{"abstract":false,"base":"http://hl7.org/fhir/StructureDefinition/DomainResource","contact":[{"telecom":[{"system":"other","value":"http://hl7.org/fhir"}]},{"telecom":[{"system":"other","value":"http://www.hl7.org/Special/committees/medication/index.cfm"}]}],"date":"2015-10-24T07:41:03+11:00","description":"Base StructureDefinition for MedicationDispense Resource","differential":{"element":[{"constraint":[{"human":"whenHandedOver cannot be before whenPrepared","key":"mdd-1","severity":"error","xpath":"not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)"}],"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.","isSummary":true,"mapping":[{"identity":"rim","map":"Supply[moodCode=EVN]"},{"identity":"w5","map":"clinical.medication"}],"max":"*","min":0,"path":"MedicationDispense","short":"Dispensing a medication to a named patient","type":[{"code":"DomainResource"}]},{"definition":"Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.","isSummary":true,"mapping":[{"identity":"rim","map":".id"},{"identity":"w5","map":"id"}],"max":"1","min":0,"path":"MedicationDispense.identifier","short":"External identifier","type":[{"code":"Identifier"}]},{"binding":{"description":"A code specifying the state of the dispense event.","strength":"required","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/medication-dispense-status"}},"definition":"A code specifying the state of the set of dispense events.","isModifier":true,"isSummary":true,"mapping":[{"identity":"rim","map":".status"},{"identity":"w5","map":"status"}],"max":"1","min":0,"path":"MedicationDispense.status","short":"in-progress | on-hold | completed | entered-in-error | stopped","type":[{"code":"code"}]},{"comments":"SubstanceAdministration->subject->Patient.","definition":"A link to a resource representing the person to whom the medication will be given.","isSummary":true,"mapping":[{"identity":"v2","map":"PID-3-Patient ID List"},{"identity":"rim","map":".participation[typeCode=SBJ].role[classCode=PAT]"},{"identity":"w5","map":"who.focus"}],"max":"1","min":0,"path":"MedicationDispense.patient","short":"Who the dispense is for","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Patient"]}]},{"definition":"The individual responsible for dispensing the medication.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-10-Dispensing Provider / PRT-5-Participation Person: PRT-4-Participation='DP' (RXD-10 is deprecated)"},{"identity":"rim","map":".participation[typeCode=PFM].role[classCode=ASSIGN]"},{"identity":"w5","map":"who.actor"}],"max":"1","min":0,"path":"MedicationDispense.dispenser","short":"Practitioner responsible for dispensing medication","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Practitioner"]}]},{"definition":"Indicates the medication order that is being dispensed against.","isSummary":true,"mapping":[{"identity":"v2","map":"ORC-2 Placer Order Number"},{"identity":"rim","map":".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"}],"max":"*","min":0,"path":"MedicationDispense.authorizingPrescription","short":"Medication order that authorizes the dispense","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/MedicationOrder"]}]},{"binding":{"description":"Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"}},"definition":"Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-33-Dispense Type"},{"identity":"rim","map":".code"}],"max":"1","min":0,"path":"MedicationDispense.type","short":"Trial fill, partial fill, emergency fill, etc.","type":[{"code":"CodeableConcept"}]},{"definition":"The amount of medication that has been dispensed. Includes unit of measure.","isSummary":true,"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"}],"max":"1","min":0,"path":"MedicationDispense.quantity","short":"Amount dispensed","type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}]},{"definition":"The amount of medication expressed as a timing amount.","isSummary":true,"max":"1","min":0,"path":"MedicationDispense.daysSupply","short":"Days Supply","type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}]},{"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. Note: do not use Medication.name to describe the dispensed medication. When the only available information is a text description of the medication, Medication.code.text should be used.","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.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-2-Dispense/Give Code"},{"identity":"rim","map":".participation[typeCode=PRD].role"}],"max":"1","min":1,"path":"MedicationDispense.medication[x]","short":"What medication was supplied","type":[{"code":"CodeableConcept"},{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Medication"]}]},{"definition":"The time when the dispensed product was packaged and reviewed.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-3-Date/Time Dispensed"},{"identity":"rim","map":".effectiveTime[xmi:type=IVL_TS].low"}],"max":"1","min":0,"path":"MedicationDispense.whenPrepared","short":"Dispense processing time","type":[{"code":"dateTime"}]},{"definition":"The time the dispensed product was provided to the patient or their representative.