Release 5 Preview #1
MedicationsThis page is part of the FHIR Specification (v4.2.0: R5 Preview #1). 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
| Pharmacy Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Encounter, Patient, Practitioner |
Raw JSON (canonical form + also see JSON Format Specification)
StructureDefinition for medicationdispense
{
"resourceType" : "StructureDefinition",
"id" : "MedicationDispense",
"meta" : {
"lastUpdated" : "2019-12-31T21:03:40.621+11:00"
},
"text" : {
"status" : "generated",
"div" : "<div>!-- Snipped for Brevity --></div>"
},
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "trial-use"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 2
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category",
"valueCode" : "patient"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "phx"
}],
"url" : "http://hl7.org/fhir/StructureDefinition/MedicationDispense",
"version" : "4.2.0",
"name" : "MedicationDispense",
"status" : "draft",
"date" : "2019-12-31T21:03:40+11:00",
"publisher" : "Health Level Seven International (Pharmacy)",
"contact" : [{
"telecom" : [{
"system" : "url",
"value" : "http://hl7.org/fhir"
}]
},
{
"telecom" : [{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/medication/index.cfm"
}]
}],
"description" : "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.",
"fhirVersion" : "4.2.0",
"mapping" : [{
"identity" : "workflow",
"uri" : "http://hl7.org/fhir/workflow",
"name" : "Workflow Pattern"
},
{
"identity" : "rim",
"uri" : "http://hl7.org/v3",
"name" : "RIM Mapping"
},
{
"identity" : "w5",
"uri" : "http://hl7.org/fhir/fivews",
"name" : "FiveWs Pattern Mapping"
},
{
"identity" : "rx-dispense-rmim",
"uri" : "http://www.hl7.org/v3/PORX_RM020070UV",
"name" : "V3 Pharmacy Dispense RMIM"
},
{
"identity" : "v2",
"uri" : "http://hl7.org/v2",
"name" : "HL7 v2 Mapping"
}],
"kind" : "resource",
"abstract" : false,
"type" : "MedicationDispense",
"baseDefinition" : "http://hl7.org/fhir/StructureDefinition/DomainResource",
"derivation" : "specialization",
"snapshot" : {
"element" : [{
"id" : "MedicationDispense",
"path" : "MedicationDispense",
"short" : "Dispensing a medication to a named patient",
"definition" : "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.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense",
"min" : 0,
"max" : "*"
},
"constraint" : [{
"key" : "dom-2",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression" : "contained.contained.empty()",
"xpath" : "not(parent::f:contained and f:contained)",
"source" : "DomainResource"
},
{
"key" : "dom-3",
"severity" : "error",
"human" : "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression" : "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath" : "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source" : "DomainResource"
},
{
"key" : "dom-4",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source" : "DomainResource"
},
{
"key" : "dom-5",
"severity" : "error",
"human" : "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression" : "contained.meta.security.empty()",
"xpath" : "not(exists(f:contained/*/f:meta/f:security))",
"source" : "DomainResource"
},
{
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean" : true
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown" : "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}],
"key" : "dom-6",
"severity" : "warning",
"human" : "A resource should have narrative for robust management",
"expression" : "text.`div`.exists()",
"xpath" : "exists(f:text/h:div)",
"source" : "DomainResource"
},
{
"key" : "mdd-1",
"severity" : "error",
"human" : "whenHandedOver cannot be before whenPrepared",
"expression" : "whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared",
"xpath" : "not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "Entity. Role, or Act"
},
{
"identity" : "workflow",
"map" : "Event"
},
{
"identity" : "rim",
"map" : "Supply[moodCode=EVN]"
}]
},
{
"id" : "MedicationDispense.id",
"path" : "MedicationDispense.id",
"short" : "Logical id of this artifact",
"definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment" : "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" : 0,
"max" : "1",
"base" : {
"path" : "Resource.id",
"min" : 0,
"max" : "1"
},
"type" : [{
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUri" : "id"
}],
"code" : "http://hl7.org/fhirpath/System.String"
}],
"isModifier" : false,
"isSummary" : true
},
{
"id" : "MedicationDispense.meta",
"path" : "MedicationDispense.meta",
"short" : "Metadata about the resource",
"definition" : "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.meta",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Meta"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : true
},
{
"id" : "MedicationDispense.implicitRules",
"path" : "MedicationDispense.implicitRules",
"short" : "A set of rules under which this content was created",
"definition" : "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment" : "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Resource.implicitRules",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "uri"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : true,
"isModifierReason" : "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary" : true
},
{
"id" : "MedicationDispense.language",
"path" : "MedicationDispense.language",
"short" : "Language of the resource content",
"definition" : "The base language in which the resource is written.",
"comment" : "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" : 0,
"max" : "1",
"base" : {
"path" : "Resource.language",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "code"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "Language"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean" : true
}],
"strength" : "preferred",
"description" : "A human language.",
"valueSet" : "http://hl7.org/fhir/ValueSet/languages"
}
},
{
"id" : "MedicationDispense.text",
"path" : "MedicationDispense.text",
"short" : "Text summary of the resource, for human interpretation",
"definition" : "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment" : "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias" : ["narrative",
"html",
"xhtml",
"display"],
"min" : 0,
"max" : "1",
"base" : {
"path" : "DomainResource.text",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Narrative"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "Act.text?"
