DSTU2 Ballot Source

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4.15.7 Resource MedicationDispense - Detailed Descriptions

Detailed Descriptions for the elements in the MedicationDispense resource.

MedicationDispense
Definition

Dispensing a medication to a named patient. This includes a description of the supply provided and the instructions for administering the medication.

Control1..1
InvariantsDefined on this element
mdd-1: whenHandedOver cannot be before whenPrepared (xpath: not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value))
MedicationDispense.identifier
Definition

Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
MedicationDispense.status
Definition

A code specifying the state of the set of dispense events.

Control0..1
BindingMedicationDispenseStatus: Required: http://hl7.org/fhir/medication-dispense-status (A code specifying the state of the dispense event.)
Typecode
Is Modifiertrue
MedicationDispense.patient
Definition

A link to a resource representing the person to whom the medication will be given.

Control0..1
TypeReference(Patient)
Comments

SubstanceAdministration->subject->Patient.

To DoWhy is patient optional? Can this be used for non-patient med tranfers?
MedicationDispense.dispenser
Definition

The individual responsible for dispensing the medication.

Control0..1
TypeReference(Practitioner)
MedicationDispense.authorizingPrescription
Definition

Indicates the medication order that is being dispensed against.

Control0..*
TypeReference(MedicationPrescription)
MedicationDispense.type
Definition

Indicates the type of dispensing event that is performed. Examples include: Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

Control0..1
BindingMedicationDispenseType: Indicates the type of dispensing event that is performed. Examples include: Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. (Example)
TypeCodeableConcept
MedicationDispense.quantity
Definition

The amount of medication that has been dispensed. Includes unit of measure.

Control0..1
TypeQuantity
MedicationDispense.daysSupply
Definition

The amount of medication expressed as a timing amount.

Control0..1
TypeQuantity
MedicationDispense.medication
Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Control0..1
TypeReference(Medication)
Comments

Note: do not use Medication.name to describe the dispensed medication. When the only available information is a text description of the medication, Medication.code.text should be used.

MedicationDispense.whenPrepared
Definition

The time when the dispensed product was packaged and reviewed.

Control0..1
TypedateTime
MedicationDispense.whenHandedOver
Definition

The time the dispensed product was provided to the patient or their representative.

Control0..1
TypedateTime
MedicationDispense.destination
Definition

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

Control0..1
TypeReference(Location)
MedicationDispense.receiver
Definition

Identifies the person who picked up the medication. This will usually be a patient or their carer, but some cases exist where it can be a healthcare professional.

Control0..*
TypeReference(Patient | Practitioner)
MedicationDispense.note
Definition

Extra information about the dispense that could not be conveyed in the other attributes.

Control0..1
Typestring
MedicationDispense.dosageInstruction
Definition

Indicates how the medication is to be used by the patient.

Control0..*
Comments

When the dose or rate is intended to change over the entire administration period, eg. Tapering dose prescriptions, multiple instances of dosage instructions will need to be supplied to convey the different doses/rates.

MedicationDispense.dosageInstruction.additionalInstructions
Definition

Additional instructions such as "Swallow with plenty of water" which may or may not be coded.

Control0..1
TypeCodeableConcept
MedicationDispense.dosageInstruction.schedule[x]
Definition

The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".

Control0..1
TypedateTime|Period|Timing
MedicationDispense.dosageInstruction.asNeeded[x]
Definition

If set to true or if specified as a CodeableConcept, indicates that the medication is only taken when needed within the specified schedule rather than at every scheduled dose. If a CodeableConcept is present, it indicates the pre-condition for taking the Medication.

Control0..1
BindingMedicationAsNeededReason: A coded concept identifying the pre-condition that should hold prior to consuming a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up", etc.
Typeboolean|CodeableConcept
MedicationDispense.dosageInstruction.site
Definition

A coded specification of the anatomic site where the medication first enters the body.

Control0..1
BindingMedicationAdministrationSite: Example: See http://hl7.org/fhir/vs/approach-site-codes (A coded concept describing the site location the medicine enters into or onto the body)
TypeCodeableConcept
MedicationDispense.dosageInstruction.route
Definition

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject.

Control0..1
BindingRouteOfAdministration: Example: See http://hl7.org/fhir/vs/route-codes (A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.)
TypeCodeableConcept
MedicationDispense.dosageInstruction.method
Definition

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. Examples: Slow Push; Deep IV.

Terminologies used often pre-coordinate this term with the route and or form of administration.

Control0..1
BindingMedicationAdministrationMethod: Example: See http://hl7.org/fhir/vs/administration-method-codes (A coded concept describing the technique by which the medicine is administered)
TypeCodeableConcept
MedicationDispense.dosageInstruction.dose[x]
Definition

The amount of therapeutic or other substance given at one administration event.

Control0..1
TypeRange|Quantity
Comments

Note that this specifies the quantity of the specified medication, not the quantity of active ingredient(s). The prescribed strength can be calculated by multiplying the doseQuantity by the strength of each active ingredient in the prescribed Medication. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule.

MedicationDispense.dosageInstruction.rate
Definition

Identifies the speed with which the substance is introduced into the subject. Typically the rate for an infusion. 200ml in 2 hours.

Control0..1
TypeRatio
Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, each change should be captured as a distinct "dosage" repetition, except for titration orders.

MedicationDispense.dosageInstruction.maxDosePerPeriod
Definition

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time, e.g. 1000mg in 24 hours.

Control0..1
TypeRatio
MedicationDispense.substitution
Definition

Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but doesn't happen, in other cases substitution is not expected but does happen. This block explains what substitition did or did not happen and why.

Control0..1
To DoShouldn't substitution be captured on a product by product basis?
MedicationDispense.substitution.type
Definition

A code signifying whether a different drug was dispensed from what was prescribed.

Control1..1
BindingMedicationIntendedSubstitutionType: A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription (Example)
TypeCodeableConcept
MedicationDispense.substitution.reason
Definition

Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.

Control0..*
BindingMedicationIntendedSubstitutionReason: A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. (Example)
TypeCodeableConcept
MedicationDispense.substitution.responsibleParty
Definition

The person or organization that has primary responsibility for the substitution.

Control0..*
TypeReference(Practitioner)
Comments

rename.