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-3-Date/Time Dispensed"},{"identity":"rim","map":".effectiveTime[xmi:type=IVL_TS].high"}],"max":"1","min":0,"path":"MedicationDispense.whenHandedOver","short":"When product was given out","type":[{"code":"dateTime"}]},{"definition":"Identification of the facility/location where the medication was shipped to, as part of the dispense event.","isSummary":true,"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"}],"max":"1","min":0,"path":"MedicationDispense.destination","short":"Where the medication was sent","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Location"]}]},{"definition":"Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.","isSummary":true,"mapping":[{"identity":"rim","map":".participation[typeCode=RCV].role"}],"max":"*","min":0,"path":"MedicationDispense.receiver","short":"Who collected the medication","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Patient"]},{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Practitioner"]}]},{"definition":"Extra information about the dispense that could not be conveyed in the other attributes.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-9 Dispense Notes"}],"max":"1","min":0,"path":"MedicationDispense.note","short":"Information about the dispense","type":[{"code":"string"}]},{"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.","definition":"Indicates how the medication is to be used by the patient.","isSummary":true,"mapping":[{"identity":"rim","map":".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"}],"max":"*","min":0,"path":"MedicationDispense.dosageInstruction","short":"Medicine administration instructions to the patient/caregiver","type":[{"code":"BackboneElement"}]},{"definition":"Free text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication.","isSummary":true,"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.text","short":"Dosage Instructions","type":[{"code":"string"}]},{"binding":{"description":"Codes identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\"","strength":"example"},"definition":"Additional instructions such as \"Swallow with plenty of water\" which may or may not be coded.","isSummary":true,"mapping":[{"identity":"rim","map":".text"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.additionalInstructions","short":"E.g. \"Take with food\"","type":[{"code":"CodeableConcept"}]},{"definition":"The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example, \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".","isSummary":true,"mapping":[{"identity":"rim","map":".effectiveTime"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.timing","short":"When medication should be administered","type":[{"code":"Timing"}]},{"binding":{"description":"A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.","strength":"example"},"definition":"Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). \n\nSpecifically if 'boolean' datatype is selected, then the following logic applies: If set to True, this indicates that the medication is only taken when needed, within the specified schedule.","isSummary":true,"mapping":[{"identity":"rim","map":"boolean: .outboundRelationship[typeCode=PRCN].negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: .outboundRelationship[typCode=PRCN].target[classCode=OBS, moodCode=EVN, isCriterionInd=true, code=\"Assertion\"].value"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.asNeeded[x]","short":"Take \"as needed\" f(or x)","type":[{"code":"boolean"},{"code":"CodeableConcept"}]},{"binding":{"description":"A coded concept describing the site location the medicine enters into or onto the body","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/approach-site-codes"}},"definition":"A coded specification of the anatomic site where the medication first enters the body.","isSummary":true,"mapping":[{"identity":"v2","map":"RXR-2-Administration Site"},{"identity":"rim","map":".approachSiteCode"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.site[x]","short":"Body site to administer to","type":[{"code":"CodeableConcept"},{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/BodySite"]}]},{"binding":{"description":"A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/route-codes"}},"definition":"A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject.","isSummary":true,"mapping":[{"identity":"v2","map":"RXR-1-Route"},{"identity":"rim","map":".routeCode"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.route","short":"How drug should enter body","type":[{"code":"CodeableConcept"}]},{"binding":{"description":"A coded concept describing the technique by which the medicine is administered","strength":"example"},"comments":"This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.","definition":"A coded value indicating the method by which the medication is intended to be or was introduced into or on the body.","isSummary":true,"mapping":[{"identity":"v2","map":"RXR-4-Administration Method"},{"identity":"rim","map":".methodCode"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.method","short":"Technique for administering medication","type":[{"code":"CodeableConcept"}]},{"comments":"Note that this specifies the quantity of the specified medication, not the quantity of active ingredient(s). The prescribed strength can be calculated by multiplying the doseQuantity by the strength of each active ingredient in the prescribed Medication. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule.","definition":"The amount of therapeutic or other substance given at one administration event.","isSummary":true,"mapping":[{"identity":"v2","map":"RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name of coding system"},{"identity":"rim","map":".doseQuantity"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.dose[x]","short":"Amount of medication per dose","type":[{"code":"Range"},{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}]},{"definition":"Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.","isSummary":true,"mapping":[{"identity":"v2","map":"RXE-22-Give Per (Time Unit)"},{"identity":"rim","map":".rateQuantity"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.rate[x]","short":"Amount of medication per unit of time","type":[{"code":"Ratio"},{"code":"Range"}]},{"definition":"The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time, e.g. 1000mg in 24 hours.","isSummary":true,"mapping":[{"identity":"v2","map":"RXE-4-Give Amount - Maximum / RXE-5-Give Units"},{"identity":"rim","map":".maxDoseQuantity"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.maxDosePerPeriod","short":"Upper limit on medication per unit of time","type":[{"code":"Ratio"}]},{"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.","isSummary":true,"mapping":[{"identity":"rim","map":".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"}],"max":"1","min":0,"path":"MedicationDispense.substitution","short":"Deals with substitution of one medicine for another","type":[{"code":"BackboneElement"}]},{"binding":{"description":"A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"}},"definition":"A code signifying whether a different drug was dispensed from what was prescribed.","isSummary":true,"mapping":[{"identity":"v2","map":"RXO-9-Allow Substitutions / RXE-9-Substitution Status"},{"identity":"rim","map":".code"}],"max":"1","min":1,"path":"MedicationDispense.substitution.type","short":"Type of substitution","type":[{"code":"CodeableConcept"}]},{"binding":{"description":"A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"}},"definition":"Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.","isSummary":true,"mapping":[{"identity":"rim","map":".reasonCode"}],"max":"*","min":0,"path":"MedicationDispense.substitution.reason","short":"Why was substitution made","type":[{"code":"CodeableConcept"}]},{"definition":"The person or organization that has primary responsibility for the substitution.","isSummary":true,"mapping":[{"identity":"rim","map":".participation[typeCode=PFM].role[classCode=ASSIGN]"}],"max":"*","min":0,"path":"MedicationDispense.substitution.responsibleParty","short":"Who is responsible for the substitution","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Practitioner"]}]}]},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm","valueInteger":1}],"fhirVersion":"1.0.2","id":"MedicationDispense","kind":"resource","mapping":[{"identity":"rim","name":"RIM","uri":"http://hl7.org/v3"},{"identity":"w5","name":"W5 Mapping","uri":"http://hl7.org/fhir/w5"},{"identity":"v2","name":"HL7 v2","uri":"http://hl7.org/v2"}],"meta":{"lastUpdated":"2015-10-24T07:41:03.495+11:00"},"name":"MedicationDispense","publisher":"Health Level Seven International (Pharmacy)","resourceType":"StructureDefinition","snapshot":{"element":[{"constraint":[{"human":"whenHandedOver cannot be before whenPrepared","key":"mdd-1","severity":"error","xpath":"not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)"}],"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.","isSummary":true,"mapping":[{"identity":"rim","map":"Supply[moodCode=EVN]"},{"identity":"w5","map":"clinical.medication"}],"max":"*","min":0,"path":"MedicationDispense","short":"Dispensing a medication to a named patient","type":[{"code":"DomainResource"}]},{"comments":"The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID.","definition":"The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.","isSummary":true,"max":"1","min":0,"path":"MedicationDispense.id","short":"Logical id of this artifact","type":[{"code":"id"}]},{"definition":"The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.","isSummary":true,"max":"1","min":0,"path":"MedicationDispense.meta","short":"Metadata about the resource","type":[{"code":"Meta"}]},{"comments":"Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.","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.","isModifier":true,"isSummary":true,"max":"1","min":0,"path":"MedicationDispense.implicitRules","short":"A set of rules under which this content was created","type":[{"code":"uri"}]},{"binding":{"description":"A human language.","strength":"required","valueSetUri":"http://tools.ietf.org/html/bcp47"},"comments":"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).","definition":"The base language in which the resource is written.","max":"1","min":0,"path":"MedicationDispense.language","short":"Language of the resource content","type":[{"code":"code"}]},{"alias":["narrative","html","xhtml","display"],"comments":"Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.","condition":["dom-1"],"definition":"A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"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.","mapping":[{"identity":"rim","map":"Act.text?"