QI-Core Implementation Guide
4.1.1 - STU 4.1.1 US

This page is part of the Quality Improvement Core Framework (v4.1.1: STU 4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: QICoreMedicationDispense

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationdispense Version: 4.1.1
Draft as of 2018-08-22 Computable Name: QICoreMedicationDispense

Profile of MedicationDispense for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

To create an expression specifically requesting information that a MedicationDispense intentionally did not occur for a medical, patient or system reason, use the profile QICore-medicationnotdispensed.

The MedicationDispense and MedicationDispenseNotDone profiles represent the positive and negative statements for a medication dispensing event. To ensure instances retrieved meet positive intent, applications should check the status element as illustrated in this example:

define MedicationDispense:
  [MedicationDispense] D
    where D.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }

The following example illustrates the use of the MedicationDispense profile

// connectathon/fhir4/cql/AdvancedIllnessandFrailtyExclusion_FHIR4-4.0.000.cql
define "Dementia Medications Dispensed":
  ["MedicationDispense": "Dementia Medications"] MedicationDispense
    where MedicationDispense.status in { 'active', 'completed', 'on-hold' }

See the patterns page for implementation and usage patterns.

Examples

Penicillin MedicationDispense Example

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from MedicationDispense

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense 0..*MedicationDispenseDispensing a medication to a named patient
... status S1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
... statusReason[x] S0..1CodeableConcept, Reference(DetectedIssue)Why a dispense was not performed
... medication[x] S1..1CodeableConcept, Reference(Medication)What medication was supplied
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

... authorizingPrescription 0..*Reference(QICoreMedicationRequest)Medication order that authorizes the dispense
... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared S0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver S0..1dateTimeWhen product was given out
... destination 0..1Reference(QICoreLocation)Where the medication was sent
... receiver 0..*Reference(QICorePatient | QICorePractitioner)Who collected the medication
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... timing S0..1TimingWhen medication should be administered
.... site 0..1CodeableConceptBody site to administer to
.... route S0..1CodeableConceptHow drug should enter body
.... doseAndRate S0..*ElementAmount of medication administered
..... type S1..1CodeableConceptThe kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] S0..1Range, SimpleQuantityAmount of medication per dose
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... responsibleParty 0..*Reference(QICorePractitioner)Who is responsible for the substitution

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense I0..*MedicationDispenseDispensing a medication to a named patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!SΣ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

... statusReason[x] S0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category 0..1CodeableConceptType of medication dispense
Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.

... medication[x] SΣ1..1What medication was supplied
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject SΣ0..1Reference(QICorePatient)Who the dispense is for
... context 0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation 0..*Reference(Resource)Information that supports the dispensing of the medication
... performer 0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptWho performed the dispense and what they did
Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.

.... actor 1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)Individual who was performing
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription 0..*Reference(QICoreMedicationRequest)Medication order that authorizes the dispense
... type 0..1CodeableConceptTrial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared SΣ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver S0..1dateTimeWhen product was given out
... destination 0..1Reference(QICoreLocation)Where the medication was sent
... receiver 0..*Reference(QICorePatient | QICorePractitioner)Who collected the medication
... note 0..*AnnotationInformation about the dispense
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text Σ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): 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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route SΣ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type SΣ1..1CodeableConceptThe kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] SΣ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

.... reason 0..*CodeableConceptWhy was substitution made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.


.... responsibleParty 0..*Reference(QICorePractitioner)Who is responsible for the substitution
... detectedIssue 0..*Reference(DetectedIssue)Clinical issue with action
... eventHistory 0..*Reference(Provenance)A list of relevant lifecycle events

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense I0..*MedicationDispenseDispensing a medication to a named patient
... status ?!Σ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

... statusReason[x] 0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... medication[x] Σ1..1What medication was supplied
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... quantity 0..1SimpleQuantityAmount dispensed
... daysSupply 0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver 0..1dateTimeWhen product was given out
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... timing Σ0..1TimingWhen medication should be administered
.... route Σ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... doseAndRate Σ0..*ElementAmount of medication administered
..... type Σ1..1CodeableConceptThe kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)

doco Documentation for this format

Differential View

This structure is derived from MedicationDispense

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense 0..*MedicationDispenseDispensing a medication to a named patient
... status S1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
... statusReason[x] S0..1CodeableConcept, Reference(DetectedIssue)Why a dispense was not performed
... medication[x] S1..1CodeableConcept, Reference(Medication)What medication was supplied
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

