Canadian Baseline
1.1.0 - CI Build
Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions
Draft as of 2020-03-05 |
Definitions for the profile-medicationdispense resource profile.
Guidance on how to interpret the contents of this table can be found here
0. MedicationDispense | |
Definition | The Canadian Baseline MedicationDispense Profile is based upon the core FHIR MedicationDispense Resource |
Short | MedicationDispense Profile |
2. MedicationDispense.extension | |
Slicing | This element introduces a set of slices on MedicationDispense.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
4. MedicationDispense.extension:renderedDosageInstruction | |
Slice Name | renderedDosageInstruction |
Definition | Provides a complete text rendering of dosageInstruction lines for an order or dispense (separate from the rendering of the overall resource instance) |
Short | Socialized Optional Extension: PrescribeIT renderedDosageInstruction |
Control | 0..1 |
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage ) |
6. MedicationDispense.extension:quantityRemaining | |
Slice Name | quantityRemaining |
Definition | The total authorized quantity outstanding after the fill issued as part of this dispense record |
Short | Socialized Optional Extension: PrescribeIT quantityRemaining |
Comments | In R5, an equivalent extension is put forth in the base FHIR specification - R5 implementors are encouraged to review: http://hl7.org/fhir/StructureDefinition/medicationdispense-quantityRemaining |
Control | 0..1 |
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining ) |
8. MedicationDispense.partOf | |
Type | Reference(Procedure Profile) |
10. MedicationDispense.status | |
Must Support | true |
12. MedicationDispense.medication[x] | |
Binding | The codes SHOULD be taken from https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred to https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct )TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time. |
Type | Choice of: CodeableConcept, Reference(Medication Profile) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Example | <br/><b>DIN</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN" }] } <br/><b>NPN</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN" }] } <br/><b>CCDD</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" }] } <br/><b>SNOMED CT (Medications) - IPS</b>:{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips" }] } <br/><b>WHO ATC IPS</b>:{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" }] } |
14. MedicationDispense.subject | |
Control | 1..? |
Type | Reference(Patient Profile) |
Must Support | true |
16. MedicationDispense.context | |
Type | Reference(Encounter Profile, EpisodeOfCare) |
18. MedicationDispense.performer | |
20. MedicationDispense.performer.actor | |
Type | Reference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile, Patient Profile, Device Profile (Implantable), RelatedPerson) |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
22. MedicationDispense.location | |
Type | Reference(Location Profile) |
24. MedicationDispense.authorizingPrescription | |
Type | Reference(MedicationRequest Profile) |
26. MedicationDispense.quantity | |
Must Support | true |
28. MedicationDispense.whenPrepared | |
Must Support | true |
30. MedicationDispense.destination | |
Type | Reference(Location Profile) |
32. MedicationDispense.receiver | |
Type | Reference(Patient Profile, Practitioner Profile (General)) |
34. MedicationDispense.dosageInstruction | |
Must Support | true |
36. MedicationDispense.dosageInstruction.extension | |
Slicing | This element introduces a set of slices on MedicationDispense.dosageInstruction.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
38. MedicationDispense.dosageInstruction.extension:instructionRelationship | |
Slice Name | instructionRelationship |
Definition | Indicates how the timing of this dosage instruction relates to the preceding dosage instruction. Specifically, is it concurrent (AND) or sequential (THEN). |
Short | Socialized Optional Extension: PrescribeIT dosageInstruction Relationship |
Control | 0..1 |
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship ) |
40. MedicationDispense.dosageInstruction.text | |
Must Support | true |
42. MedicationDispense.substitution | |
44. MedicationDispense.substitution.responsibleParty | |
Type | Reference(Practitioner Profile (General), PractitionerRole Profile (General)) |
Guidance on how to interpret the contents of this table can be found here
0. MedicationDispense | |
Definition | The Canadian Baseline MedicationDispense Profile is based upon the core FHIR MedicationDispense Resource 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. |
Short | MedicationDispense ProfileDispensing a medication to a named patient |
Control | 0..* |
Is Modifier | false |
Summary | false |
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) mdd-1: whenHandedOver cannot be before whenPrepared ( whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared )mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared) |
2. MedicationDispense.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Short | A set of rules under which this content was created |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
4. MedicationDispense.extension | |
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | ExtensionAdditional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on MedicationDispense.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
6. MedicationDispense.extension:renderedDosageInstruction | |
Slice Name | renderedDosageInstruction |
Definition | Provides a complete text rendering of dosageInstruction lines for an order or dispense (separate from the rendering of the overall resource instance) |
Short | Socialized Optional Extension: PrescribeIT renderedDosageInstruction |
Control | 0..1 |
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage ) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
8. MedicationDispense.extension:quantityRemaining | |
Slice Name | quantityRemaining |
Definition | The total authorized quantity outstanding after the fill issued as part of this dispense record |
Short | Socialized Optional Extension: PrescribeIT quantityRemaining |