}],"max":"1","min":0,"path":"MedicationDispense.text","short":"Text summary of the resource, for human interpretation","type":[{"code":"Narrative"}]},{"alias":["inline resources","anonymous resources","contained resources"],"comments":"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.","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.","mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"path":"MedicationDispense.contained","short":"Contained, inline Resources","type":[{"code":"Resource"}]},{"alias":["extensions","user content"],"comments":"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.","definition":"May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"path":"MedicationDispense.extension","short":"Additional Content defined by implementations","type":[{"code":"Extension"}]},{"alias":["extensions","user content"],"comments":"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.","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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.","isModifier":true,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"path":"MedicationDispense.modifierExtension","short":"Extensions that cannot be ignored","type":[{"code":"Extension"}]},{"definition":"Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.","isSummary":true,"mapping":[{"identity":"rim","map":".id"},{"identity":"w5","map":"id"}],"max":"1","min":0,"path":"MedicationDispense.identifier","short":"External identifier","type":[{"code":"Identifier"}]},{"binding":{"description":"A code specifying the state of the dispense event.","strength":"required","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/medication-dispense-status"}},"definition":"A code specifying the state of the set of dispense events.","isModifier":true,"isSummary":true,"mapping":[{"identity":"rim","map":".status"},{"identity":"w5","map":"status"}],"max":"1","min":0,"path":"MedicationDispense.status","short":"in-progress | on-hold | completed | entered-in-error | stopped","type":[{"code":"code"}]},{"comments":"SubstanceAdministration->subject->Patient.","definition":"A link to a resource representing the person to whom the medication will be given.","isSummary":true,"mapping":[{"identity":"v2","map":"PID-3-Patient ID List"},{"identity":"rim","map":".participation[typeCode=SBJ].role[classCode=PAT]"},{"identity":"w5","map":"who.focus"}],"max":"1","min":0,"path":"MedicationDispense.patient","short":"Who the dispense is for","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Patient"]}]},{"definition":"The individual responsible for dispensing the medication.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-10-Dispensing Provider / PRT-5-Participation Person: PRT-4-Participation='DP' (RXD-10 is deprecated)"},{"identity":"rim","map":".participation[typeCode=PFM].role[classCode=ASSIGN]"},{"identity":"w5","map":"who.actor"}],"max":"1","min":0,"path":"MedicationDispense.dispenser","short":"Practitioner responsible for dispensing medication","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Practitioner"]}]},{"definition":"Indicates the medication order that is being dispensed against.","isSummary":true,"mapping":[{"identity":"v2","map":"ORC-2 Placer Order Number"},{"identity":"rim","map":".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"}],"max":"*","min":0,"path":"MedicationDispense.authorizingPrescription","short":"Medication order that authorizes the dispense","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/MedicationOrder"]}]},{"binding":{"description":"Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"}},"definition":"Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-33-Dispense Type"},{"identity":"rim","map":".code"}],"max":"1","min":0,"path":"MedicationDispense.type","short":"Trial fill, partial fill, emergency fill, etc.","type":[{"code":"CodeableConcept"}]},{"definition":"The amount of medication that has been dispensed. Includes unit of measure.","isSummary":true,"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"}],"max":"1","min":0,"path":"MedicationDispense.quantity","short":"Amount dispensed","type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}]},{"definition":"The amount of medication expressed as a timing amount.","isSummary":true,"max":"1","min":0,"path":"MedicationDispense.daysSupply","short":"Days Supply","type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}]},{"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. Note: do not use Medication.name to describe the dispensed medication. When the only available information is a text description of the medication, Medication.code.text should be used.","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.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-2-Dispense/Give Code"},{"identity":"rim","map":".participation[typeCode=PRD].role"}],"max":"1","min":1,"path":"MedicationDispense.medication[x]","short":"What medication was supplied","type":[{"code":"CodeableConcept"},{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Medication"]}]},{"definition":"The time when the dispensed product was packaged and reviewed.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-3-Date/Time Dispensed"},{"identity":"rim","map":".effectiveTime[xmi:type=IVL_TS].low"}],"max":"1","min":0,"path":"MedicationDispense.whenPrepared","short":"Dispense processing time","type":[{"code":"dateTime"}]},{"definition":"The time the dispensed product was provided to the patient or their representative.