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Breaking Change: FHIR R4 MedicationRequest

Andrew Fagan-OracleNov 12 2024 — edited Nov 14 2024

This notification is to inform of a breaking change coming to the FHIR R4 MedicationRequest resource. Currently the MedicationRequest response returns extensions that are part of the Swedish National Medication List NLLMedicationRequest profile.

  • MedicationRequest.extension.NLLPrescriptionFormat
  • MedicationRequest.extension.NLLRegistrationBasis
  • MedicationRequest.DispenseRequest.extension.NLLDosePackaging

Going forward these extensions will only be present in Sweden.

Additionally, the MedicationRequest.dispenseRequest.initialFill.quantity.value is currently returned as a string instead of a decimal which does not comply with the FHIR specification. Going forward, the MedicationRequest.dispenseRequest.initialFill.quantity.value will return as a decimal.

Impact: SMART on FHIR applications in regions outside of Sweden that rely on the presence of the Sweden extensions may experience processing failures. SMART on FHIR applications that return MedicationRequest.dispenseRequest.initialFill.quantity.value may experience processing failures when the data type changes from string to decimal.

This change will first be introduced in the public developer sandbox on January 16, 2025. The change will be made generally available on January 23, 2025.

Key Dates to Note:

  • Announcement Date: November 12th, 2024
  • Developer Sandbox Effective Date: January 16, 2025
  • General Availability Date: January 23, 2025

What does this mean for you?

  • Affected Services: FHIR R4 MedicationRequest Resource
  • Call to Action: Update SMART on FHIR applications to remove references to the following Sweden specific extensions:

How we can help:

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