... authorizingPrescription 0..*Reference(QICoreMedicationRequest)Medication order that authorizes the dispense
... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared S0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver S0..1dateTimeWhen product was given out
... destination 0..1Reference(QICoreLocation)Where the medication was sent
... receiver 0..*Reference(QICorePatient | QICorePractitioner)Who collected the medication
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... timing S0..1TimingWhen medication should be administered
.... site 0..1CodeableConceptBody site to administer to
.... route S0..1CodeableConceptHow drug should enter body
.... doseAndRate S0..*ElementAmount of medication administered
..... type S1..1CodeableConceptThe kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] S0..1Range, SimpleQuantityAmount of medication per dose
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... responsibleParty 0..*Reference(QICorePractitioner)Who is responsible for the substitution

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense I0..*MedicationDispenseDispensing a medication to a named patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!SΣ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

... statusReason[x] S0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category 0..1CodeableConceptType of medication dispense
Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.

... medication[x] SΣ1..1What medication was supplied
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject SΣ0..1Reference(QICorePatient)Who the dispense is for
... context 0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation 0..*Reference(Resource)Information that supports the dispensing of the medication
... performer 0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptWho performed the dispense and what they did
Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.

.... actor 1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)Individual who was performing
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription 0..*Reference(QICoreMedicationRequest)Medication order that authorizes the dispense
... type 0..1CodeableConceptTrial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared SΣ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver S0..1dateTimeWhen product was given out
... destination 0..1Reference(QICoreLocation)Where the medication was sent
... receiver 0..*Reference(QICorePatient | QICorePractitioner)Who collected the medication
... note 0..*AnnotationInformation about the dispense
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text Σ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): 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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route SΣ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type SΣ1..1CodeableConceptThe kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] SΣ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

.... reason 0..*CodeableConceptWhy was substitution made
Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.


.... responsibleParty 0..*Reference(QICorePractitioner)Who is responsible for the substitution
... detectedIssue 0..*Reference(DetectedIssue)Clinical issue with action
... eventHistory 0..*Reference(Provenance)A list of relevant lifecycle events

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
MedicationDispense.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationDispense.statusrequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
MedicationDispense.categorypreferredMedicationDispense Category Codes
MedicationDispense.medication[x]preferredUSCoreMedicationCodes
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
MedicationDispense.typeexampleActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
MedicationDispense.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
MedicationDispense.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationDispense.dosageInstruction.routeexampleSNOMEDCTRouteCodes
MedicationDispense.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
MedicationDispense.dosageInstruction.doseAndRate.typepreferredQICoreMedicationDoseType
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonexampleSubstanceAdminSubstitutionReason

Constraints

IdGradePathDetailsRequirements
dom-2errorMedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationDispenseIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6Best PracticeMedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
mdd-1errorMedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
ele-1errorMedicationDispense.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.statusReason[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.medication[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.contextAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.supportingInformationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.performer.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.performer.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.performer.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.performer.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.performer.functionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.performer.actorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.locationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.authorizingPrescriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.quantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.daysSupplyAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.whenPreparedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.whenHandedOverAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.destinationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.receiverAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.dosageInstruction.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.dosageInstruction.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.dosageInstruction.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.dosageInstruction.sequenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.additionalInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.patientInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.timingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.asNeeded[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.siteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.routeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.methodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.doseAndRateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.doseAndRate.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.dosageInstruction.doseAndRate.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.dosageInstruction.doseAndRate.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.doseAndRate.dose[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.doseAndRate.rate[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.maxDosePerPeriodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.maxDosePerAdministrationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.dosageInstruction.maxDosePerLifetimeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.substitutionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.substitution.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.substitution.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.substitution.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationDispense.substitution.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationDispense.substitution.wasSubstitutedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.substitution.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.substitution.reasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.substitution.responsiblePartyAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.detectedIssueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationDispense.eventHistoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())