This page is part of the FHIR Specification (v4.4.0: R5 Preview #2). 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: 2 | Trial Use | Security Category: Patient | Compartments: Encounter, Patient, Practitioner |
Detailed Descriptions for the elements in the MedicationDispense resource.
MedicationDispense | |||||||||
Element Id | MedicationDispense | ||||||||
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. | ||||||||
Cardinality | 0..* | ||||||||
Type | DomainResource | ||||||||
Invariants |
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MedicationDispense.identifier | |||||||||
Element Id | MedicationDispense.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. | ||||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||||
Cardinality | 0..* | ||||||||
Type | Identifier | ||||||||
Comments | This is a business identifier, not a resource identifier. | ||||||||
MedicationDispense.basedOn | |||||||||
Element Id | MedicationDispense.basedOn | ||||||||
Definition | A plan that is fulfilled in whole or in part by this MedicationDispense. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(CarePlan) | ||||||||
MedicationDispense.partOf | |||||||||
Element Id | MedicationDispense.partOf | ||||||||
Definition | The procedure that trigger the dispense. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(Procedure) | ||||||||
MedicationDispense.status | |||||||||
Element Id | MedicationDispense.status | ||||||||
Definition | A code specifying the state of the set of dispense events. | ||||||||
Cardinality | 1..1 | ||||||||
Terminology Binding | Medication dispense status codes (Required) | ||||||||
Type | code | ||||||||
Is Modifier | true (Reason: 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) | ||||||||
Summary | true | ||||||||
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||||||||
MedicationDispense.statusReason | |||||||||
Element Id | MedicationDispense.statusReason | ||||||||
Definition | Indicates the reason why a dispense was not performed. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Medication dispense status reason codes (Example) | ||||||||
Type | CodeableReference(DetectedIssue) | ||||||||
MedicationDispense.category | |||||||||
Element Id | MedicationDispense.category | ||||||||
Definition | Indicates the type of medication dispense (for example, drug classification like ATC, where meds would be administered, legal category of the medication.). | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | Medication dispense administration location codes (Example) | ||||||||
Type | CodeableConcept | ||||||||
Comments | 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. | ||||||||
MedicationDispense.medication | |||||||||
Element Id | MedicationDispense.medication | ||||||||
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. | ||||||||
Cardinality | 1..1 | ||||||||
Terminology Binding | SNOMED CT Medication Codes (Example) | ||||||||
Type | CodeableReference(Medication) | ||||||||
Summary | true | ||||||||
Comments | 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. | ||||||||
MedicationDispense.subject | |||||||||
Element Id | MedicationDispense.subject | ||||||||
Definition | A link to a resource representing the person or the group to whom the medication will be given. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Patient | Group) | ||||||||
Patterns | Reference(Patient,Group): Common patterns = Participant | ||||||||
Summary | true | ||||||||
Comments | SubstanceAdministration->subject->Patient. | ||||||||
MedicationDispense.encounter | |||||||||
Element Id | MedicationDispense.encounter | ||||||||
Definition | The encounter that establishes the context for this event. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Encounter) | ||||||||
MedicationDispense.supportingInformation | |||||||||
Element Id | MedicationDispense.supportingInformation | ||||||||
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. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(Any) | ||||||||
MedicationDispense.performer | |||||||||
Element Id | MedicationDispense.performer | ||||||||
Definition | Indicates who or what performed the event. | ||||||||
Cardinality | 0..* | ||||||||
MedicationDispense.performer.function | |||||||||
Element Id | MedicationDispense.performer.function | ||||||||
Definition | Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Medication dispense performer function codes (Example) | ||||||||
Type | CodeableConcept | ||||||||
Requirements | Allows disambiguation of the types of involvement of different performers. | ||||||||
MedicationDispense.performer.actor | |||||||||
Element Id | MedicationDispense.performer.actor | ||||||||
Definition | The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. | ||||||||
Cardinality | 1..1 | ||||||||
Type | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | ||||||||
Patterns | Reference(Practitioner,PractitionerRole,Organization,Patient,Device,RelatedPerson,CareTeam): Common patterns = Participant | ||||||||
MedicationDispense.location | |||||||||
Element Id | MedicationDispense.location | ||||||||
Definition | The principal physical location where the dispense was performed. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Location) | ||||||||
MedicationDispense.authorizingPrescription | |||||||||
Element Id | MedicationDispense.authorizingPrescription | ||||||||