Comments | In R5, an equivalent extension is put forth in the base FHIR specification - R5 implementors are encouraged to review: http://hl7.org/fhir/StructureDefinition/medicationdispense-quantityRemaining |
Control | 0..1 |
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining ) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
10. MedicationDispense.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Summary | false |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
12. MedicationDispense.partOf | |
Definition | The procedure that trigger the dispense. |
Short | Event that dispense is part of |
Control | 0..* |
Type | Reference(Procedure Profile, Procedure) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. MedicationDispense.status | |
Definition | A code specifying the state of the set of dispense events. |
Short | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown |
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
Control | 1..1 |
Binding | The codes SHALL be taken from MedicationDispense Status Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 )A coded concept specifying the state of the dispense event. |
Type | code |
Is Modifier | true because 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 |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
16. MedicationDispense.medication[x] | |
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. |
Short | What medication was supplied |
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. |
Control | 1..1 |
Binding | The codes SHOULD be taken from For example codes, see https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproducthttp://hl7.org/fhir/ValueSet/medication-codes (preferred to https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct )TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time. A coded concept identifying which substance or product can be dispensed. |
Type | Choice of: CodeableConcept, Reference(Medication Profile, Medication) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Summary | true |
Example | <br/><b>DIN</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN" }] } <br/><b>NPN</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN" }] } <br/><b>CCDD</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" }] } <br/><b>SNOMED CT (Medications) - IPS</b>:{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips" }] } <br/><b>WHO ATC IPS</b>:{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" }] } |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
18. MedicationDispense.subject | |
Definition | A link to a resource representing the person or the group to whom the medication will be given. |
Short | Who the dispense is for |
Comments | SubstanceAdministration->subject->Patient. |
Control | 10..1 |
Type | Reference(Patient Profile, Patient, Group) |
Is Modifier | false |
Must Support | true |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
20. MedicationDispense.context | |
Definition | The encounter or episode of care that establishes the context for this event. |
Short | Encounter / Episode associated with event |
Control | 0..1 |
Type | Reference(Encounter Profile, EpisodeOfCare, Encounter) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
22. MedicationDispense.performer | |
Definition | Indicates who or what performed the event. |
Short | Who performed event |
Control | 0..* |
Type | BackboneElement |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
24. MedicationDispense.performer.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored even if unrecognized |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
26. MedicationDispense.performer.actor | |
Definition | The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. |
Short | Individual who was performing |
Control | 1..1 |
Type | Reference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile, Patient Profile, Device Profile (Implantable), RelatedPerson, Practitioner, PractitionerRole, Organization, Patient, Device) |
Is Modifier | false |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
28. MedicationDispense.location | |
Definition | The principal physical location where the dispense was performed. |
Short | Where the dispense occurred |
Control | 0..1 |
Type | Reference(Location Profile, Location) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
30. MedicationDispense.authorizingPrescription | |
Definition | Indicates the medication order that is being dispensed against. |
Short | Medication order that authorizes the dispense |
Comments | Maps to basedOn in Event logical model. |
Control | 0..* |
Type | Reference(MedicationRequest Profile, MedicationRequest) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
32. MedicationDispense.quantity | |
Definition | The amount of medication that has been dispensed. Includes unit of measure. |
Short | Amount dispensed |
Control | 0..1 |
Type | Quantity(SimpleQuantity) |
Is Modifier | false |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
34. MedicationDispense.whenPrepared | |
Definition | The time when the dispensed product was packaged and reviewed. |
Short | When product was packaged and reviewed |
Control | 0..1 |
Type | dateTime |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
36. MedicationDispense.destination | |
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event. |
Short | Where the medication was sent |
Control | 0..1 |
Type | Reference(Location Profile, Location) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
38. MedicationDispense.receiver | |
Definition | Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. |
Short | Who collected the medication |
Control | 0..* |
Type | Reference(Patient Profile, Practitioner Profile (General), Patient, Practitioner) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
40. MedicationDispense.dosageInstruction | |
Definition | Indicates how the medication is to be used by the patient. |
Short | How the medication is to be used by the patient or administered by the caregiver |
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. |
Control | 0..* |
Type | Dosage |
Is Modifier | false |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
42. MedicationDispense.dosageInstruction.extension | |