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-3-Date/Time Dispensed"},{"identity":"rim","map":".effectiveTime[xmi:type=IVL_TS].high"}],"max":"1","min":0,"path":"MedicationDispense.whenHandedOver","short":"When product was given out","type":[{"code":"dateTime"}]},{"definition":"Identification of the facility/location where the medication was shipped to, as part of the dispense event.","isSummary":true,"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"}],"max":"1","min":0,"path":"MedicationDispense.destination","short":"Where the medication was sent","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Location"]}]},{"definition":"Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.","isSummary":true,"mapping":[{"identity":"rim","map":".participation[typeCode=RCV].role"}],"max":"*","min":0,"path":"MedicationDispense.receiver","short":"Who collected the medication","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Patient"]},{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Practitioner"]}]},{"definition":"Extra information about the dispense that could not be conveyed in the other attributes.","isSummary":true,"mapping":[{"identity":"v2","map":"RXD-9 Dispense Notes"}],"max":"1","min":0,"path":"MedicationDispense.note","short":"Information about the dispense","type":[{"code":"string"}]},{"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.","definition":"Indicates how the medication is to be used by the patient.","isSummary":true,"mapping":[{"identity":"rim","map":".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"}],"max":"*","min":0,"path":"MedicationDispense.dosageInstruction","short":"Medicine administration instructions to the patient/caregiver","type":[{"code":"BackboneElement"}]},{"definition":"unique id for the element within a resource (for internal references).","mapping":[{"identity":"rim","map":"n/a"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.id","representation":["xmlAttr"],"short":"xml:id (or equivalent in JSON)","type":[{"code":"id"}]},{"alias":["extensions","user content"],"comments":"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.","definition":"May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","mapping":[{"identity":"rim","map":"n/a"}],"max":"*","min":0,"path":"MedicationDispense.dosageInstruction.extension","short":"Additional Content defined by implementations","type":[{"code":"Extension"}]},{"alias":["extensions","user content","modifiers"],"comments":"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.","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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.","isModifier":true,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"path":"MedicationDispense.dosageInstruction.modifierExtension","short":"Extensions that cannot be ignored","type":[{"code":"Extension"}]},{"definition":"Free text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication.","isSummary":true,"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.text","short":"Dosage Instructions","type":[{"code":"string"}]},{"binding":{"description":"Codes identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\"","strength":"example"},"definition":"Additional instructions such as \"Swallow with plenty of water\" which may or may not be coded.","isSummary":true,"mapping":[{"identity":"rim","map":".text"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.additionalInstructions","short":"E.g. \"Take with food\"","type":[{"code":"CodeableConcept"}]},{"definition":"The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example, \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".","isSummary":true,"mapping":[{"identity":"rim","map":".effectiveTime"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.timing","short":"When medication should be administered","type":[{"code":"Timing"}]},{"binding":{"description":"A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.","strength":"example"},"definition":"Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). \n\nSpecifically if 'boolean' datatype is selected, then the following logic applies: If set to True, this indicates that the medication is only taken when needed, within the specified schedule.","isSummary":true,"mapping":[{"identity":"rim","map":"boolean: .outboundRelationship[typeCode=PRCN].negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: .outboundRelationship[typCode=PRCN].target[classCode=OBS, moodCode=EVN, isCriterionInd=true, code=\"Assertion\"].value"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.asNeeded[x]","short":"Take \"as needed\" f(or x)","type":[{"code":"boolean"},{"code":"CodeableConcept"}]},{"binding":{"description":"A coded concept describing the site location the medicine enters into or onto the body","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/approach-site-codes"}},"definition":"A coded specification of the anatomic site where the medication first enters the body.","isSummary":true,"mapping":[{"identity":"v2","map":"RXR-2-Administration Site"},{"identity":"rim","map":".approachSiteCode"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.site[x]","short":"Body site to administer to","type":[{"code":"CodeableConcept"},{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/BodySite"]}]},{"binding":{"description":"A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/route-codes"}},"definition":"A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject.","isSummary":true,"mapping":[{"identity":"v2","map":"RXR-1-Route"},{"identity":"rim","map":".routeCode"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.route","short":"How drug should enter body","type":[{"code":"CodeableConcept"}]},{"binding":{"description":"A coded concept describing the technique by which the medicine is administered","strength":"example"},"comments":"This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.","definition":"A coded value indicating the method by which the medication is intended to be or was introduced into or on the body.","isSummary":true,"mapping":[{"identity":"v2","map":"RXR-4-Administration Method"},{"identity":"rim","map":".methodCode"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.method","short":"Technique for administering medication","type":[{"code":"CodeableConcept"}]},{"comments":"Note that this specifies the quantity of the specified medication, not the quantity of active ingredient(s). The prescribed strength can be calculated by multiplying the doseQuantity by the strength of each active ingredient in the prescribed Medication. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule.","definition":"The amount of therapeutic or other substance given at one administration event.","isSummary":true,"mapping":[{"identity":"v2","map":"RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name of coding system"},{"identity":"rim","map":".doseQuantity"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.dose[x]","short":"Amount of medication per dose","type":[{"code":"Range"},{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}]},{"definition":"Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.","isSummary":true,"mapping":[{"identity":"v2","map":"RXE-22-Give Per (Time Unit)"},{"identity":"rim","map":".rateQuantity"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.rate[x]","short":"Amount of medication per unit of time","type":[{"code":"Ratio"},{"code":"Range"}]},{"definition":"The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time, e.g. 1000mg in 24 hours.","isSummary":true,"mapping":[{"identity":"v2","map":"RXE-4-Give Amount - Maximum / RXE-5-Give Units"},{"identity":"rim","map":".maxDoseQuantity"}],"max":"1","min":0,"path":"MedicationDispense.dosageInstruction.maxDosePerPeriod","short":"Upper limit on medication per unit of time","type":[{"code":"Ratio"}]},{"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.","isSummary":true,"mapping":[{"identity":"rim","map":".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"}],"max":"1","min":0,"path":"MedicationDispense.substitution","short":"Deals with substitution of one medicine for another","type":[{"code":"BackboneElement"}]},{"definition":"unique id for the element within a resource (for internal references).","mapping":[{"identity":"rim","map":"n/a"}],"max":"1","min":0,"path":"MedicationDispense.substitution.id","representation":["xmlAttr"],"short":"xml:id (or equivalent in JSON)","type":[{"code":"id"}]},{"alias":["extensions","user content"],"comments":"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.","definition":"May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","mapping":[{"identity":"rim","map":"n/a"}],"max":"*","min":0,"path":"MedicationDispense.substitution.extension","short":"Additional Content defined by implementations","type":[{"code":"Extension"}]},{"alias":["extensions","user content","modifiers"],"comments":"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.","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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.","isModifier":true,"mapping":[{"identity":"rim","map":"N/A"}],"max":"*","min":0,"path":"MedicationDispense.substitution.modifierExtension","short":"Extensions that cannot be ignored","type":[{"code":"Extension"}]},{"binding":{"description":"A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"}},"definition":"A code signifying whether a different drug was dispensed from what was prescribed.","isSummary":true,"mapping":[{"identity":"v2","map":"RXO-9-Allow Substitutions / RXE-9-Substitution Status"},{"identity":"rim","map":".code"}],"max":"1","min":1,"path":"MedicationDispense.substitution.type","short":"Type of substitution","type":[{"code":"CodeableConcept"}]},{"binding":{"description":"A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed","strength":"example","valueSetReference":{"reference":"http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"}},"definition":"Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.","isSummary":true,"mapping":[{"identity":"rim","map":".reasonCode"}],"max":"*","min":0,"path":"MedicationDispense.substitution.reason","short":"Why was substitution made","type":[{"code":"CodeableConcept"}]},{"definition":"The person or organization that has primary responsibility for the substitution.","isSummary":true,"mapping":[{"identity":"rim","map":".participation[typeCode=PFM].role[classCode=ASSIGN]"}],"max":"*","min":0,"path":"MedicationDispense.substitution.responsibleParty","short":"Who is responsible for the substitution","type":[{"code":"Reference","profile":["http://hl7.org/fhir/StructureDefinition/Practitioner"]}]}]},"status":"draft","text":{"div":"
\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\" MedicationDispense Σ IDomainResourceDispensing a medication to a named patient
whenHandedOver cannot be before whenPrepared
\".\"\".\"\".\" identifier Σ0..1IdentifierExternal identifier
\".\"\".\"\".\" status ?! Σ0..1codein-progress | on-hold | completed | entered-in-error | stopped
MedicationDispenseStatus (Required)
\".\"\".\"\".\" patient Σ0..1Reference(Patient)Who the dispense is for
\".\"\".\"\".\" dispenser Σ0..1Reference(Practitioner)Practitioner responsible for dispensing medication
\".\"\".\"\".\" authorizingPrescription Σ0..*Reference(MedicationOrder)Medication order that authorizes the dispense
\".\"\".\"\".\" type Σ0..1CodeableConceptTrial fill, partial fill, emergency fill, etc.
