VisionPrescription

An authorization for the provision of glasses and/or contact lenses to a patient.

Schema

Elements

Name	Required	Type	Description
identifier		Identifier[]	Business Identifier for vision prescription Details A unique identifier assigned to this vision prescription.
status	✓	code	active | cancelled | draft | entered-in-error Details The status of the resource instance. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
created	✓	dateTime	Response creation date Details The date this resource was created.
patient	✓	Reference<Patient>	Who prescription is for Details A resource reference to the person to whom the vision prescription applies.
encounter		Reference<Encounter>	Created during encounter / admission / stay Details A reference to a resource that identifies the particular occurrence of contact between patient and health care provider during which the prescription was issued.
dateWritten	✓	dateTime	When prescription was authorized Details The date (and perhaps time) when the prescription was written. Jurisdictions determine the valid lifetime of a prescription. Typically vision prescriptions are valid for two years from the date written.
prescriber	✓	Reference<Practitioner | PractitionerRole>	Who authorized the vision prescription Details The healthcare professional responsible for authorizing the prescription.
lensSpecification	✓	VisionPrescriptionLensSpecification[]	Vision lens authorization Details Contain the details of the individual lens specifications and serves as the authorization for the fullfillment by certified professionals.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
product	✓	CodeableConcept	Product to be supplied Details Identifies the type of vision correction product which is required for the patient.
eye	✓	code	right | left Details The eye for which the lens specification applies. May also appear as OD (oculus dexter) for the right eye and OS (oculus siniter) for the left eye.
sphere		decimal	Power of the lens Details Lens power measured in dioptres (0.25 units). The value is negative for near-sighted and positive for far sighted. Often insurance will not cover a lens with power between +75 and -75.
cylinder		decimal	Lens power for astigmatism Details Power adjustment for astigmatism measured in dioptres (0.25 units).
axis		integer	Lens meridian which contain no power for astigmatism Details Adjustment for astigmatism measured in integer degrees. The limits are +180 and -180 degrees.
prism		VisionPrescriptionLensSpecificationPrism[]	Eye alignment compensation Details Allows for adjustment on two axis.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
amount	✓	decimal	Amount of adjustment Details Amount of prism to compensate for eye alignment in fractional units.
base	✓	code	up | down | in | out Details The relative base, or reference lens edge, for the prism.
add		decimal	Added power for multifocal levels Details Power adjustment for multifocal lenses measured in dioptres (0.25 units).
power		decimal	Contact lens power Details Contact lens power measured in dioptres (0.25 units).
backCurve		decimal	Contact lens back curvature Details Back curvature measured in millimetres.
diameter		decimal	Contact lens diameter Details Contact lens diameter measured in millimetres.
duration		Quantity	Lens wear duration Details The recommended maximum wear period for the lens.
color		string	Color required Details Special color or pattern.
brand		string	Brand required Details Brand recommendations or restrictions.
note		Annotation[]	Notes for coatings Details Notes for special requirements such as coatings and lens materials.

Search Parameters

Name	Type	Description	Expression
identifier	token	Return prescriptions with this external identifier	VisionPrescription.identifier
patient	reference	The identity of a patient to list dispenses for	VisionPrescription.patient
encounter	reference	Return prescriptions with this encounter identifier	VisionPrescription.encounter
datewritten	date	Return prescriptions written on this date	VisionPrescription.dateWritten
prescriber	reference	Who authorized the vision prescription	VisionPrescription.prescriber
status	token	The status of the vision prescription	VisionPrescription.status

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta		Meta	Metadata about the resource Details The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
implicitRules		uri	A set of rules under which this content was created Details A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
language		code	Language of the resource content Details The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
text		Narrative	Text summary of the resource, for human interpretation Details A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
contained		Resource[]	Contained, inline Resources Details These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
modifierExtension		Extension[]	Extensions that cannot be ignored Details May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Usage

The VisionPrescription resource is intended to support the information requirements for a prescription for glasses and contact lenses for a patient. Corrective optical lenses are considered a controlled substance and therefore a prescription is typically required for the provision of patient-specific lenses.

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.

The VisionPrescription resource is an "request" resource from a FHIR workflow perspective - see Workflow Request.

Additional Information

Additional information regarding resources conveying electronic claims content and usage may be found at:

• Financial Resource Status Lifecycle: how .status is used in the financial resources.

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	The VisionPrescription resource is used to provide the authorized specification of lenses for glasses and contacts.
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	This resource is used to prescribe, authorize, and request provision of medications such a pharmaceuticals and vaccines.
ServiceRequest	This resource is used to prescribe, authorize, and request provision of health care services such as consultative or rehabilitative services.

Referenced By

• CarePlan
• Claim
• ExplanationOfBenefit