type: resource-definitionsresource: MedicationRequest

MedicationRequest Definitions

MedicationRequest

Ordering of medication for patient or group

Definition: 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.

Aliases: Prescription, Order

Cardinality: 0..*

Mappings: workflow=Request; script10.6=Message/Body/NewRx; rim=CombinedMedicationRequest; w5=clinical.medication

MedicationRequest.identifier

External ids for this request

Definition: 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.

Comments: This is a business identifier, not a resource identifier.

Cardinality: 0..*

Type: Identifier

Mappings: workflow=Request.identifier; script10.6=Message/Header/PrescriberOrderNumber; w5=FiveWs.identifier; v2=ORC-2-Placer Order Number / ORC-3-Filler Order Number; rim=.id

MedicationRequest.basedOn

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

Definition: Whenever the medication request is being issued because of another request, eg. a procedure that is being planned (ServiceRequest) and MedicationRequests are known to be needed, this element documents those requests.

Cardinality: 0..*

Type: Reference(CarePlan, MedicationRequest, ServiceRequest, RequestOrchestration)

Summary: true

Mappings: workflow=Request.basedOn; rim=.outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

MedicationRequest.priorPrescription

Reference to an order/prescription that is being replaced by this MedicationRequest

Definition: Reference to an order/prescription that is being replaced by this MedicationRequest.

Cardinality: 0..1

Type: Reference(MedicationRequest)

Mappings: workflow=Request.replaces; script10.6=not mapped; rim=.outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]

MedicationRequest.groupIdentifier

Composite request this is part of

Definition: A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time.

Requirements: 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.

Cardinality: 0..1

Type: Identifier

Summary: true

Mappings: workflow=Request.groupIdentifier; rim=.outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id

MedicationRequest.status

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

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

Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

Cardinality: 1..1

Type: code

Binding: required:medicationrequest-status

Summary: true

Is Modifier: true (Reason: 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)

Mappings: workflow=Request.status; script10.6=no mapping; w5=FiveWs.status; rim=.statusCode

MedicationRequest.statusReason

Reason for current status

Definition: Captures the reason for the current state of the MedicationRequest.

Comments: 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.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:medicationrequest-status-reason

Mappings: workflow=Request.statusReason; rim=.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

MedicationRequest.statusChanged

When the status was changed

Definition: The date (and perhaps time) when the status was changed.

Cardinality: 0..1

Type: dateTime

Mappings: rim=subjectOf Observation[code = statusChange].value = date

MedicationRequest.intent

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

Comments: This element is expected to be immutable. E.g. A 'proposal' instance should never change to be a 'plan' instance or 'order' instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value. 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.

Cardinality: 1..1

Type: code

Binding: required:medicationrequest-intent

Summary: true

Is Modifier: true (Reason: 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)

Mappings: workflow=Request.intent; w5=FiveWs.class; rim=.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

MedicationRequest.category

Grouping or category of medication request

Definition: An arbitrary categorization or grouping of the medication request. It could be used for indicating where meds are intended to be administered, eg. in an inpatient setting or in a patient's home, or a legal category of the medication.

Comments: The category can be used to include where the medication is expected to be consumed or other types of requests. The exemplar value set represents where the meds are intended to be administered and is just one example of request categorization.

The committee will revisit these codes, expecting to use a codesystem from terminology.hl7.org.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:medicationrequest-category

Mappings: script10.6=Message/Body/NewRx/MedicationPrescribed/Directions

Message/Body/NewRx/MedicationPrescribed/StructuredSIG; w5=FiveWs.class; rim=.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

MedicationRequest.priority

routine | urgent | asap | stat

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

Cardinality: 0..1

Type: code

Binding: required:request-priority

Summary: true

Mappings: workflow=Request.priority; w5=FiveWs.grade; rim=.priorityCode

MedicationRequest.doNotPerform

If true, indicates the provider is ordering a patient should not take the specified medication

Definition: If true, indicates the provider is ordering a patient should not take the specified medication. The reason for this order can be provided in the .reason element. A MedicationRequest with .doNotPerform = true will not result in any dispense or administration. A request not to take or administer medication is a standalone request, and does not update any other medication request.
When true, active orders that may exist for the same medication are expected to be canceled/ended, and new orders for the same medication are not expected.

