QI-Core Implementation Guide
6.0.0 - STU6
QI-Core Implementation Guide
6.0.0 - STU6
This page is part of the Quality Improvement Core Framework (v6.0.0: STU6 (v6.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationdispense | Version: 6.0.0 | |||
| Active 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.
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 following example illustrates the use of the MedicationDispense profile
define "Dementia Medication Dispensed":
["MedicationDispense": "Dementia Medications"] MedicationDispense
where MedicationDispense.status in { 'active', 'completed', 'on-hold' }
| Penicillin MedicationDispense Example |
| MedicationDispense Cumulative Duration Example |
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCoreMedicationDispenseProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  MedicationDispense | 0..* | USCoreMedicationDispenseProfile | Dispensing a medication to a named patient | |
  status | 1..1 | code | (QI-Core)(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationDispense Status (required) | |
  medication[x] | 1..1 | (QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug  (extensible): The set of RxNorm codes to represent medications | ||
  medicationCodeableConcept | CodeableConcept | |||
  medicationReference | Reference(QICore Medication) | |||
| subject | 1..1 | Reference(QICore Patient) | (QI-Core)(USCDI) Who the dispense is for | |
| authorizingPrescription | 0..* | Reference(QICore MedicationRequest) | (QI-Core)(USCDI) Medication order that authorizes the dispense | |
| type | 0..1 | CodeableConcept | (QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible) | |
| quantity | 0..1 | Quantity | (QI-Core)(USCDI) Amount dispensed | |
| daysSupply | 0..1 | SimpleQuantity | (QI-Core) Amount of medication expressed as a timing amount | |
| whenPrepared | 0..1 | dateTime | (QI-Core) When product was packaged and reviewed | |
| whenHandedOver | 0..1 | dateTime | (QI-Core)(USCDI) When product was given out or mailed | |
 dosageInstruction | 0..* | Dosage | (QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver | |
 text | 0..1 | string | (QI-Core)(USCDI) Free text dosage instructions e.g. SIG | |
| timing | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | |
| doseAndRate | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | |
| dose[x] | 0..1 | (QI-Core)(USCDI) Amount of medication per dose | ||
| doseQuantity | Quantity | |||
| doseRange | Range | |||
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MedicationDispense.status | required | NonNegativeMedicationDispenseStatushttp://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-statusfrom this IG | |
| MedicationDispense.medication[x] | extensible | Medication Clinical Drug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 | |
| MedicationDispense.type | extensible | ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile | Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed" | ||||
 implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| status | ?!SΣC | 1..1 | code | (QI-Core)(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationDispense Status (required) | ||||
| medication[x] | SΣ | 1..1 | (QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(QICore Medication) | |||||||
| subject | SΣ | 1..1 | Reference(QICore Patient) | (QI-Core)(USCDI) Who the dispense is for | ||||
| performer | S | 0..* | BackboneElement | (USCDI) Who performed event | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| actor | S | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile) | (USCDI) Individual who was performing | ||||
| authorizingPrescription | S | 0..* | Reference(QICore MedicationRequest) | (QI-Core)(USCDI) Medication order that authorizes the dispense | ||||
| type | S | 0..1 | CodeableConcept | (QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible) | ||||
| quantity | S | 0..1 | Quantity | (QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred)
| ||||
| daysSupply | 0..1 | SimpleQuantity | (QI-Core) Amount of medication expressed as a timing amount | |||||
| whenPrepared | Σ | 0..1 | dateTime | (QI-Core) When product was packaged and reviewed | ||||
| whenHandedOver | SC | 0..1 | dateTime | (QI-Core)(USCDI) When product was given out or mailed | ||||
| dosageInstruction | S | 0..* | Dosage | (QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| text | SΣ | 0..1 | string | (QI-Core)(USCDI) Free text dosage instructions e.g. SIG | ||||
| timing | SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| doseAndRate | SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| dose[x] | SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity | Quantity | |||||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MedicationDispense.status | required | NonNegativeMedicationDispenseStatushttp://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-statusfrom this IG | ||||
| MedicationDispense.medication[x] | extensible | Medication Clinical Drug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 | ||||
| MedicationDispense.type | extensible | ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType | ||||
| MedicationDispense.quantity | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : 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-4 | error | MedicationDispense | If 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-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared | |
| us-core-20 | error | MedicationDispense | whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists() |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile | Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed" | ||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
 extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | 0..* | Identifier | External identifier | |||||
| partOf | 0..* | Reference(Procedure) | Event that dispense is part of | |||||
