Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html).

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

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

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.

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. 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.

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

SubstanceAdministration->subject->Patient.

The individual responsible for dispensing the medication.

The organizaation responsible for the dispense of the medication.

Indicates the medication order that is being dispensed against.

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

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

The amount of medication expressed as a timing amount.

The time when the dispensed product was packaged and reviewed.

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

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

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

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

Indicates how the medication is to be used by the patient. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

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

Free text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication.

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

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". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Specifically if 'boolean' datatype is selected, then the following logic applies: If set to True, this indicates that the medication is only taken when needed, within the specified schedule.

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

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

A coded value indicating the method by which the medication is intended to be or was introduced into or on the body.

This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.

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

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.

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

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.

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

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

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

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

A summary of the events of interest that have occurred, such as when the dispense was verified.

This is not the same as an audit trail. It is a view of the important things that happened in the past. Typically, there would only be one entry for any given status, and systems may not record all the status events.

The status for the event.

The action that was taken (e.g. verify).

The date/time at which the event occurred.

The person responsible for taking the action.

The reason why the action was taken.