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Pharmacy Work GroupMaturity Level: 2 Trial Use Compartments: Patient, Practitioner

Detailed Descriptions for the elements in the MedicationDispense resource.

MedicationDispense
Element IdMedicationDispense
Definition

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

Control1..1
InvariantsDefined on this element
  • Rule mdd-1: whenHandedOver cannot be before whenPrepared (expression : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared, xpath: not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value))
MedicationDispense.identifier
Element IdMedicationDispense.identifier
Definition

Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
MedicationDispense.partOf
Element IdMedicationDispense.partOf
Definition

The procedure that trigger the dispense.

Control0..*
TypeReference(Procedure)
MedicationDispense.status
Element IdMedicationDispense.status
Definition

A code specifying the state of the set of dispense events.

Control1..1
Terminology BindingMedicationDispenseStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

MedicationDispense.category
Element IdMedicationDispense.category
Definition

Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

Control0..1
Terminology BindingMedicationDispenseCategory (Preferred)
TypeCodeableConcept
Comments

The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

MedicationDispense.medication[x]
Element IdMedicationDispense.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.

Control1..1
Terminology BindingSNOMED CT Medication Codes (Example)
TypeCodeableConcept|Reference(Medication)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example if you require form or lot number, then you must reference the Medication resource.

MedicationDispense.subject
Element IdMedicationDispense.subject
Definition

A link to a resource representing the person or the group to whom the medication will be given.

Control0..1
TypeReference(Patient | Group)
Summarytrue
Comments

SubstanceAdministration->subject->Patient.

MedicationDispense.context
Element IdMedicationDispense.context
Definition

The encounter or episode of care that establishes the context for this event.

Control0..1
TypeReference(Encounter | EpisodeOfCare)
MedicationDispense.supportingInformation
Element IdMedicationDispense.supportingInformation
Definition

Additional information that supports the medication being dispensed.

Control0..*
TypeReference(Any)
MedicationDispense.performer
Element IdMedicationDispense.performer
Definition

Indicates who or what performed the event.

Control0..*
MedicationDispense.performer.function
Element IdMedicationDispense.performer.function
Definition

Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

Control0..1
Terminology BindingMedicationDispensePerformerFunction (Example)
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

MedicationDispense.performer.actor
Element IdMedicationDispense.performer.actor
Definition

The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

Control1..1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)
MedicationDispense.location
Element IdMedicationDispense.location
Definition

The principal physical location where the dispense was performed.

Control0..1
TypeReference(Location)
MedicationDispense.authorizingPrescription
Element IdMedicationDispense.authorizingPrescription
Definition

Indicates the medication order that is being dispensed against.

Control0..*
TypeReference(MedicationRequest)
Comments

Maps to basedOn in Event logical model.

MedicationDispense.type
Element IdMedicationDispense.type
Definition

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

Control0..1
Terminology BindingActPharmacySupplyType (Example)
TypeCodeableConcept
MedicationDispense.quantity
Element IdMedicationDispense.quantity
Definition

The amount of medication that has been dispensed. Includes unit of measure.

Control0..1
TypeSimpleQuantity
MedicationDispense.daysSupply
Element IdMedicationDispense.daysSupply
Definition

The amount of medication expressed as a timing amount.

Control0..1
TypeSimpleQuantity
MedicationDispense.whenPrepared
Element IdMedicationDispense.whenPrepared
Definition

The time when the dispensed product was packaged and reviewed.

Control0..1
TypedateTime
Summarytrue
MedicationDispense.whenHandedOver
Element IdMedicationDispense.whenHandedOver
Definition

The time the dispensed product was provided to the patient or their representative.

Control0..1
TypedateTime
MedicationDispense.destination
Element IdMedicationDispense.destination
Definition

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

Control0..1
TypeReference(Location)
MedicationDispense.receiver
Element IdMedicationDispense.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.

Control0..*
TypeReference(Patient | Practitioner)
MedicationDispense.note
Element IdMedicationDispense.note
Definition

Extra information about the dispense that could not be conveyed in the other attributes.

Control0..*
TypeAnnotation
MedicationDispense.dosageInstruction
Element IdMedicationDispense.dosageInstruction
Definition

Indicates how the medication is to be used by the patient.

Control0..*
TypeDosage
Comments

When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

MedicationDispense.substitution
Element IdMedicationDispense.substitution
Definition

Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

Control0..1
MedicationDispense.substitution.wasSubstituted
Element IdMedicationDispense.substitution.wasSubstituted
Definition

True if the dispenser dispensed a different drug or product from what was prescribed.

Control1..1
Typeboolean
MedicationDispense.substitution.type
Element IdMedicationDispense.substitution.type
Definition

A code signifying whether a different drug was dispensed from what was prescribed.

Control0..1
Terminology BindingActSubstanceAdminSubstitutionCode (Example)
TypeCodeableConcept
MedicationDispense.substitution.reason
Element IdMedicationDispense.substitution.reason
Definition

Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

Control0..*
Terminology BindingSubstanceAdminSubstitutionReason (Example)
TypeCodeableConcept
MedicationDispense.substitution.responsibleParty
Element IdMedicationDispense.substitution.responsibleParty
Definition

The person or organization that has primary responsibility for the substitution.

Control0..*
TypeReference(Practitioner)
MedicationDispense.detectedIssue
Element IdMedicationDispense.detectedIssue
Definition

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

Control0..*
TypeReference(DetectedIssue)
Alternate NamesContraindication; Drug Utilization Review (DUR); Alert
Comments

This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

MedicationDispense.statusReason[x]
Element IdMedicationDispense.statusReason[x]
Definition

Indicates the reason why a dispense was not performed.

Control0..1
Terminology BindingMedicationDispenseStatusReason (Example)
TypeCodeableConcept|Reference(DetectedIssue)
[x] NoteSee Choice of Data Types for further information about how to use [x]
MedicationDispense.eventHistory
Element IdMedicationDispense.eventHistory
Definition

A summary of the events of interest that have occurred, such as when the dispense was verified.

Control0..*
TypeReference(Provenance)
Comments

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).