Comments: If do not perform is not specified, the request is a positive request (e.g., "do perform").

The attributes provided with the request qualify what is not to be done.

If a performerType is specified, then the "do not" request only applies to performers of that type.

Qualifiers include: code, subject, occurrence, performerType and performer.

For example:

doNotPerform=true + code=Lithium → "do not give Lithium" (any other med is ok)
doNotPerform=true + dosage.timing.when=lunch → "do not give at lunch" (not impacting giving at other times)
doNotPerform=true + dosage.route=oral → "do not give orally" (not impacting other routes)

Cardinality: 0..1

Type: boolean

Summary: true

Is Modifier: true (Reason: 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.))

Mappings: rim=SubstanceAdministration.actionNegationInd

MedicationRequest.medication

Medication to be taken

Definition: 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.

Comments: 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.

Cardinality: 1..1

Type: CodeableReference

Binding: example:medication-codes

Summary: true

Mappings: workflow=Request.code; script10.6=Message/Body/NewRx/MedicationPrescribed

Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode

Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier

Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription; w5=FiveWs.what[x]; v2=RXE-2-Give Code / RXO-1 Requested Give Code / RXC-2 Component Code; rim=consumable.administrableMedication

MedicationRequest.subject

Individual or group for whom the medication has been requested

Definition: The individual or group for whom the medication has been requested.

Comments: 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.

Cardinality: 1..1

Type: Reference(Patient, Group)

Summary: true

Mappings: workflow=Request.subject; script10.6=Message/Body/NewRx/Patient

(need detail to link to specific patient … Patient.Identification in SCRIPT); w5=FiveWs.subject; v2=PID-3 Patient ID List; rim=.participation[typeCode=AUT].role

MedicationRequest.informationSource

The person or organization who provided the information about this request, if the source is someone other than the requestor

Definition: The person or organization who provided the information about this request, if the source is someone other than the requestor. The informationSource element is generally used when details of a prescription are being reported by someone who is not the requestor, e.g., I indicate that I received a prescription for a med out of my jurisdiction and the details are recorded in the system as a MedicationRequest. Normally when this element is populated, the .isRecordOfRequest element would be set to "true".

Comments: MedicationStatement is indeed intended to capture that the patient is on a given medication, or is expected/planned to be on, whether this is reported by the patient or any other entity. In some cases, however, there has been a need for MedicationRequest.isRecordOfRequest and .informationSource to represent that an order exists, as reported by someone. The informationSource is therefore not the "original requester", but the reporter of that MedicationRequest.

Cardinality: 0..*

Type: Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization, Group)

Mappings: rim=.participation[typeCode=INF].role[classCode=PAT, or codes for Practitioner or Related Person or Practitioner Role or Organization

MedicationRequest.encounter

Encounter created as part of encounter/admission/stay

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

Comments: 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.

Cardinality: 0..1

Type: Reference(Encounter)

Mappings: workflow=Request.encounter; script10.6=no mapping; w5=FiveWs.context; v2=PV1-19 Visit Number; rim=.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

MedicationRequest.supportingInformation

Information to support fulfilling of the medication

Definition: Information to support fulfilling (i.e. dispensing or administering) of the medication, for example, patient height and weight, a MedicationStatement for the patient).

Comments: This attribute can be used to reference a MedicationStatement about the patients' medication use.

Cardinality: 0..*

Type: Reference(Resource)

Mappings: workflow=Request.supportingInfo; w5=FiveWs.context; rim=.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

MedicationRequest.authoredOn

When request was initially authored

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

Cardinality: 0..1

Type: dateTime

Summary: true

Mappings: workflow=Request.authoredOn; script10.6=Message/Body/NewRx/MedicationPrescribed/WrittenDate; w5=FiveWs.recorded; v2=RXE-32 Original Order Date/Time / ORC-9-Date Time of Transaction; rim=author.time

MedicationRequest.requester

Who/What requested the Request

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

Cardinality: 0..1

Type: Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)

Summary: true

Mappings: workflow=Request.requester; w5=FiveWs.author; rim=.participation[typeCode=AUT].role

MedicationRequest.isRecordOfRequest

Whether this is record of a Medication Request or the actual request itself

Definition: The information in this instance is a record of the Medication Request and is not request or order itself and should not be considered as such, i.e. the information should not be used for medication dispense | supply and administration.