Definition | Indicates the medication order that is being dispensed against. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(MedicationRequest) | ||||||||
Comments | Maps to basedOn in Event logical model. | ||||||||
MedicationDispense.type | |||||||||
Element Id | MedicationDispense.type | ||||||||
Definition | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | V3 Value SetActPharmacySupplyType (Example) | ||||||||
Type | CodeableConcept | ||||||||
MedicationDispense.quantity | |||||||||
Element Id | MedicationDispense.quantity | ||||||||
Definition | The amount of medication that has been dispensed. Includes unit of measure. | ||||||||
Cardinality | 0..1 | ||||||||
Type | SimpleQuantity | ||||||||
MedicationDispense.daysSupply | |||||||||
Element Id | MedicationDispense.daysSupply | ||||||||
Definition | The amount of medication expressed as a timing amount. | ||||||||
Cardinality | 0..1 | ||||||||
Type | SimpleQuantity | ||||||||
MedicationDispense.whenPrepared | |||||||||
Element Id | MedicationDispense.whenPrepared | ||||||||
Definition | The time when the dispensed product was packaged and reviewed. | ||||||||
Cardinality | 0..1 | ||||||||
Type | dateTime | ||||||||
Summary | true | ||||||||
MedicationDispense.whenHandedOver | |||||||||
Element Id | MedicationDispense.whenHandedOver | ||||||||
Definition | The time the dispensed product was provided to the patient or their representative. | ||||||||
Cardinality | 0..1 | ||||||||
Type | dateTime | ||||||||
MedicationDispense.destination | |||||||||
Element Id | MedicationDispense.destination | ||||||||
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Location) | ||||||||
MedicationDispense.receiver | |||||||||
Element Id | MedicationDispense.receiver | ||||||||
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. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole) | ||||||||
Patterns | Reference(Patient,Practitioner,RelatedPerson,Location,PractitionerRole): Common patterns = Participant | ||||||||
MedicationDispense.note | |||||||||
Element Id | MedicationDispense.note | ||||||||
Definition | Extra information about the dispense that could not be conveyed in the other attributes. | ||||||||
Cardinality | 0..* | ||||||||
Type | Annotation | ||||||||
MedicationDispense.renderedDosageInstruction | |||||||||
Element Id | MedicationDispense.renderedDosageInstruction | ||||||||
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. | ||||||||
Cardinality | 0..1 | ||||||||
Type | string | ||||||||
Comments | The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content. | ||||||||
MedicationDispense.dosageInstruction | |||||||||
Element Id | MedicationDispense.dosageInstruction | ||||||||
Definition | Indicates how the medication is to be used by the patient. | ||||||||
Cardinality | 0..* | ||||||||
Type | Dosage | ||||||||
Comments | 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. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed. | ||||||||
MedicationDispense.substitution | |||||||||
Element Id | MedicationDispense.substitution | ||||||||
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. | ||||||||
Cardinality | 0..1 | ||||||||
MedicationDispense.substitution.wasSubstituted | |||||||||
Element Id | MedicationDispense.substitution.wasSubstituted | ||||||||
Definition | True if the dispenser dispensed a different drug or product from what was prescribed. | ||||||||
Cardinality | 1..1 | ||||||||
Type | boolean | ||||||||
MedicationDispense.substitution.type | |||||||||
Element Id | MedicationDispense.substitution.type | ||||||||
Definition | A code signifying whether a different drug was dispensed from what was prescribed. | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | V3 Value SetActSubstanceAdminSubstitutionCode (Example) | ||||||||
Type | CodeableConcept | ||||||||
MedicationDispense.substitution.reason | |||||||||
Element Id | MedicationDispense.substitution.reason | ||||||||
Definition | Indicates the reason for the substitution (or lack of substitution) from what was prescribed. | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | V3 Value SetSubstanceAdminSubstitutionReason (Example) | ||||||||
Type | CodeableConcept | ||||||||
MedicationDispense.substitution.responsibleParty | |||||||||
Element Id | MedicationDispense.substitution.responsibleParty | ||||||||
Definition | The person or organization that has primary responsibility for the substitution. | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Practitioner | PractitionerRole | Organization) | ||||||||
Patterns | Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant | ||||||||
MedicationDispense.detectedIssue | |||||||||
Element Id | MedicationDispense.detectedIssue | ||||||||
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. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(DetectedIssue) | ||||||||
Alternate Names | Contraindication; Drug Utilization Review (DUR); Alert | ||||||||
Comments | 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. | ||||||||
MedicationDispense.eventHistory | |||||||||
Element Id | MedicationDispense.eventHistory | ||||||||
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified. | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(Provenance) | ||||||||
Comments | 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.). |