}]
},
{
"id" : "MedicationDispense.contained",
"path" : "MedicationDispense.contained",
"short" : "Contained, inline Resources",
"definition" : "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.",
"comment" : "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias" : ["inline resources",
"anonymous resources",
"contained resources"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.contained",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Resource"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "N/A"
}]
},
{
"id" : "MedicationDispense.extension",
"path" : "MedicationDispense.extension",
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "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" : ["extensions",
"user content"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.extension",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Extension"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "Extension"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "N/A"
}]
},
{
"id" : "MedicationDispense.modifierExtension",
"path" : "MedicationDispense.modifierExtension",
"short" : "Extensions that cannot be ignored",
"definition" : "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "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.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias" : ["extensions",
"user content"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "DomainResource.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Extension"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "Extension"
}],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "N/A"
}]
},
{
"id" : "MedicationDispense.identifier",
"path" : "MedicationDispense.identifier",
"short" : "External identifier",
"definition" : "Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.",
"comment" : "This is a business identifier, not a resource identifier.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.identifier",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Identifier"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.identifier"
},
{
"identity" : "w5",
"map" : "FiveWs.identifier"
},
{
"identity" : "rim",
"map" : ".id"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.id"
}]
},
{
"id" : "MedicationDispense.basedOn",
"path" : "MedicationDispense.basedOn",
"short" : "Plan that is fulfilled by this dispense",
"definition" : "A plan that is fulfilled in whole or in part by this MedicationDispense.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.basedOn",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/CarePlan"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=FLFS].target"
}]
},
{
"id" : "MedicationDispense.partOf",
"path" : "MedicationDispense.partOf",
"short" : "Event that dispense is part of",
"definition" : "The procedure that trigger the dispense.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.partOf",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Procedure"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.partOf"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"
}]
},
{
"id" : "MedicationDispense.status",
"path" : "MedicationDispense.status",
"short" : "preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown",
"definition" : "A code specifying the state of the set of dispense events.",
"comment" : "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "MedicationDispense.status",
"min" : 1,
"max" : "1"
},
"type" : [{
"code" : "code"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : true,
"isModifierReason" : "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary" : true,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseStatus"
}],
"strength" : "required",
"description" : "A coded concept specifying the state of the dispense event.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-status|4.2.0"
},
"mapping" : [{
"identity" : "workflow",
"map" : "Event.status"
},
{
"identity" : "w5",
"map" : "FiveWs.status"
},
{
"identity" : "rim",
"map" : ".statusCode"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.statusCode"
}]
},
{
"id" : "MedicationDispense.statusReason[x]",
"path" : "MedicationDispense.statusReason[x]",
"short" : "Why a dispense was not performed",
"definition" : "Indicates the reason why a dispense was not performed.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.statusReason[x]",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "CodeableConcept"
},
{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/DetectedIssue"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseStatusReason"
}],
"strength" : "example",
"description" : "A code describing why a dispense was not performed.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-status-reason"
},
"mapping" : [{
"identity" : "workflow",
"map" : "Event.statusReason"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"not done reason\"].value"
}]
},
{
"id" : "MedicationDispense.category",
"path" : "MedicationDispense.category",
"short" : "Type of medication dispense",
"definition" : "Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).",
"comment" : "The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.category",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "CodeableConcept"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseCategory"
}],
"strength" : "preferred",
"description" : "A code describing where the dispensed medication is expected to be consumed or administered.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-category"
},
"mapping" : [{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication dispense\"].value"
}]
},
{
"id" : "MedicationDispense.medication[x]",
"path" : "MedicationDispense.medication[x]",
"short" : "What medication was supplied",
"definition" : "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
"comment" : "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. For example, if you require form or lot number, then you must reference the Medication resource.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "MedicationDispense.medication[x]",
"min" : 1,
"max" : "1"
},
"type" : [{
"code" : "CodeableConcept"
},
{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Medication"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : true,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationCode"
}],
"strength" : "example",
"description" : "A coded concept identifying which substance or product can be dispensed.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medication-codes"