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | ExtensionAdditional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on MedicationDispense.dosageInstruction.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
44. MedicationDispense.dosageInstruction.extension:instructionRelationship | |
Slice Name | instructionRelationship |
Definition | Indicates how the timing of this dosage instruction relates to the preceding dosage instruction. Specifically, is it concurrent (AND) or sequential (THEN). |
Short | Socialized Optional Extension: PrescribeIT dosageInstruction Relationship |
Control | 0..1 |
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship ) |
Is Modifier | false |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
46. MedicationDispense.dosageInstruction.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored even if unrecognized |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
48. MedicationDispense.dosageInstruction.text | |
Definition | Free text dosage instructions e.g. SIG. |
Short | Free text dosage instructions e.g. SIG |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. MedicationDispense | |||||
Definition | The Canadian Baseline MedicationDispense Profile is based upon the core FHIR MedicationDispense Resource | ||||
Short | MedicationDispense Profile | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty() )dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty() )dom-6: A resource should have narrative for robust management ( text.`div`.exists() )mdd-1: whenHandedOver cannot be before whenPrepared ( whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared ) | ||||
2. MedicationDispense.id | |||||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
Short | Logical id of this artifact | ||||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Summary | true | ||||
4. MedicationDispense.meta | |||||
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
6. MedicationDispense.implicitRules | |||||
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
Short | A set of rules under which this content was created | ||||
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
8. MedicationDispense.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language of the resource content | ||||
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
10. MedicationDispense.text | |||||
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
Short | Text summary of the resource, for human interpretation | ||||
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
Control | 0..1 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
12. MedicationDispense.contained | |||||
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
Short | Contained, inline Resources | ||||
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. MedicationDispense.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on MedicationDispense.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
16. MedicationDispense.extension:renderedDosageInstruction | |||||
Slice Name | renderedDosageInstruction | ||||
Definition | Provides a complete text rendering of dosageInstruction lines for an order or dispense (separate from the rendering of the overall resource instance) | ||||
Short | Socialized Optional Extension: PrescribeIT renderedDosageInstruction | ||||
Control | 0..1 | ||||
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage ) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
18. MedicationDispense.extension:quantityRemaining | |||||
Slice Name | quantityRemaining | ||||
Definition | The total authorized quantity outstanding after the fill issued as part of this dispense record | ||||
Short | Socialized Optional Extension: PrescribeIT quantityRemaining | ||||
Comments | In R5, an equivalent extension is put forth in the base FHIR specification - R5 implementors are encouraged to review: http://hl7.org/fhir/StructureDefinition/medicationdispense-quantityRemaining | ||||
Control | 0..1 | ||||
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining ) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
20. MedicationDispense.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
22. MedicationDispense.identifier | |||||
Definition | Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. | ||||
Short | External identifier | ||||
Comments | This is a business identifier, not a resource identifier. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
24. MedicationDispense.partOf | |||||
Definition | The procedure that trigger the dispense. | ||||
Short | Event that dispense is part of | ||||
Control | 0..* | ||||
Type | Reference(Procedure Profile) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
26. MedicationDispense.status | |||||
Definition | A code specifying the state of the set of dispense events. | ||||
Short | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown | ||||
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from MedicationDispense Status Codes (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 )A coded concept specifying the state of the dispense event. | ||||
Type | code | ||||
Is Modifier | true because 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 | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
28. MedicationDispense.statusReason[x] | |||||
Definition | Indicates the reason why a dispense was not performed. | ||||
Short | Why a dispense was not performed | ||||
Control | 0..1 | ||||
Binding | For example codes, see MedicationDispense Status Reason Codes (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason )A code describing why a dispense was not performed. | ||||
Type | Choice of: CodeableConcept, Reference(DetectedIssue) | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
30. MedicationDispense.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)). | ||||
Short | Type of medication dispense | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from MedicationDispense Category Codes (preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category )A code describing where the dispensed medication is expected to be consumed or administered. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
32. MedicationDispense.medication[x] | |||||
