STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Medicationdispense.profile.xml

Raw XML (canonical form)

StructureDefinition for medicationdispense

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="MedicationDispense"/>
  <meta>
    <lastUpdated value="2016-12-06T12:22:34.981+11:00"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
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          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="The logical name of the element">Name</a>
          </th>
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Information about the use of the element">Flags</a>
          </th>
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a>
          </th>
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a>
          </th>
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a>
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/>
              </a>
            </span>
          </th>
        </tr>
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            Nj6C+QmaxAek5tyAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Resource"/> 
            <span title="MedicationDispense : 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.">MedicationDispense</span>
            <a name="MedicationDispense"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element has or is affected by some invariants">I</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Dispensing a medication to a named patient
            <br/>
            <span style="font-style: italic" title="mdd-1">whenHandedOver cannot be before whenPrepared</span>
          </td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            <span title="MedicationDispense.identifier : Identifier assigned by the dispensing facility - this
             is an identifier assigned outside FHIR.">identifier</span>
            <a name="MedicationDispense.identifier"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">External identifier</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            <span title="MedicationDispense.status : A code specifying the state of the set of dispense events.">status</span>
            <a name="MedicationDispense.status"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element is a modifier element">?!</span>
            <span style="padding: 3px" title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">in-progress | on-hold | completed | entered-in-error | stopped
            <br/>
            <a href="valueset-medication-dispense-status.html" title="A coded concept specifying the state of the dispense event.">MedicationDispenseStatus</a> (
            <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value
             set.">Required</a>)
          </td>
        </tr>

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            <span title="MedicationDispense.medication[x] : 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.">medication[x]</span>
            <a name="MedicationDispense.medication_x_"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">1..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">What medication was supplied
            <br/>
            <a href="valueset-medication-codes.html" title="A coded concept identifying which substance or product can be dispensed">SNOMED CT Medication Codes</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

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            <span title="A concept that may be defined by a formal reference to a terminology or ontology or may
             be provided by text.">medicationCodeableConcept</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
        </tr>

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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> medicationReference
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="medication.html">Medication</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.patient : A link to a resource representing the person to whom the
             medication will be given.">patient</span>
            <a name="MedicationDispense.patient"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span style="padding: 3px" title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="patient.html">Patient</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who the dispense is for</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.supportingInformation : Additional information that supports the medication
             being dispensed.">supportingInformation</span>
            <a name="MedicationDispense.supportingInformation"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="resourcelist.html">Any</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Information that supports the dispensing of the medication</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.dispenser : The individual responsible for dispensing the medication.">dispenser</span>
            <a name="MedicationDispense.dispenser"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="practitioner.html">Practitioner</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Practitioner responsible for dispensing medication</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.dispensingOrganization : The organizaation responsible for the dispense
             of the medication.">dispensingOrganization</span>
            <a name="MedicationDispense.dispensingOrganization"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="organization.html">Organization</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Organization responsible for the dispense of the medication</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> 
            <span title="MedicationDispense.authorizingPrescription : Indicates the medication order that is being
             dispensed against.">authorizingPrescription</span>
            <a name="MedicationDispense.authorizingPrescription"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="medicationrequest.html">MedicationRequest</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Medication order that authorizes the dispense</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.type : Indicates the type of dispensing event that is performed. For
             example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.">type</span>
            <a name="MedicationDispense.type"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Trial fill, partial fill, emergency fill, etc.
            <br/>
            <a href="v3/ActPharmacySupplyType/vs.html" title="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
             of Trial, Partial Fill, Emergency Fill, Samples, etc.">ActPharmacySupplyType</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