},
"mapping" : [{
"identity" : "workflow",
"map" : "Event.code"
},
{
"identity" : "w5",
"map" : "FiveWs.what[x]"
},
{
"identity" : "v2",
"map" : "RXD-2-Dispense/Give Code"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=PRD].role"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationRequest.component1.AdministrationRequest.consumable"
}]
},
{
"id" : "MedicationDispense.subject",
"path" : "MedicationDispense.subject",
"short" : "Who the dispense is for",
"definition" : "A link to a resource representing the person or the group to whom the medication will be given.",
"comment" : "SubstanceAdministration->subject->Patient.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.subject",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : true,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.subject"
},
{
"identity" : "w5",
"map" : "FiveWs.subject[x]"
},
{
"identity" : "v2",
"map" : "PID-3-Patient ID List"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=SBJ].role[classCode=PAT]"
},
{
"identity" : "w5",
"map" : "FiveWs.subject"
}]
},
{
"id" : "MedicationDispense.encounter",
"path" : "MedicationDispense.encounter",
"short" : "Encounter associated with event",
"definition" : "The encounter that establishes the context for this event.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.encounter",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.context"
},
{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
}]
},
{
"id" : "MedicationDispense.supportingInformation",
"path" : "MedicationDispense.supportingInformation",
"short" : "Information that supports the dispensing of the medication",
"definition" : "Additional information that supports the medication being dispensed. For example, there may be requirements that a specific lab test has been completed prior to dispensing or the patient's weight at the time of dispensing is documented.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.supportingInformation",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Resource"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "w5",
"map" : "FiveWs.context"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"
}]
},
{
"id" : "MedicationDispense.performer",
"path" : "MedicationDispense.performer",
"short" : "Who performed event",
"definition" : "Indicates who or what performed the event.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.performer",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "BackboneElement"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.performer"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=PRF]"
}]
},
{
"id" : "MedicationDispense.performer.id",
"path" : "MedicationDispense.performer.id",
"representation" : ["xmlAttr"],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [{
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUri" : "id"
}],
"code" : "http://hl7.org/fhirpath/System.String"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "n/a"
}]
},
{
"id" : "MedicationDispense.performer.extension",
"path" : "MedicationDispense.performer.extension",
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "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" : ["extensions",
"user content"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Extension"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "Extension"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "n/a"
}]
},
{
"id" : "MedicationDispense.performer.modifierExtension",
"path" : "MedicationDispense.performer.modifierExtension",
"short" : "Extensions that cannot be ignored even if unrecognized",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "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.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias" : ["extensions",
"user content",
"modifiers"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "BackboneElement.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Extension"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "Extension"
}],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary" : true,
"mapping" : [{
"identity" : "rim",
"map" : "N/A"
}]
},
{
"id" : "MedicationDispense.performer.function",
"path" : "MedicationDispense.performer.function",
"short" : "Who performed the dispense and what they did",
"definition" : "Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.",
"requirements" : "Allows disambiguation of the types of involvement of different performers.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.performer.function",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "CodeableConcept"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispensePerformerFunction"
}],
"strength" : "example",
"description" : "A code describing the role an individual played in dispensing a medication.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-performer-function"
},
"mapping" : [{
"identity" : "rim",
"map" : "participation[typeCode=PRF].functionCode"
}]
},
{
"id" : "MedicationDispense.performer.actor",
"path" : "MedicationDispense.performer.actor",
"short" : "Individual who was performing",
"definition" : "The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "MedicationDispense.performer.actor",
"min" : 1,
"max" : "1"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.performer.actor"
},
{
"identity" : "rim",
"map" : ".role"
}]
},
{
"id" : "MedicationDispense.location",
"path" : "MedicationDispense.location",
"short" : "Where the dispense occurred",
"definition" : "The principal physical location where the dispense was performed.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.location",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".participation[typeCode=LOC].role"
}]
},
{
"id" : "MedicationDispense.authorizingPrescription",
"path" : "MedicationDispense.authorizingPrescription",
"short" : "Medication order that authorizes the dispense",
"definition" : "Indicates the medication order that is being dispensed against.",
"comment" : "Maps to basedOn in Event logical model.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.authorizingPrescription",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/MedicationRequest"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.basedOn"
},
{
"identity" : "v2",
"map" : "ORC-2 Placer Order Number"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.inFulfillmentOf"
}]
},
{
"id" : "MedicationDispense.type",
"path" : "MedicationDispense.type",
"short" : "Trial fill, partial fill, emergency fill, etc.",