ActPharmacySupplyType (Example)
\".\"\".\"\".\" quantity Σ0..1SimpleQuantityAmount dispensed
\".\"\".\"\".\" daysSupply Σ0..1SimpleQuantityDays Supply
\".\"\".\"\".\" medication[x] Σ1..1What medication was supplied
\".\"\".\"\".\"\".\" medicationCodeableConceptCodeableConcept
\".\"\".\"\".\"\".\" medicationReferenceReference(Medication)
\".\"\".\"\".\" whenPrepared Σ0..1dateTimeDispense processing time
\".\"\".\"\".\" whenHandedOver Σ0..1dateTimeWhen product was given out
\".\"\".\"\".\" destination Σ0..1Reference(Location)Where the medication was sent
\".\"\".\"\".\" receiver Σ0..*Reference(Patient | Practitioner)Who collected the medication
\".\"\".\"\".\" note Σ0..1stringInformation about the dispense
\".\"\".\"\".\" dosageInstruction Σ0..*BackboneElementMedicine administration instructions to the patient/caregiver
\".\"\".\"\".\"\".\" text Σ0..1stringDosage Instructions
\".\"\".\"\".\"\".\" additionalInstructions Σ0..1CodeableConceptE.g. "Take with food"
\".\"\".\"\".\"\".\" timing Σ0..1TimingWhen medication should be administered
\".\"\".\"\".\"\".\" asNeeded[x] Σ0..1Take "as needed" f(or x)
\".\"\".\"\".\"\".\"\".\" asNeededBooleanboolean
\".\"\".\"\".\"\".\"\".\" asNeededCodeableConceptCodeableConcept
\".\"\".\"\".\"\".\" site[x] Σ0..1Body site to administer to
SNOMED CT Anatomical Structure for Administration Site Codes (Example)
\".\"\".\"\".\"\".\"\".\" siteCodeableConceptCodeableConcept
\".\"\".\"\".\"\".\"\".\" siteReferenceReference(BodySite)
\".\"\".\"\".\"\".\" route Σ0..1CodeableConceptHow drug should enter body
SNOMED CT Route Codes (Example)
\".\"\".\"\".\"\".\" method Σ0..1CodeableConceptTechnique for administering medication
\".\"\".\"\".\"\".\" dose[x] Σ0..1Amount of medication per dose
\".\"\".\"\".\"\".\"\".\" doseRangeRange
\".\"\".\"\".\"\".\"\".\" doseQuantitySimpleQuantity
\".\"\".\"\".\"\".\" rate[x] Σ0..1Amount of medication per unit of time
\".\"\".\"\".\"\".\"\".\" rateRatioRatio
\".\"\".\"\".\"\".\"\".\" rateRangeRange
\".\"\".\"\".\"\".\" maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
\".\"\".\"\".\" substitution Σ0..1BackboneElementDeals with substitution of one medicine for another
\".\"\".\"\".\"\".\" type Σ1..1CodeableConceptType of substitution
ActSubstanceAdminSubstitutionCode (Example)
\".\"\".\"\".\"\".\" reason Σ0..*CodeableConceptWhy was substitution made
SubstanceAdminSubstitutionReason (Example)
\".\"\".\"\".\"\".\" responsibleParty Σ0..*Reference(Practitioner)Who is responsible for the substitution

\"doco\" Documentation for this format
","status":"generated"},"url":"http://hl7.org/fhir/StructureDefinition/MedicationDispense"}