| status | ?!SΣC | 1..1 | code | (QI-Core)(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationDispense Status (required) | ||||
| statusReason[x] | 0..1 | Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed. | ||||||
| statusReasonCodeableConcept | CodeableConcept | |||||||
| statusReasonReference | Reference(DetectedIssue) | |||||||
| category | 0..1 | CodeableConcept | Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered. | |||||
| medication[x] | SΣ | 1..1 | (QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(QICore Medication) | |||||||
| subject | SΣ | 1..1 | Reference(QICore Patient) | (QI-Core)(USCDI) Who the dispense is for | ||||
| context | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with event | |||||
| supportingInformation | 0..* | Reference(Resource) | Information that supports the dispensing of the medication | |||||
| performer | S | 0..* | BackboneElement | (USCDI) Who performed event | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| function | 0..1 | CodeableConcept | Who 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 | S | 1..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | (USCDI) Individual who was performing | ||||
| location | 0..1 | Reference(Location) | Where the dispense occurred | |||||
| authorizingPrescription | S | 0..* | Reference(QICore MedicationRequest) | (QI-Core)(USCDI) Medication order that authorizes the dispense | ||||
| type | S | 0..1 | CodeableConcept | (QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible) | ||||
| quantity | S | 0..1 | Quantity | (QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred)
| ||||
| daysSupply | 0..1 | SimpleQuantity | (QI-Core) Amount of medication expressed as a timing amount | |||||
| whenPrepared | Σ | 0..1 | dateTime | (QI-Core) When product was packaged and reviewed | ||||
| whenHandedOver | SC | 0..1 | dateTime | (QI-Core)(USCDI) When product was given out or mailed | ||||
| destination | 0..1 | Reference(Location) | Where the medication was sent | |||||
| receiver | 0..* | Reference(Patient | Practitioner) | Who collected the medication | |||||
| note | 0..* | Annotation | Information about the dispense | |||||
| dosageInstruction | S | 0..* | Dosage | (QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| sequence | Σ | 0..1 | integer | The order of the dosage instructions | ||||
| text | SΣ | 0..1 | string | (QI-Core)(USCDI) Free text dosage instructions e.g. SIG | ||||
| additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental 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 | Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
| timing | SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| asNeeded[x] | Σ | 0..1 | Take "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. | |||||
| asNeededBoolean | boolean | |||||||
| asNeededCodeableConcept | CodeableConcept | |||||||
| site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | ||||
| route | Σ | 0..1 | CodeableConcept | How 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 | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | ||||
| doseAndRate | SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. | ||||
| dose[x] | SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity | Quantity S | |||||||
| doseRange | Range | |||||||
| rate[x] | Σ | 0..1 | Amount of medication per unit of time | |||||
| rateRatio | Ratio | |||||||
| rateRange | Range | |||||||
| rateQuantity | Quantity(SimpleQuantity) | |||||||
| maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | ||||
| maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration | ||||
| maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient | ||||
| substitution | 0..1 | BackboneElement | Whether a substitution was performed on the dispense | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| wasSubstituted | 1..1 | boolean | Whether a substitution was or was not performed on the dispense | |||||
| type | 0..1 | CodeableConcept | Code 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..* | CodeableConcept | Why 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(Practitioner | PractitionerRole) | Who is responsible for the substitution | |||||
| detectedIssue | 0..* | Reference(DetectedIssue) | Clinical issue with action | |||||
| eventHistory | 0..* | Reference(Provenance) | A list of relevant lifecycle events | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MedicationDispense.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| MedicationDispense.status | required | NonNegativeMedicationDispenseStatushttp://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-statusfrom this IG | ||||
| MedicationDispense.statusReason[x] | example | MedicationDispense Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reasonfrom the FHIR Standard | ||||
| MedicationDispense.category | preferred | MedicationDispense Category Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-categoryfrom the FHIR Standard | ||||
| MedicationDispense.medication[x] | extensible | Medication Clinical Drug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 | ||||
| MedicationDispense.performer.function | example | MedicationDispense Performer Function Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-performer-functionfrom the FHIR Standard | ||||
| MedicationDispense.type | extensible | ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType | ||||
| MedicationDispense.quantity | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.doseAndRate.type | example | DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-typefrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard | ||||
| MedicationDispense.substitution.type | example | ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode | ||||
| MedicationDispense.substitution.reason | example | SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : 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-4 | error | MedicationDispense | If 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-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared | |
| us-core-20 | error | MedicationDispense | whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists() |
This structure is derived from USCoreMedicationDispenseProfile
Differential View
This structure is derived from USCoreMedicationDispenseProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationDispense | 0..* | USCoreMedicationDispenseProfile | Dispensing a medication to a named patient | |
| status | 1..1 | code | (QI-Core)(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationDispense Status (required) | |
| medication[x] | 1..1 | (QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications | ||
| medicationCodeableConcept | CodeableConcept | |||
| medicationReference | Reference(QICore Medication) | |||
| subject | 1..1 | Reference(QICore Patient) | (QI-Core)(USCDI) Who the dispense is for | |
| authorizingPrescription | 0..* | Reference(QICore MedicationRequest) | (QI-Core)(USCDI) Medication order that authorizes the dispense | |
| type | 0..1 | CodeableConcept | (QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible) | |
| quantity | 0..1 | Quantity | (QI-Core)(USCDI) Amount dispensed | |
| daysSupply | 0..1 | SimpleQuantity | (QI-Core) Amount of medication expressed as a timing amount | |
| whenPrepared | 0..1 | dateTime | (QI-Core) When product was packaged and reviewed | |
| whenHandedOver | 0..1 | dateTime | (QI-Core)(USCDI) When product was given out or mailed | |
| dosageInstruction | 0..* | Dosage | (QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver | |
| text | 0..1 | string | (QI-Core)(USCDI) Free text dosage instructions e.g. SIG | |
| timing | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | |
| doseAndRate | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | |
| dose[x] | 0..1 | (QI-Core)(USCDI) Amount of medication per dose | ||
| doseQuantity | Quantity | |||
| doseRange | Range | |||
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| MedicationDispense.status | required | NonNegativeMedicationDispenseStatushttp://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-statusfrom this IG | |
| MedicationDispense.medication[x] | extensible | Medication Clinical Drug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 | |
| MedicationDispense.type | extensible | ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile | Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed" | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| status | ?!SΣC | 1..1 | code | (QI-Core)(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationDispense Status (required) | ||||
| medication[x] | SΣ | 1..1 | (QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(QICore Medication) | |||||||
| subject | SΣ | 1..1 | Reference(QICore Patient) | (QI-Core)(USCDI) Who the dispense is for | ||||
| performer | S | 0..* | BackboneElement | (USCDI) Who performed event | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| actor | S | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile) | (USCDI) Individual who was performing | ||||
| authorizingPrescription | S | 0..* | Reference(QICore MedicationRequest) | (QI-Core)(USCDI) Medication order that authorizes the dispense | ||||
| type | S | 0..1 | CodeableConcept | (QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible) | ||||
| quantity | S | 0..1 | Quantity | (QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred)
| ||||
| daysSupply | 0..1 | SimpleQuantity | (QI-Core) Amount of medication expressed as a timing amount | |||||
| whenPrepared | Σ | 0..1 | dateTime | (QI-Core) When product was packaged and reviewed | ||||
| whenHandedOver | SC | 0..1 | dateTime | (QI-Core)(USCDI) When product was given out or mailed | ||||
| dosageInstruction | S | 0..* | Dosage | (QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| text | SΣ | 0..1 | string | (QI-Core)(USCDI) Free text dosage instructions e.g. SIG | ||||
| timing | SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| doseAndRate | SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| dose[x] | SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity | Quantity | |||||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MedicationDispense.status | required | NonNegativeMedicationDispenseStatushttp://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-statusfrom this IG | ||||
| MedicationDispense.medication[x] | extensible | Medication Clinical Drug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 | ||||
| MedicationDispense.type | extensible | ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType | ||||
| MedicationDispense.quantity | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : 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-4 | error | MedicationDispense | If 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-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared | |
| us-core-20 | error | MedicationDispense | whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile | Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed" | ||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | 0..* | Identifier | External identifier | |||||
| partOf | 0..* | Reference(Procedure) | Event that dispense is part of | |||||
| status | ?!SΣC | 1..1 | code | (QI-Core)(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationDispense Status (required) | ||||
| statusReason[x] | 0..1 | Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed. | ||||||
| statusReasonCodeableConcept | CodeableConcept | |||||||
| statusReasonReference | Reference(DetectedIssue) | |||||||
| category | 0..1 | CodeableConcept | Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered. | |||||
| medication[x] | SΣ | 1..1 | (QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(QICore Medication) | |||||||
| subject | SΣ | 1..1 | Reference(QICore Patient) | (QI-Core)(USCDI) Who the dispense is for | ||||