"definition" : "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.type",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "CodeableConcept"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseType"
}],
"strength" : "example",
"description" : "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.",
"valueSet" : "http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"
},
"mapping" : [{
"identity" : "v2",
"map" : "RXD-33-Dispense Type"
},
{
"identity" : "rim",
"map" : ".code"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.code"
}]
},
{
"id" : "MedicationDispense.quantity",
"path" : "MedicationDispense.quantity",
"short" : "Amount dispensed",
"definition" : "The amount of medication that has been dispensed. Includes unit of measure.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.quantity",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Quantity",
"profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "v2",
"map" : "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system"
},
{
"identity" : "rim",
"map" : ".quantity"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.quantity"
}]
},
{
"id" : "MedicationDispense.daysSupply",
"path" : "MedicationDispense.daysSupply",
"short" : "Amount of medication expressed as a timing amount",
"definition" : "The amount of medication expressed as a timing amount.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.daysSupply",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Quantity",
"profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "v2",
"map" : "TQ1.6 Timing/Quantity Segment Service Duration.\rPrior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14� represents “14 days supply�\rFrom v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days�, the numeric value is TQ1.6.1 (…|14^\rFor backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6"
},
{
"identity" : "rim",
"map" : "effectiveUseTime"
}]
},
{
"id" : "MedicationDispense.whenPrepared",
"path" : "MedicationDispense.whenPrepared",
"short" : "When product was packaged and reviewed",
"definition" : "The time when the dispensed product was packaged and reviewed.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.whenPrepared",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "dateTime"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : true,
"mapping" : [{
"identity" : "v2",
"map" : "RXD-3-Date/Time Dispensed"
},
{
"identity" : "rim",
"map" : ".effectiveTime[xmi:type=IVL_TS].low"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.effectiveTime"
}]
},
{
"id" : "MedicationDispense.whenHandedOver",
"path" : "MedicationDispense.whenHandedOver",
"short" : "When product was given out",
"definition" : "The time the dispensed product was provided to the patient or their representative.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.whenHandedOver",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "dateTime"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.occurrence[x]"
},
{
"identity" : "v2",
"map" : "RXD-3-Date/Time Dispensed"
},
{
"identity" : "rim",
"map" : ".effectiveTime[xmi:type=IVL_TS].high"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.effectiveTime"
}]
},
{
"id" : "MedicationDispense.destination",
"path" : "MedicationDispense.destination",
"short" : "Where the medication was sent",
"definition" : "Identification of the facility/location where the medication was shipped to, as part of the dispense event.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.destination",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "v2",
"map" : "RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=DST].role"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.destination"
}]
},
{
"id" : "MedicationDispense.receiver",
"path" : "MedicationDispense.receiver",
"short" : "Who collected the medication or where the medication was delivered",
"definition" : "Identifies the person who picked up the medication or the location of where the medication was delivered. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional or a location.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.receiver",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Location",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".participation[typeCode=RCV].role"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.receiver"
}]
},
{
"id" : "MedicationDispense.note",
"path" : "MedicationDispense.note",
"short" : "Information about the dispense",
"definition" : "Extra information about the dispense that could not be conveyed in the other attributes.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.note",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Annotation"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.note"
},
{
"identity" : "v2",
"map" : "RXD-9 Dispense Notes"
},
{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"
}]
},
{
"id" : "MedicationDispense.renderedDosageInstruction",
"path" : "MedicationDispense.renderedDosageInstruction",
"short" : "Full representation of the dosage instructions",
"definition" : "The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.",
"comment" : "The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.renderedDosageInstruction",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "string"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "SubstanceAdministration.text"
}]
},
{
"id" : "MedicationDispense.dosageInstruction",
"path" : "MedicationDispense.dosageInstruction",
"short" : "How the medication is to be used by the patient or administered by the caregiver",
"definition" : "Indicates how the medication is to be used by the patient.",
"comment" : "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.\rThe pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.dosageInstruction",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Dosage"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"
}]
},
{
"id" : "MedicationDispense.substitution",
"path" : "MedicationDispense.substitution",
"short" : "Whether a substitution was performed on the dispense",
"definition" : "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. If nothing is specified, substitution was not done.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.substitution",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "BackboneElement"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade"
}]
},
{
"id" : "MedicationDispense.substitution.id",
"path" : "MedicationDispense.substitution.id",
"representation" : ["xmlAttr"],