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            <span title="MedicationDispense.quantity : The amount of medication that has been dispensed. Includes
             unit of measure.">quantity</span>
            <a name="MedicationDispense.quantity"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Amount dispensed</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.daysSupply : The amount of medication expressed as a timing amount.">daysSupply</span>
            <a name="MedicationDispense.daysSupply"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Amount of medication expressed as a timing amount</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW
            XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i
            8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> 
            <span title="MedicationDispense.whenPrepared : The time when the dispensed product was packaged and
             reviewed.">whenPrepared</span>
            <a name="MedicationDispense.whenPrepared"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element is included in summaries">Σ</span>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">When product was packaged and reviewed</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          sPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW
            XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i
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            <span title="MedicationDispense.whenHandedOver : The time the dispensed product was provided to the
             patient or their representative.">whenHandedOver</span>
            <a name="MedicationDispense.whenHandedOver"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">When product was given out</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
          goAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgC
          sPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/>
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav
            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/>
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj
            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
            EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ
            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> 
            <span title="MedicationDispense.destination : Identification of the facility/location where the medication
             was shipped to, as part of the dispense event.">destination</span>
            <a name="MedicationDispense.destination"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="location.html">Location</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Where the medication was sent</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.receiver : 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.">receiver</span>
            <a name="MedicationDispense.receiver"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="patient.html">Patient</a> | 
            <a href="practitioner.html">Practitioner</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who collected the medication</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.note : Extra information about the dispense that could not be conveyed
             in the other attributes.">note</span>
            <a name="MedicationDispense.note"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#Annotation">Annotation</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Information about the dispense</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <span title="MedicationDispense.dosageInstruction : 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.">dosageInstruction</span>
            <a name="MedicationDispense.dosageInstruction"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="dosageinstruction.html#DosageInstruction">DosageInstruction</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Medicine administration instructions to the patient/caregiver</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          sPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw
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            FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> 
            <span title="MedicationDispense.substitution : 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.">substitution</span>
            <a name="MedicationDispense.substitution"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Deals with substitution of one medicine for another</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          CZBkurQFbnaRSlAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> 
            <span title="MedicationDispense.substitution.type : A code signifying whether a different drug was
             dispensed from what was prescribed.">type</span>
            <a name="MedicationDispense.substitution.type"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">1..1</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Code signifying whether a different drug was dispensed from what was prescribed
            <br/>
            <a href="v3/ActSubstanceAdminSubstitutionCode/vs.html" title="A coded concept describing whether a different medicinal product may be dispensed other
             than the product as specified exactly in the prescription">ActSubstanceAdminSubstitutionCode</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> 
            <span title="MedicationDispense.substitution.reason : Indicates the reason for the substitution of
             (or lack of substitution) from what was prescribed.">reason</span>
            <a name="MedicationDispense.substitution.reason"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Why was substitution made
            <br/>
            <a href="v3/SubstanceAdminSubstitutionReason/vs.html" title="A coded concept describing the reason that a different medication should (or should not)
             be substituted from what was prescribed">SubstanceAdminSubstitutionReason</a> (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a>)
          </td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            <span title="MedicationDispense.substitution.responsibleParty : The person or organization that has
             primary responsibility for the substitution.">responsibleParty</span>
            <a name="MedicationDispense.substitution.responsibleParty"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="practitioner.html">Practitioner</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who is responsible for the substitution</td>
        </tr>

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          AASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj
            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> 
            <span title="MedicationDispense.eventHistory : A summary of the events of interest that have occurred,
             such as when the dispense was verified.">eventHistory</span>
            <a name="MedicationDispense.eventHistory"> </a>
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a>(
            <a href="provenance.html">Provenance</a>)
          </td>
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">A list of events of interest in the lifecycle</td>
        </tr>