| context | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with event | |||||
| supportingInformation | 0..* | Reference(Resource) | Information that supports the dispensing of the medication | |||||
| performer | S | 0..* | BackboneElement | (USCDI) Who performed event | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| function | 0..1 | CodeableConcept | Who 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 | S | 1..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | (USCDI) Individual who was performing | ||||
| location | 0..1 | Reference(Location) | Where the dispense occurred | |||||
| authorizingPrescription | S | 0..* | Reference(QICore MedicationRequest) | (QI-Core)(USCDI) Medication order that authorizes the dispense | ||||
| type | S | 0..1 | CodeableConcept | (QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible) | ||||
| quantity | S | 0..1 | Quantity | (QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred)
| ||||
| daysSupply | 0..1 | SimpleQuantity | (QI-Core) Amount of medication expressed as a timing amount | |||||
| whenPrepared | Σ | 0..1 | dateTime | (QI-Core) When product was packaged and reviewed | ||||
| whenHandedOver | SC | 0..1 | dateTime | (QI-Core)(USCDI) When product was given out or mailed | ||||
| destination | 0..1 | Reference(Location) | Where the medication was sent | |||||
| receiver | 0..* | Reference(Patient | Practitioner) | Who collected the medication | |||||
| note | 0..* | Annotation | Information about the dispense | |||||
| dosageInstruction | S | 0..* | Dosage | (QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| sequence | Σ | 0..1 | integer | The order of the dosage instructions | ||||
| text | SΣ | 0..1 | string | (QI-Core)(USCDI) Free text dosage instructions e.g. SIG | ||||
| additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental 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 | Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
| timing | SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| asNeeded[x] | Σ | 0..1 | Take "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. | |||||
| asNeededBoolean | boolean | |||||||
| asNeededCodeableConcept | CodeableConcept | |||||||
| site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | ||||
| route | Σ | 0..1 | CodeableConcept | How 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 | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | ||||
| doseAndRate | SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. | ||||
| dose[x] | SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity | Quantity S | |||||||
| doseRange | Range | |||||||
| rate[x] | Σ | 0..1 | Amount of medication per unit of time | |||||
| rateRatio | Ratio | |||||||
| rateRange | Range | |||||||
| rateQuantity | Quantity(SimpleQuantity) | |||||||
| maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | ||||
| maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration | ||||
| maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient | ||||
| substitution | 0..1 | BackboneElement | Whether a substitution was performed on the dispense | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| wasSubstituted | 1..1 | boolean | Whether a substitution was or was not performed on the dispense | |||||
| type | 0..1 | CodeableConcept | Code 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..* | CodeableConcept | Why 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(Practitioner | PractitionerRole) | Who is responsible for the substitution | |||||
| detectedIssue | 0..* | Reference(DetectedIssue) | Clinical issue with action | |||||
| eventHistory | 0..* | Reference(Provenance) | A list of relevant lifecycle events | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | URI | |||
| MedicationDispense.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| MedicationDispense.status | required | NonNegativeMedicationDispenseStatushttp://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-statusfrom this IG | ||||
| MedicationDispense.statusReason[x] | example | MedicationDispense Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reasonfrom the FHIR Standard | ||||
| MedicationDispense.category | preferred | MedicationDispense Category Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-categoryfrom the FHIR Standard | ||||
| MedicationDispense.medication[x] | extensible | Medication Clinical Drug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 | ||||
| MedicationDispense.performer.function | example | MedicationDispense Performer Function Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-performer-functionfrom the FHIR Standard | ||||
| MedicationDispense.type | extensible | ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType | ||||
| MedicationDispense.quantity | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.doseAndRate.type | example | DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-typefrom the FHIR Standard | ||||
| MedicationDispense.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
http://hl7.org/fhir/ValueSet/ucum-commonfrom the FHIR Standard | ||||
| MedicationDispense.substitution.type | example | ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode | ||||
| MedicationDispense.substitution.reason | example | SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : 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-4 | error | MedicationDispense | If 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-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared | |
| us-core-20 | error | MedicationDispense | whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists() |
This structure is derived from USCoreMedicationDispenseProfile
Other representations of profile: CSV, Excel, Schematron
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.qicore#6.0.0 based on FHIR 4.0.1. Generated 2024-03-01
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change