"short" : "Unique id for inter-element referencing",
"definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "Element.id",
"min" : 0,
"max" : "1"
},
"type" : [{
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUri" : "id"
}],
"code" : "http://hl7.org/fhirpath/System.String"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "n/a"
}]
},
{
"id" : "MedicationDispense.substitution.extension",
"path" : "MedicationDispense.substitution.extension",
"short" : "Additional content defined by implementations",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment" : "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" : ["extensions",
"user content"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "Element.extension",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Extension"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "Extension"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : "n/a"
}]
},
{
"id" : "MedicationDispense.substitution.modifierExtension",
"path" : "MedicationDispense.substitution.modifierExtension",
"short" : "Extensions that cannot be ignored even if unrecognized",
"definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment" : "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.",
"requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias" : ["extensions",
"user content",
"modifiers"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "BackboneElement.modifierExtension",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Extension"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
},
{
"key" : "ext-1",
"severity" : "error",
"human" : "Must have either extensions or value[x], not both",
"expression" : "extension.exists() != value.exists()",
"xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source" : "Extension"
}],
"isModifier" : true,
"isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary" : true,
"mapping" : [{
"identity" : "rim",
"map" : "N/A"
}]
},
{
"id" : "MedicationDispense.substitution.wasSubstituted",
"path" : "MedicationDispense.substitution.wasSubstituted",
"short" : "Whether a substitution was or was not performed on the dispense",
"definition" : "True if the dispenser dispensed a different drug or product from what was prescribed.",
"min" : 1,
"max" : "1",
"base" : {
"path" : "MedicationDispense.substitution.wasSubstituted",
"min" : 1,
"max" : "1"
},
"type" : [{
"code" : "boolean"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".actionNegationInd"
}]
},
{
"id" : "MedicationDispense.substitution.type",
"path" : "MedicationDispense.substitution.type",
"short" : "Code signifying whether a different drug was dispensed from what was prescribed",
"definition" : "A code signifying whether a different drug was dispensed from what was prescribed.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.substitution.type",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "CodeableConcept"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationIntendedSubstitutionType"
}],
"strength" : "example",
"description" : "A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.",
"valueSet" : "http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"
},
"mapping" : [{
"identity" : "v2",
"map" : "RXO-9-Allow Substitutions / RXE-9-Substitution Status"
},
{
"identity" : "rim",
"map" : ".code"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade.code"
}]
},
{
"id" : "MedicationDispense.substitution.reason",
"path" : "MedicationDispense.substitution.reason",
"short" : "Why was substitution made",
"definition" : "Indicates the reason for the substitution (or lack of substitution) from what was prescribed.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.substitution.reason",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "CodeableConcept"
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationIntendedSubstitutionReason"
}],
"strength" : "example",
"description" : "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.",
"valueSet" : "http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"
},
"mapping" : [{
"identity" : "rim",
"map" : ".reasonCode"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade.reasonCode"
}]
},
{
"id" : "MedicationDispense.substitution.responsibleParty",
"path" : "MedicationDispense.substitution.responsibleParty",
"short" : "Who is responsible for the substitution",
"definition" : "The person or organization that has primary responsibility for the substitution.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "MedicationDispense.substitution.responsibleParty",
"min" : 0,
"max" : "1"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".participation[typeCode=PFM].role[classCode=ASSIGN]"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade.ResponsibleParty"
}]
},
{
"id" : "MedicationDispense.detectedIssue",
"path" : "MedicationDispense.detectedIssue",
"short" : "Clinical issue with action",
"definition" : "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.",
"comment" : "This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.",
"alias" : ["Contraindication",
"Drug Utilization Review (DUR)",
"Alert"],
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.detectedIssue",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/DetectedIssue"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"
}]
},
{
"id" : "MedicationDispense.eventHistory",
"path" : "MedicationDispense.eventHistory",
"short" : "A list of relevant lifecycle events",
"definition" : "A summary of the events of interest that have occurred, such as when the dispense was verified.",
"comment" : "This might not include provenances for all versions of the request – only those deemed “relevant� or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant� change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).",
"min" : 0,
"max" : "*",
"base" : {
"path" : "MedicationDispense.eventHistory",
"min" : 0,
"max" : "*"
},
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Provenance"]
}],
"constraint" : [{
"key" : "ele-1",
"severity" : "error",
"human" : "All FHIR elements must have a @value or children",
"expression" : "hasValue() or (children().count() > id.count())",
"xpath" : "@value|f:*|h:div",
"source" : "Element"
}],
"isModifier" : false,
"isSummary" : false,
"mapping" : [{
"identity" : "rim",
"map" : ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
}]
}]
},
"differential" : {
"element" : [{
"id" : "MedicationDispense",
"path" : "MedicationDispense",
"short" : "Dispensing a medication to a named patient",