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. | ||||
Short | What medication was supplied | ||||
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. | ||||
Control | 1..1 | ||||
Binding | The codes SHOULD be taken from https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred to https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct )TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time. | ||||
Type | Choice of: CodeableConcept, Reference(Medication Profile) | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||
Summary | true | ||||
Example | <br/><b>DIN</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN" }] } <br/><b>NPN</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN" }] } <br/><b>CCDD</b>:{ "coding" : [{ "system" : "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" }] } <br/><b>SNOMED CT (Medications) - IPS</b>:{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips" }] } <br/><b>WHO ATC IPS</b>:{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" }] } | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
34. MedicationDispense.subject | |||||
Definition | A link to a resource representing the person or the group to whom the medication will be given. | ||||
Short | Who the dispense is for | ||||
Comments | SubstanceAdministration->subject->Patient. | ||||
Control | 1..1 | ||||
Type | Reference(Patient Profile) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
36. MedicationDispense.context | |||||
Definition | The encounter or episode of care that establishes the context for this event. | ||||
Short | Encounter / Episode associated with event | ||||
Control | 0..1 | ||||
Type | Reference(Encounter Profile, EpisodeOfCare) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
38. MedicationDispense.supportingInformation | |||||
Definition | Additional information that supports the medication being dispensed. | ||||
Short | Information that supports the dispensing of the medication | ||||
Control | 0..* | ||||
Type | Reference(Resource) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
40. MedicationDispense.performer | |||||
Definition | Indicates who or what performed the event. | ||||
Short | Who performed event | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
42. MedicationDispense.performer.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
44. MedicationDispense.performer.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
46. MedicationDispense.performer.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
48. MedicationDispense.performer.function | |||||
Definition | Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. | ||||
Short | Who performed the dispense and what they did | ||||
Control | 0..1 | ||||
Binding | For example codes, see MedicationDispense Performer Function Codes (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function )A code describing the role an individual played in dispensing a medication. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Allows disambiguation of the types of involvement of different performers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
50. MedicationDispense.performer.actor | |||||
Definition | The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. | ||||
Short | Individual who was performing | ||||
Control | 1..1 | ||||
Type | Reference(Practitioner Profile (General), PractitionerRole Profile (General), Organization Profile, Patient Profile, Device Profile (Implantable), RelatedPerson) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
52. MedicationDispense.location | |||||
Definition | The principal physical location where the dispense was performed. | ||||
Short | Where the dispense occurred | ||||
Control | 0..1 | ||||
Type | Reference(Location Profile) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
54. MedicationDispense.authorizingPrescription | |||||
Definition | Indicates the medication order that is being dispensed against. | ||||
Short | Medication order that authorizes the dispense | ||||
Comments | Maps to basedOn in Event logical model. | ||||
Control | 0..* | ||||
Type | Reference(MedicationRequest Profile) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
56. MedicationDispense.type | |||||
Definition | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. | ||||
Short | Trial fill, partial fill, emergency fill, etc. | ||||
Control | 0..1 | ||||
Binding | For example codes, see ActPharmacySupplyType (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType )Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
58. MedicationDispense.quantity | |||||
Definition | The amount of medication that has been dispensed. Includes unit of measure. | ||||
Short | Amount dispensed | ||||
Control | 0..1 | ||||
Type | Quantity(SimpleQuantity) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
60. MedicationDispense.daysSupply | |||||
Definition | The amount of medication expressed as a timing amount. | ||||
Short | Amount of medication expressed as a timing amount | ||||
Control | 0..1 | ||||
Type | Quantity(SimpleQuantity) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
62. MedicationDispense.whenPrepared | |||||
Definition | The time when the dispensed product was packaged and reviewed. | ||||
Short | When product was packaged and reviewed | ||||
Control | 0..1 | ||||
Type | dateTime | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
64. MedicationDispense.whenHandedOver | |||||
Definition | The time the dispensed product was provided to the patient or their representative. | ||||
Short | When product was given out | ||||
Control | 0..1 | ||||
Type | dateTime | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
66. MedicationDispense.destination | |||||
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event. | ||||
Short | Where the medication was sent | ||||
Control | 0..1 | ||||
Type | Reference(Location Profile) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
68. MedicationDispense.receiver | |||||
Definition | Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. | ||||
Short | Who collected the medication | ||||
Control | 0..* | ||||
Type | Reference(Patient Profile, Practitioner Profile (General)) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