Comments: If not populated, then assume that this is the original record and not reported

Cardinality: 0..1

Type: boolean

Summary: true

Mappings: rim=.participation[typeCode=INF].role

MedicationRequest.performerType

Desired kind of performer of the medication administration

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

Comments: 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.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:medication-intended-performer-role

Summary: true

Mappings: workflow=Request.performerType; rim=.participation[typeCode=PRF].role[scoper.determinerCode=KIND].code

MedicationRequest.performer

Intended performer of administration

Definition: The specified desired performer of the medication treatment (e.g. the performer of the medication administration). For devices, this is the device that is intended to perform the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers.

Cardinality: 0..*

Type: Reference(Practitioner, PractitionerRole, Organization, Patient, DeviceDefinition, RelatedPerson, CareTeam, HealthcareService, Group)

Mappings: workflow=Request.performer; w5=FiveWs.actor; rim=.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

MedicationRequest.device

Intended type of device for the administration

Definition: The intended type of device that is to be used for the administration of the medication (for example, PCA Pump).

Cardinality: 0..*

Type: CodeableReference

Mappings: rim=.participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

MedicationRequest.recorder

Person who entered the request

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

Cardinality: 0..1

Type: Reference(Practitioner, PractitionerRole)

Mappings: w5=FiveWs.who; rim=.participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)

MedicationRequest.reason

Reason or indication for ordering or not ordering the medication

Definition: When the medication request was issued as a result of something that occurred, i.e. a lab test or a performed procedure, this documents those reasons.

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

Cardinality: 0..*

Type: CodeableReference

Binding: example:condition-code

Mappings: workflow=Request.reason; script10.6=Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value; w5=FiveWs.why[x]; v2=ORC-16 Order Control Code Reason /RXE-27 Give Indication/RXO-20-Indication / RXD-21 Indication / RXG-22 Indication / RXA-19 Indication; rim=reason.observation.reasonCode | reason.observation[code=ASSERTION].value

MedicationRequest.courseOfTherapyType

Overall pattern of medication administration

Definition: The description of the overall pattern of the administration of the medication to the patient.

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

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:medicationrequest-course-of-therapy

Mappings: rim=Act.code where classCode = LIST and moodCode = EVN

MedicationRequest.insurance

Associated insurance coverage

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

Cardinality: 0..*

Type: Reference(Coverage, ClaimResponse)

Mappings: workflow=Request.insurance; rim=.outboundRelationship[typeCode=COVBY].target

MedicationRequest.note

Information about the prescription

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

Cardinality: 0..*

Type: Annotation

Mappings: workflow=Request.note; script10.6=Message/Body/NewRx/MedicationPrescribed/Note; rim=.inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

MedicationRequest.effectiveTiming[x]

Period over which the medication is to be taken, can be specified as a duration or a range

Definition: The period over which the medication is to be taken. Can be specified as a duration or a range. Where there are multiple dosageInstruction lines (for example, tapering doses), this is the earliest date and the latest end date of the dosageInstructions.

Cardinality: 0..1

Type: Duration, Range, Period

Mappings: rim=substanceAdministration.effectiveTime

MedicationRequest.dosageInstruction

Specific instructions for how the medication should be taken

Definition: Specific instructions for how the medication is to be used by the patient.

Cardinality: 0..1

Type: DosageDetails

Mappings: rim=see dosageInstruction mapping

MedicationRequest.dispenseRequest

Medication supply authorization

Definition: 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.