"definition" : "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.",
"min" : 0,
"max" : "*",
"constraint" : [{
"key" : "mdd-1",
"severity" : "error",
"human" : "whenHandedOver cannot be before whenPrepared",
"expression" : "whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared",
"xpath" : "not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)"
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event"
},
{
"identity" : "rim",
"map" : "Supply[moodCode=EVN]"
}]
},
{
"id" : "MedicationDispense.identifier",
"path" : "MedicationDispense.identifier",
"short" : "External identifier",
"definition" : "Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.",
"comment" : "This is a business identifier, not a resource identifier.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Identifier"
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.identifier"
},
{
"identity" : "w5",
"map" : "FiveWs.identifier"
},
{
"identity" : "rim",
"map" : ".id"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.id"
}]
},
{
"id" : "MedicationDispense.basedOn",
"path" : "MedicationDispense.basedOn",
"short" : "Plan that is fulfilled by this dispense",
"definition" : "A plan that is fulfilled in whole or in part by this MedicationDispense.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/CarePlan"]
}],
"mapping" : [{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=FLFS].target"
}]
},
{
"id" : "MedicationDispense.partOf",
"path" : "MedicationDispense.partOf",
"short" : "Event that dispense is part of",
"definition" : "The procedure that trigger the dispense.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Procedure"]
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.partOf"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"
}]
},
{
"id" : "MedicationDispense.status",
"path" : "MedicationDispense.status",
"short" : "preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown",
"definition" : "A code specifying the state of the set of dispense events.",
"comment" : "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"min" : 1,
"max" : "1",
"type" : [{
"code" : "code"
}],
"isModifier" : true,
"isModifierReason" : "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary" : true,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseStatus"
}],
"strength" : "required",
"description" : "A coded concept specifying the state of the dispense event.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-status|4.2.0"
},
"mapping" : [{
"identity" : "workflow",
"map" : "Event.status"
},
{
"identity" : "w5",
"map" : "FiveWs.status"
},
{
"identity" : "rim",
"map" : ".statusCode"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.statusCode"
}]
},
{
"id" : "MedicationDispense.statusReason[x]",
"path" : "MedicationDispense.statusReason[x]",
"short" : "Why a dispense was not performed",
"definition" : "Indicates the reason why a dispense was not performed.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "CodeableConcept"
},
{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/DetectedIssue"]
}],
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseStatusReason"
}],
"strength" : "example",
"description" : "A code describing why a dispense was not performed.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-status-reason"
},
"mapping" : [{
"identity" : "workflow",
"map" : "Event.statusReason"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"not done reason\"].value"
}]
},
{
"id" : "MedicationDispense.category",
"path" : "MedicationDispense.category",
"short" : "Type of medication dispense",
"definition" : "Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).",
"comment" : "The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "CodeableConcept"
}],
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseCategory"
}],
"strength" : "preferred",
"description" : "A code describing where the dispensed medication is expected to be consumed or administered.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-category"
},
"mapping" : [{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication dispense\"].value"
}]
},
{
"id" : "MedicationDispense.medication[x]",
"path" : "MedicationDispense.medication[x]",
"short" : "What medication was supplied",
"definition" : "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
"comment" : "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. For example, if you require form or lot number, then you must reference the Medication resource.",
"min" : 1,
"max" : "1",
"type" : [{
"code" : "CodeableConcept"
},
{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Medication"]
}],
"isSummary" : true,
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationCode"
}],
"strength" : "example",
"description" : "A coded concept identifying which substance or product can be dispensed.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medication-codes"
},
"mapping" : [{
"identity" : "workflow",
"map" : "Event.code"
},
{
"identity" : "w5",
"map" : "FiveWs.what[x]"
},
{
"identity" : "v2",
"map" : "RXD-2-Dispense/Give Code"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=PRD].role"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationRequest.component1.AdministrationRequest.consumable"
}]
},
{
"id" : "MedicationDispense.subject",
"path" : "MedicationDispense.subject",
"short" : "Who the dispense is for",
"definition" : "A link to a resource representing the person or the group to whom the medication will be given.",
"comment" : "SubstanceAdministration->subject->Patient.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group"]
}],
"isSummary" : true,
"mapping" : [{
"identity" : "workflow",
"map" : "Event.subject"
},
{
"identity" : "w5",
"map" : "FiveWs.subject[x]"
},
{
"identity" : "v2",
"map" : "PID-3-Patient ID List"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=SBJ].role[classCode=PAT]"
},
{
"identity" : "w5",
"map" : "FiveWs.subject"
}]
},
{
"id" : "MedicationDispense.encounter",
"path" : "MedicationDispense.encounter",
"short" : "Encounter associated with event",
"definition" : "The encounter that establishes the context for this event.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"]
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.context"
},
{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
}]
},
{
"id" : "MedicationDispense.supportingInformation",
"path" : "MedicationDispense.supportingInformation",
"short" : "Information that supports the dispensing of the medication",