        <tr>
          <td class="hierarchy" colspan="5">
            <br/>
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/> Documentation for this format
            </a>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="phx"/>
  </extension>
  <url value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/>
  <name value="MedicationDispense"/>
  <status value="draft"/>
  <publisher value="Health Level Seven International (Pharmacy)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/medication/index.cfm"/>
    </telecom>
  </contact>
  <date value="2016-12-06T12:22:34+11:00"/>
  <description value="Base StructureDefinition for MedicationDispense Resource"/>
  <fhirVersion value="1.8.0"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="MedicationDispense"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="MedicationDispense">
      <path value="MedicationDispense"/>
      <short value="Dispensing a medication to a named patient"/>
      <definition value="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."/>
      <comments value="The WG will be updating the MedicationDispense resource  to adjust each affected resource
       to align with the workflow pattern (see workflow.html)."/>
      <min value="0"/>
      <max value="*"/>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated"/>
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere
         in the resource"/>
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()"/>
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f
        :reference/@value=concat('#', $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="mdd-1"/>
        <severity value="error"/>
        <human value="whenHandedOver cannot be before whenPrepared"/>
        <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/>
        <xpath value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va
        lue &gt;= f:whenPrepared/@value)"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Supply[moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.medication"/>
      </mapping>
    </element>
    <element id="MedicationDispense.id">
      <path value="MedicationDispense.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="MedicationDispense.meta">
      <path value="MedicationDispense.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="MedicationDispense.implicitRules">
      <path value="MedicationDispense.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="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 as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="MedicationDispense.language">
      <path value="MedicationDispense.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="MedicationDispense.text">
      <path value="MedicationDispense.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may 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 &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="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 &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded in formation is added
       later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="MedicationDispense.contained">
      <path value="MedicationDispense.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="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."/>
      <comments value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.extension">
      <path value="MedicationDispense.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.modifierExtension">
      <path value="MedicationDispense.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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.
       Usually modifier elements provide negation or qualification. In order 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/>
      <short value="External identifier"/>
      <definition value="Identifier assigned by the dispensing facility - this is an identifier assigned outside
       FHIR."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/>
      <short value="in-progress | on-hold | completed | entered-in-error | stopped"/>
      <definition value="A code specifying the state of the set of dispense events."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="A coded concept specifying the state of the dispense event."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-dispense-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/>
      <short value="What medication was supplied"/>
      <definition value="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."/>
      <comments value="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."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept identifying which substance or product can be dispensed"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-2-Dispense/Give Code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRD].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element id="MedicationDispense.patient">
      <path value="MedicationDispense.patient"/>
      <short value="Who the dispense is for"/>
      <definition value="A link to a resource representing the person to whom the medication will be given."/>
      <comments value="SubstanceAdministration-&gt;subject-&gt;Patient."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3-Patient ID List"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/>
      <short value="Information that supports the dispensing of the medication"/>
      <definition value="Additional information that supports the medication being dispensed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dispenser">
      <path value="MedicationDispense.dispenser"/>
      <short value="Practitioner responsible for dispensing medication"/>
      <definition value="The individual responsible for dispensing the medication."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-10-Dispensing Provider / PRT-5-Participation Person: PRT-4-Participation='DP' (RXD-10
         is deprecated)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dispensingOrganization">
      <path value="MedicationDispense.dispensingOrganization"/>
      <short value="Organization responsible for the dispense of the medication"/>
      <definition value="The organizaation responsible for the dispense of the medication."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=RESP].role[classCode=ASSIGNED]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/>
      <short value="Medication order that authorizes the dispense"/>
      <definition value="Indicates the medication order that is being dispensed against."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-2 Placer Order Number"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/>
      <short value="Trial fill, partial fill, emergency fill, etc."/>
      <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
       of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
         of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-33-Dispense Type"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/>
      <short value="Amount dispensed"/>
      <definition value="The amount of medication that has been dispensed. Includes unit of measure."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".quantity"/>
      </mapping>
    </element>
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/>
      <short value="Amount of medication expressed as a timing amount"/>
      <definition value="The amount of medication expressed as a timing amount."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveUseTime"/>
      </mapping>
    </element>
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/>
      <short value="When product was packaged and reviewed"/>
      <definition value="The time when the dispensed product was packaged and reviewed."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-3-Date/Time Dispensed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/>
      </mapping>
    </element>
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/>
      <short value="When product was given out"/>
      <definition value="The time the dispensed product was provided to the patient or their representative."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-3-Date/Time Dispensed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/>
      </mapping>
    </element>
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/>
      <short value="Where the medication was sent"/>
      <definition value="Identification of the facility/location where the medication was shipped to, as part of
       the dispense event."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy
         Address"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DST].role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/>
      <short value="Who collected the medication"/>
      <definition value="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."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=RCV].role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/>
      <short value="Information about the dispense"/>
      <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-9 Dispense Notes"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/>
      <short value="Medicine administration instructions to the patient/caregiver"/>
      <definition value="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."/>
      <comments value="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."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="DosageInstruction"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/>
      <short value="Deals with substitution of one medicine for another"/>
      <definition value="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."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="children().count() &gt; id.count()"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.id">
      <path value="MedicationDispense.substitution.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.extension">
