This page is part of the US-Medication FHIR IG (v0.0.1: STU 1 Ballot 1) based on FHIR v1.8.0. The current version which supercedes this version is 1.2.0. For a full list of available versions, see the Directory of published versions
Definitions for the StructureDefinition-medicationdispense Profile.
MedicationDispense(US CoreMedicationDispense) | |
Definition | Dispense that a medication is/was actively taken by a patient. |
Control | 0..* |
Comments | The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html). |
Invariants | Defined on this element dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (xpath: not(parent::f:contained and f:text)) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (xpath: not(parent::f:contained and f:contained)) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (xpath: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (xpath: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))) mdd-1: whenHandedOver cannot be before whenPrepared (xpath: not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)) |
MedicationDispense.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Control | 0..1 |
Type | id |
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. |
MedicationDispense.meta | |
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. |
Control | 0..1 |
Type | Meta |
MedicationDispense.implicitRules | |
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. |
Control | 0..1 |
Type | uri |
Is Modifier | true |
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. |
MedicationDispense.language | |
Definition | The base language in which the resource is written. |
Control | 0..1 |
Binding | A human language. The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable |
Type | code |
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). |
MedicationDispense.text | |
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. |
Control | 0..1 This element is affected by the following invariants: dom-1 |
Type | Narrative |
Alternate Names | narrative, html, xhtml, display |
Comments | 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 in formation is added later. |
MedicationDispense.contained | |
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. |
Control | 0..* |
Type | Resource |
Alternate Names | 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. |
MedicationDispense.extension | |
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. |
Control | 0..* |
Type | Extension |
Alternate Names | 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. |
MedicationDispense.modifierExtension | |
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. |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Alternate Names | 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. |
MedicationDispense.identifier | |
Definition | Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR. |
Note | This is a business identifer, not a resource identifier (see discussion) |
Control | 0..1 |
Type | Identifier |
MedicationDispense.status | |
Definition | A code specifying the state of the set of dispense events. |
Control | 1..1 |
Binding | A set of codes indicating the current status of a MedicationDispense. The codes SHALL be taken from http://hl7.org/fhir/ValueSet/medication-Dispense-status |
Type | code |
Is Modifier | true |
Must Support | true |
MedicationDispense.medication[x] | |
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. |
Control | 1..1 |
Binding | Prescribable medications The codes SHALL be taken from Medication Clinical Drug (RxNorm); other codes may be used where these codes are not suitable |
Type | Choice of: CodeableConcept, Reference(US Core Medication Profile) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | 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. 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. |
MedicationDispense.patient | |
Definition | A link to a resource representing the person to whom the medication will be given. |
Control | 1..1 |
Type | Reference(US Core Patient Profile) |
Must Support | true |
Comments | SubstanceAdministration->subject->Patient. |
MedicationDispense.supportingInformation | |
Definition | Additional information that supports the medication being dispensed. |
Control | 0..* |
Type | Reference(Resource) |
MedicationDispense.dispenser | |
Definition | The individual responsible for dispensing the medication. |
Control | 0..1 |
Type | Reference(US Core Practitioner) |
Must Support | true |
MedicationDispense.dispensingOrganization | |
Definition | The organizaation responsible for the dispense of the medication. |
Control | 0..1 |
Type | Reference(US Core Organization Profile) |
Must Support | true |
MedicationDispense.authorizingPrescription | |
Definition | Indicates the medication order that is being dispensed against. |
Control | 0..* |
Type | Reference(MedicationRequest) |
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. |
Control | 0..1 |
Binding | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. For example codes, see ActPharmacySupplyType |
Type | CodeableConcept |
MedicationDispense.quantity | |
Definition | The amount of medication that has been dispensed. Includes unit of measure. |
Control | 0..1 |
Type | Quantity(SimpleQuantity) |
MedicationDispense.daysSupply | |
Definition | The amount of medication expressed as a timing amount. |
Control | 0..1 |
Type | Quantity(SimpleQuantity) |
MedicationDispense.whenPrepared | |
Definition | The time when the dispensed product was packaged and reviewed. |
Control | 0..1 |
Type | dateTime |
MedicationDispense.whenHandedOver | |
Definition | The time the dispensed product was provided to the patient or their representative. |
Control | 1..1 |
Type | dateTime |
Must Support | true |
MedicationDispense.destination | |
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event. |
Control | 0..1 |
Type | Reference(Location) |
MedicationDispense.receiver | |
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. |
Control | 0..* |
Type | Choice of: Reference(Patient), Reference(Practitioner) |
MedicationDispense.note | |
Definition | Extra information about the dispense that could not be conveyed in the other attributes. |
Control | 0..* |
Type | Annotation |
MedicationDispense.dosageInstruction | |
Definition | Indicates how the medication is to be used by the patient. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed. |
Control | 0..1 |
Type | DosageInstruction |
Must Support | true |
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. |
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. |
Control | 0..1 |
Type | BackboneElement |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div) |
MedicationDispense.substitution.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
MedicationDispense.substitution.extension | |
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. |
Control | 0..* |
Type | Extension |
Alternate Names | 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. |
MedicationDispense.substitution.modifierExtension | |
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. |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Alternate Names | 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. |
MedicationDispense.substitution.type | |
Definition | A code signifying whether a different drug was dispensed from what was prescribed. |
Control | 1..1 |
Binding | A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription For example codes, see ActSubstanceAdminSubstitutionCode |
Type | CodeableConcept |
MedicationDispense.substitution.reason | |
Definition | Indicates the reason for the substitution of (or lack of substitution) from what was prescribed. |
Control | 0..* |
Binding | A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed For example codes, see SubstanceAdminSubstitutionReason |
Type | CodeableConcept |
MedicationDispense.substitution.responsibleParty | |
Definition | The person or organization that has primary responsibility for the substitution. |
Control | 0..* |
Type | Reference(Practitioner) |
MedicationDispense.eventHistory | |
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified. |
Control | 0..* |
Type | Reference(Provenance) |
Comments | See usage notes in Request pattern in request history. |