"definition" : "Additional information that supports the medication being dispensed. For example, there may be requirements that a specific lab test has been completed prior to dispensing or the patient's weight at the time of dispensing is documented.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Resource"]
}],
"mapping" : [{
"identity" : "w5",
"map" : "FiveWs.context"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"
}]
},
{
"id" : "MedicationDispense.performer",
"path" : "MedicationDispense.performer",
"short" : "Who performed event",
"definition" : "Indicates who or what performed the event.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "BackboneElement"
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.performer"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=PRF]"
}]
},
{
"id" : "MedicationDispense.performer.function",
"path" : "MedicationDispense.performer.function",
"short" : "Who performed the dispense and what they did",
"definition" : "Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.",
"requirements" : "Allows disambiguation of the types of involvement of different performers.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "CodeableConcept"
}],
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispensePerformerFunction"
}],
"strength" : "example",
"description" : "A code describing the role an individual played in dispensing a medication.",
"valueSet" : "http://hl7.org/fhir/ValueSet/medicationdispense-performer-function"
},
"mapping" : [{
"identity" : "rim",
"map" : "participation[typeCode=PRF].functionCode"
}]
},
{
"id" : "MedicationDispense.performer.actor",
"path" : "MedicationDispense.performer.actor",
"short" : "Individual who was performing",
"definition" : "The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.",
"min" : 1,
"max" : "1",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"]
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.performer.actor"
},
{
"identity" : "rim",
"map" : ".role"
}]
},
{
"id" : "MedicationDispense.location",
"path" : "MedicationDispense.location",
"short" : "Where the dispense occurred",
"definition" : "The principal physical location where the dispense was performed.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
}],
"mapping" : [{
"identity" : "rim",
"map" : ".participation[typeCode=LOC].role"
}]
},
{
"id" : "MedicationDispense.authorizingPrescription",
"path" : "MedicationDispense.authorizingPrescription",
"short" : "Medication order that authorizes the dispense",
"definition" : "Indicates the medication order that is being dispensed against.",
"comment" : "Maps to basedOn in Event logical model.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/MedicationRequest"]
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.basedOn"
},
{
"identity" : "v2",
"map" : "ORC-2 Placer Order Number"
},
{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.inFulfillmentOf"
}]
},
{
"id" : "MedicationDispense.type",
"path" : "MedicationDispense.type",
"short" : "Trial fill, partial fill, emergency fill, etc.",
"definition" : "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "CodeableConcept"
}],
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationDispenseType"
}],
"strength" : "example",
"description" : "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.",
"valueSet" : "http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"
},
"mapping" : [{
"identity" : "v2",
"map" : "RXD-33-Dispense Type"
},
{
"identity" : "rim",
"map" : ".code"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.code"
}]
},
{
"id" : "MedicationDispense.quantity",
"path" : "MedicationDispense.quantity",
"short" : "Amount dispensed",
"definition" : "The amount of medication that has been dispensed. Includes unit of measure.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Quantity",
"profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
}],
"mapping" : [{
"identity" : "v2",
"map" : "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system"
},
{
"identity" : "rim",
"map" : ".quantity"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.quantity"
}]
},
{
"id" : "MedicationDispense.daysSupply",
"path" : "MedicationDispense.daysSupply",
"short" : "Amount of medication expressed as a timing amount",
"definition" : "The amount of medication expressed as a timing amount.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Quantity",
"profile" : ["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]
}],
"mapping" : [{
"identity" : "v2",
"map" : "TQ1.6 Timing/Quantity Segment Service Duration.\rPrior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14� represents “14 days supply�\rFrom v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days�, the numeric value is TQ1.6.1 (…|14^\rFor backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6"
},
{
"identity" : "rim",
"map" : "effectiveUseTime"
}]
},
{
"id" : "MedicationDispense.whenPrepared",
"path" : "MedicationDispense.whenPrepared",
"short" : "When product was packaged and reviewed",
"definition" : "The time when the dispensed product was packaged and reviewed.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "dateTime"
}],
"isSummary" : true,
"mapping" : [{
"identity" : "v2",
"map" : "RXD-3-Date/Time Dispensed"
},
{
"identity" : "rim",
"map" : ".effectiveTime[xmi:type=IVL_TS].low"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.effectiveTime"
}]
},
{
"id" : "MedicationDispense.whenHandedOver",
"path" : "MedicationDispense.whenHandedOver",
"short" : "When product was given out",
"definition" : "The time the dispensed product was provided to the patient or their representative.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "dateTime"
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.occurrence[x]"
},
{
"identity" : "v2",
"map" : "RXD-3-Date/Time Dispensed"
},
{
"identity" : "rim",
"map" : ".effectiveTime[xmi:type=IVL_TS].high"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.effectiveTime"
}]
},
{
"id" : "MedicationDispense.destination",
"path" : "MedicationDispense.destination",
"short" : "Where the medication was sent",
"definition" : "Identification of the facility/location where the medication was shipped to, as part of the dispense event.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Location"]
}],
"mapping" : [{
"identity" : "v2",
"map" : "RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address"
},
{
"identity" : "rim",
"map" : ".participation[typeCode=DST].role"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.destination"
}]
},
{
"id" : "MedicationDispense.receiver",
