingTypes | reason=Unknown | pattern=Reference(Group) - shortUnmatched | reason=Unknown | pattern=Individual the service is ordered/prohibited for | resource=Who prescription is for - definitionUnmatched | reason=Unknown | pattern=The individual or set of individuals the action is to be performed/not performed on or for. | resource=A resource reference to the person to whom the vision prescription applies. - requirementsUnmatched | reason=Unknown | pattern=Links the request to the Patient context. | resource=Needed to identify the patient for whom the vision prescription has been issued. - **Request.encounter** → **VisionPrescription.encounter** - summary | reason=Unknown | pattern=true - shortUnmatched | reason=Unknown | pattern=Encounter the vision prescription is tied to | resource=Created during encounter / admission / stay - definitionUnmatched | reason=Unknown | pattern=The Encounter during which this vision prescription was created or to which the creation of this record is tightly associated. | resource=A reference to a resource that identifies the particular occurrence of contact between patient and health care provider during which the prescription was issued. - commentsUnmatched | reason=Unknown | pattern=This will typically be the encounter during which the vision prescription was created. However, some {{title}s may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission activities). - requirementsUnmatched | reason=Unknown | pattern=Links the vision prescription to the Encounter context. | resource=Used in some jurisdictions to link clinical events to claim items. - **Request.authoredOn** → **VisionPrescription.dateWritten** - shortUnmatched | reason=Unknown | pattern=When request was created/transitioned to active | resource=When prescription was authorized - definitionUnmatched | reason=Unknown | pattern=For draft vision prescriptions, indicates the date of initial creation. For requests with other statuses, indicates the date of activation. | resource=The date (and perhaps time) when the prescription was written. - **Request.requester** → **VisionPrescription.prescriber** - missingTypes | reason=Unknown | pattern=Reference(Organization, Patient, RelatedPerson, Device) - shortUnmatched | reason=Unknown | pattern=Who/what is requesting service | resource=Who authorized the vision prescription - definitionUnmatched | reason=Unknown | pattern=Who initiated the {{request}} and has responsibility for its activation. | resource=The healthcare professional responsible for authorizing the prescription. ### Unmapped Elements - **Request.intent** — Unknown - **Request.insurance** — Unknown - **Request.occurrence** — Unknown - **Request.deliverTo** — Unknown - **Request.replaces** — Unknown - **Request.supportingInfo** — Unknown - **Request.note** — Unknown - **Request.performer** — Unknown - **Request.category** — Unknown - **Request.reason** — Unknown - **Request.reported** — Unknown - **Request.relevantHistory** — Unknown - **Request.code** — Unknown - **Request.statusReason** — Unknown - **Request.performerType** — Unknown - **Request.doNotPerform** — Unknown - **Request.product** — Unknown