Cardinality: 0..1

Type: BackboneElement

Mappings: script10.6=Message/Body/NewRx/MedicationPrescribed/ExpirationDate; rim=component.supplyEvent

MedicationRequest.dispenseRequest.initialFill

First fill details

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

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

Cardinality: 0..1

Type: BackboneElement

Mappings: rim=SubstanceAdministration -> ActRelationship[sequenceNumber = '1'] -> Supply

MedicationRequest.dispenseRequest.initialFill.quantity

First fill quantity

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

Cardinality: 0..1

Type: Quantity(SimpleQuantity)

Mappings: rim=Supply.quantity[moodCode=RQO]

MedicationRequest.dispenseRequest.initialFill.duration

First fill duration

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

Cardinality: 0..1

Type: Duration

Mappings: rim=Supply.effectivetime[moodCode=RQO]

MedicationRequest.dispenseRequest.dispenseInterval

Minimum period of time between dispenses

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

Cardinality: 0..1

Type: Duration

Mappings: rim=Supply.effectivetime[moodCode=RQO]

MedicationRequest.dispenseRequest.validityPeriod

Time period supply is authorized for

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

Comments: 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.

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

Cardinality: 0..1

Type: Period

Mappings: script10.6=Message/Body/NewRx/MedicationPrescribed/Refills; rim=effectiveTime

MedicationRequest.dispenseRequest.numberOfRepeatsAllowed

Number of refills authorized

Definition: 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.

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

Cardinality: 0..1

Type: unsignedInt

Mappings: script10.6=Message/Body/NewRx/MedicationPrescribed/Quantity; v2=RXE-12 Number of Refills; rim=repeatNumber

MedicationRequest.dispenseRequest.quantity

Amount of medication to supply per dispense

Definition: The amount that is to be dispensed for one fill.

Cardinality: 0..1

Type: Quantity(SimpleQuantity)

Mappings: script10.6=Message/Body/NewRx/MedicationPrescribed/DaysSupply; v2=RXD-4 Actual Dispense Amount / RXD-5.1 Actual Dispense Units.code / RXD-5.3 Actual Dispense Units.name of coding system; rim=quantity

MedicationRequest.dispenseRequest.expectedSupplyDuration

Number of days supply per dispense

Definition: 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.

Comments: 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.

Cardinality: 0..1

Type: Duration

Mappings: script10.6=Message/Body/NewRx/MedicationPrescribed/Substitutions; rim=expectedUseTime

MedicationRequest.dispenseRequest.dispenser

Intended performer of dispense

Definition: Indicates the intended performing Organization that will dispense the medication as specified by the prescriber.

Cardinality: 0..1

Type: Reference(Organization)

Mappings: w5=FiveWs.who; rim=.outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]

MedicationRequest.dispenseRequest.dispenserInstruction

Additional information for the dispenser

Definition: Provides additional information to the dispenser, for example, counselling to be provided to the patient.

Cardinality: 0..*

Type: CodeableConcept

Binding: example:medicationrequest-dispenser-instructions

Mappings: rim=Supply.text

MedicationRequest.dispenseRequest.doseAdministrationAid

Type of adherence packaging to use for the dispense

Definition: Provides information about the type of adherence packaging to be supplied for the medication dispense.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:medication-dose-aid

Mappings: rim=Supply.administerableMedication.product.asContent.container.code

MedicationRequest.dispenseRequest.destination

Where the medication is expected to be delivered

Definition: Identification of the facility/location where the medication is expected to be delivered.

Cardinality: 0..1

Type: Reference(Location)

Mappings: v2=RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.destination

MedicationRequest.substitution

Any restrictions on medication substitution

Definition: 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.

Cardinality: 0..1

Type: BackboneElement

Mappings: script10.6=specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions; rim=subjectOf.substitutionPermission

MedicationRequest.substitution.allowed[x]

Whether substitution is allowed or not

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

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

Cardinality: 1..1

Type: boolean, CodeableConcept

Binding: preferred:v3-ActSubstanceAdminSubstitutionCode

Mappings: script10.6=specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions; v2=RXO-9 Allow Substitutions / RXE-9 Substitution Status; rim=code

MedicationRequest.substitution.reason

Why should (not) substitution be made

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

Cardinality: 0..1

Type: CodeableConcept

Binding: example:v3-SubstanceAdminSubstitutionReason

Mappings: script10.6=not mapped; v2=RXE-9 Substition status; rim=reasonCode

MedicationRequest.eventHistory

A list of events of interest in the lifecycle

Definition: 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.

Comments: 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.).

Cardinality: 0..*

Type: Reference(Provenance)

Mappings: workflow=Request.relevantHistory; rim=.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]