"path" : "MedicationDispense.receiver",
"short" : "Who collected the medication or where the medication was delivered",
"definition" : "Identifies the person who picked up the medication or the location of where the medication was delivered. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional or a location.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Location",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole"]
}],
"mapping" : [{
"identity" : "rim",
"map" : ".participation[typeCode=RCV].role"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.SupplyEvent.receiver"
}]
},
{
"id" : "MedicationDispense.note",
"path" : "MedicationDispense.note",
"short" : "Information about the dispense",
"definition" : "Extra information about the dispense that could not be conveyed in the other attributes.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Annotation"
}],
"mapping" : [{
"identity" : "workflow",
"map" : "Event.note"
},
{
"identity" : "v2",
"map" : "RXD-9 Dispense Notes"
},
{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"
}]
},
{
"id" : "MedicationDispense.renderedDosageInstruction",
"path" : "MedicationDispense.renderedDosageInstruction",
"short" : "Full representation of the dosage instructions",
"definition" : "The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.",
"comment" : "The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "string"
}],
"mapping" : [{
"identity" : "rim",
"map" : "SubstanceAdministration.text"
}]
},
{
"id" : "MedicationDispense.dosageInstruction",
"path" : "MedicationDispense.dosageInstruction",
"short" : "How the medication is to be used by the patient or administered by the caregiver",
"definition" : "Indicates how the medication is to be used by the patient.",
"comment" : "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.\rThe pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Dosage"
}],
"mapping" : [{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"
}]
},
{
"id" : "MedicationDispense.substitution",
"path" : "MedicationDispense.substitution",
"short" : "Whether a substitution was performed on the dispense",
"definition" : "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. If nothing is specified, substitution was not done.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "BackboneElement"
}],
"mapping" : [{
"identity" : "rim",
"map" : ".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade"
}]
},
{
"id" : "MedicationDispense.substitution.wasSubstituted",
"path" : "MedicationDispense.substitution.wasSubstituted",
"short" : "Whether a substitution was or was not performed on the dispense",
"definition" : "True if the dispenser dispensed a different drug or product from what was prescribed.",
"min" : 1,
"max" : "1",
"type" : [{
"code" : "boolean"
}],
"mapping" : [{
"identity" : "rim",
"map" : ".actionNegationInd"
}]
},
{
"id" : "MedicationDispense.substitution.type",
"path" : "MedicationDispense.substitution.type",
"short" : "Code signifying whether a different drug was dispensed from what was prescribed",
"definition" : "A code signifying whether a different drug was dispensed from what was prescribed.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "CodeableConcept"
}],
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationIntendedSubstitutionType"
}],
"strength" : "example",
"description" : "A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.",
"valueSet" : "http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"
},
"mapping" : [{
"identity" : "v2",
"map" : "RXO-9-Allow Substitutions / RXE-9-Substitution Status"
},
{
"identity" : "rim",
"map" : ".code"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade.code"
}]
},
{
"id" : "MedicationDispense.substitution.reason",
"path" : "MedicationDispense.substitution.reason",
"short" : "Why was substitution made",
"definition" : "Indicates the reason for the substitution (or lack of substitution) from what was prescribed.",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "CodeableConcept"
}],
"binding" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString" : "MedicationIntendedSubstitutionReason"
}],
"strength" : "example",
"description" : "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.",
"valueSet" : "http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"
},
"mapping" : [{
"identity" : "rim",
"map" : ".reasonCode"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade.reasonCode"
}]
},
{
"id" : "MedicationDispense.substitution.responsibleParty",
"path" : "MedicationDispense.substitution.responsibleParty",
"short" : "Who is responsible for the substitution",
"definition" : "The person or organization that has primary responsibility for the substitution.",
"min" : 0,
"max" : "1",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization"]
}],
"mapping" : [{
"identity" : "rim",
"map" : ".participation[typeCode=PFM].role[classCode=ASSIGN]"
},
{
"identity" : "rx-dispense-rmim",
"map" : "CombinedMedicationDispense.substitutionMade.ResponsibleParty"
}]
},
{
"id" : "MedicationDispense.detectedIssue",
"path" : "MedicationDispense.detectedIssue",
"short" : "Clinical issue with action",
"definition" : "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.",
"comment" : "This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.",
"alias" : ["Contraindication",
"Drug Utilization Review (DUR)",
"Alert"],
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/DetectedIssue"]
}],
"mapping" : [{
"identity" : "rim",
"map" : ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"
}]
},
{
"id" : "MedicationDispense.eventHistory",
"path" : "MedicationDispense.eventHistory",
"short" : "A list of relevant lifecycle events",
"definition" : "A summary of the events of interest that have occurred, such as when the dispense was verified.",
"comment" : "This might not include provenances for all versions of the request – only those deemed “relevant� or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant� change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).",
"min" : 0,
"max" : "*",
"type" : [{
"code" : "Reference",
"targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Provenance"]
}],
"mapping" : [{
"identity" : "rim",
"map" : ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
}]
}]
}
}
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.
FHIR ®© HL7.org 2011+. FHIR CI Build hl7.fhir.core#4.2.0 (GitHub f996518d66) generated on Tue, Dec 31, 2019 21:14+1100.
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