      <path value="MedicationDispense.substitution.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.modifierExtension">
      <path value="MedicationDispense.substitution.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/>
      <short value="Code signifying whether a different drug was dispensed from what was prescribed"/>
      <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing whether a different medicinal product may be dispensed other
         than the product as specified exactly in the prescription"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/>
      <short value="Why was substitution made"/>
      <definition value="Indicates the reason for the substitution of (or lack of substitution) from what was prescribed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing the reason that a different medication should (or should not)
         be substituted from what was prescribed"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/>
      <short value="Who is responsible for the substitution"/>
      <definition value="The person or organization that has primary responsibility for the substitution."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/>
      <short value="A list of events of interest in the lifecycle"/>
      <definition value="A summary of the events of interest that have occurred, such as when the dispense was
       verified."/>
      <comments value="See usage notes in Request pattern in request history."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/>
      </type>
    </element>
  </snapshot>
  <differential>
    <element id="MedicationDispense">
      <path value="MedicationDispense"/>
      <short value="Dispensing a medication to a named patient"/>
      <definition value="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."/>
      <comments value="The WG will be updating the MedicationDispense resource  to adjust each affected resource
       to align with the workflow pattern (see workflow.html)."/>
      <min value="0"/>
      <max value="*"/>
      <constraint>
        <key value="mdd-1"/>
        <severity value="error"/>
        <human value="whenHandedOver cannot be before whenPrepared"/>
        <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/>
        <xpath value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va
        lue &gt;= f:whenPrepared/@value)"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="Supply[moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.medication"/>
      </mapping>
    </element>
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/>
      <short value="External identifier"/>
      <definition value="Identifier assigned by the dispensing facility - this is an identifier assigned outside
       FHIR."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/>
      <short value="in-progress | on-hold | completed | entered-in-error | stopped"/>
      <definition value="A code specifying the state of the set of dispense events."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="A coded concept specifying the state of the dispense event."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-dispense-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/>
      <short value="What medication was supplied"/>
      <definition value="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."/>
      <comments value="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."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept identifying which substance or product can be dispensed"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-2-Dispense/Give Code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRD].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element id="MedicationDispense.patient">
      <path value="MedicationDispense.patient"/>
      <short value="Who the dispense is for"/>
      <definition value="A link to a resource representing the person to whom the medication will be given."/>
      <comments value="SubstanceAdministration-&gt;subject-&gt;Patient."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3-Patient ID List"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/>
      <short value="Information that supports the dispensing of the medication"/>
      <definition value="Additional information that supports the medication being dispensed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dispenser">
      <path value="MedicationDispense.dispenser"/>
      <short value="Practitioner responsible for dispensing medication"/>
      <definition value="The individual responsible for dispensing the medication."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-10-Dispensing Provider / PRT-5-Participation Person: PRT-4-Participation='DP' (RXD-10
         is deprecated)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dispensingOrganization">
      <path value="MedicationDispense.dispensingOrganization"/>
      <short value="Organization responsible for the dispense of the medication"/>
      <definition value="The organizaation responsible for the dispense of the medication."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=RESP].role[classCode=ASSIGNED]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/>
      <short value="Medication order that authorizes the dispense"/>
      <definition value="Indicates the medication order that is being dispensed against."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-2 Placer Order Number"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/>
      <short value="Trial fill, partial fill, emergency fill, etc."/>
      <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
       of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
         of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-33-Dispense Type"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/>
      <short value="Amount dispensed"/>
      <definition value="The amount of medication that has been dispensed. Includes unit of measure."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".quantity"/>
      </mapping>
    </element>
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/>
      <short value="Amount of medication expressed as a timing amount"/>
      <definition value="The amount of medication expressed as a timing amount."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveUseTime"/>
      </mapping>
    </element>
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/>
      <short value="When product was packaged and reviewed"/>
      <definition value="The time when the dispensed product was packaged and reviewed."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-3-Date/Time Dispensed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/>
      </mapping>
    </element>
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/>
      <short value="When product was given out"/>
      <definition value="The time the dispensed product was provided to the patient or their representative."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-3-Date/Time Dispensed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/>
      </mapping>
    </element>
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/>
      <short value="Where the medication was sent"/>
      <definition value="Identification of the facility/location where the medication was shipped to, as part of
       the dispense event."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy
         Address"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DST].role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/>
      <short value="Who collected the medication"/>
      <definition value="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."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=RCV].role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/>
      <short value="Information about the dispense"/>
      <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-9 Dispense Notes"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/>
      <short value="Medicine administration instructions to the patient/caregiver"/>
      <definition value="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."/>
      <comments value="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."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="DosageInstruction"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/>
      <short value="Deals with substitution of one medicine for another"/>
      <definition value="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."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/>
      <short value="Code signifying whether a different drug was dispensed from what was prescribed"/>
      <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing whether a different medicinal product may be dispensed other
         than the product as specified exactly in the prescription"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/>
      <short value="Why was substitution made"/>
      <definition value="Indicates the reason for the substitution of (or lack of substitution) from what was prescribed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing the reason that a different medication should (or should not)
         be substituted from what was prescribed"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/>
      <short value="Who is responsible for the substitution"/>
      <definition value="The person or organization that has primary responsibility for the substitution."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/>
      <short value="A list of events of interest in the lifecycle"/>
      <definition value="A summary of the events of interest that have occurred, such as when the dispense was
       verified."/>
      <comments value="See usage notes in Request pattern in request history."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/>
      </type>
    </element>
  </differential>
</StructureDefinition>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.