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 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 aplan, to a trueorder. This separates "we're thinking about this drug" from "give this drug." - Category — the care setting the order applies to:
inpatient,outpatient,community, ordischarge. 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.
Related
- Reference: Medication Request (technical)
- Concept: Medication Dispense
- Concept: Medication Administration
- Concept: Medication Statement
- Concept: Encounter
- Concept: Patient
FHIR reference
This concept aligns with the HL7 FHIR 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.