70. MedicationDispense.note | |||||
Definition | Extra information about the dispense that could not be conveyed in the other attributes. | ||||
Short | Information about the dispense | ||||
Control | 0..* | ||||
Type | Annotation | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
72. MedicationDispense.dosageInstruction | |||||
Definition | Indicates how the medication is to be used by the patient. | ||||
Short | How the medication is to be used by the patient or administered by the caregiver | ||||
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. | ||||
Control | 0..* | ||||
Type | Dosage | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
74. MedicationDispense.dosageInstruction.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
76. MedicationDispense.dosageInstruction.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on MedicationDispense.dosageInstruction.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
78. MedicationDispense.dosageInstruction.extension:instructionRelationship | |||||
Slice Name | instructionRelationship | ||||
Definition | Indicates how the timing of this dosage instruction relates to the preceding dosage instruction. Specifically, is it concurrent (AND) or sequential (THEN). | ||||
Short | Socialized Optional Extension: PrescribeIT dosageInstruction Relationship | ||||
Control | 0..1 | ||||
Type | Extension(http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship ) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
80. MedicationDispense.dosageInstruction.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
82. MedicationDispense.dosageInstruction.sequence | |||||
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. | ||||
Short | The order of the dosage instructions | ||||
Control | 0..1 | ||||
Type | integer | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
84. MedicationDispense.dosageInstruction.text | |||||
Definition | Free text dosage instructions e.g. SIG. | ||||
Short | Free text dosage instructions e.g. SIG | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
86. MedicationDispense.dosageInstruction.additionalInstruction | |||||
Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). | ||||
Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" | ||||
Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. | ||||
Control | 0..* | ||||
Binding | For example codes, see SNOMEDCTAdditionalDosageInstructions (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes )A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
88. MedicationDispense.dosageInstruction.patientInstruction | |||||
Definition | Instructions in terms that are understood by the patient or consumer. | ||||
Short | Patient or consumer oriented instructions | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
90. MedicationDispense.dosageInstruction.timing | |||||
Definition | When medication should be administered. | ||||
Short | When medication should be administered | ||||
Comments | This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. | ||||
Control | 0..1 | ||||
Type | Timing | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
92. MedicationDispense.dosageInstruction.asNeeded[x] | |||||
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). | ||||
Short | Take "as needed" (for x) | ||||
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". | ||||
Control | 0..1 | ||||
Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason )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. | ||||
Type | Choice of: boolean, CodeableConcept | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
94. MedicationDispense.dosageInstruction.site | |||||
Definition | Body site to administer to. | ||||
Short | Body site to administer to | ||||
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. | ||||
Control | 0..1 | ||||
Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example to http://hl7.org/fhir/ValueSet/approach-site-codes )A coded concept describing the site location the medicine enters into or onto the body. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | A coded specification of the anatomic site where the medication first enters the body. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
96. MedicationDispense.dosageInstruction.route | |||||
Definition | How drug should enter body. | ||||
Short | How drug should enter body | ||||
Control | 0..1 | ||||
Binding | For example codes, see SNOMEDCTRouteCodes (example to http://hl7.org/fhir/ValueSet/route-codes )A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
98. MedicationDispense.dosageInstruction.method | |||||
Definition | Technique for administering medication. | ||||
Short | Technique for administering medication | ||||
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. | ||||
Control | 0..1 | ||||
Binding | For example codes, see SNOMEDCTAdministrationMethodCodes (example to http://hl7.org/fhir/ValueSet/administration-method-codes )A coded concept describing the technique by which the medicine is administered. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
100. MedicationDispense.dosageInstruction.doseAndRate | |||||
Definition | The amount of medication administered. | ||||
Short | Amount of medication administered | ||||
Control | 0..* | ||||
Type | Element | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
102. MedicationDispense.dosageInstruction.doseAndRate.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
104. MedicationDispense.dosageInstruction.doseAndRate.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
106. MedicationDispense.dosageInstruction.doseAndRate.type | |||||
Definition | The kind of dose or rate specified, for example, ordered or calculated. | ||||
Short | The kind of dose or rate specified | ||||
Control | 0..1 | ||||
Binding | For example codes, see DoseAndRateType (example to http://hl7.org/fhir/ValueSet/dose-rate-type )The kind of dose or rate specified. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | If the type is not populated, assume to be "ordered". | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
108. MedicationDispense.dosageInstruction.doseAndRate.dose[x] | |||||
Definition | Amount of medication per dose. | ||||
Short | Amount of medication per dose | ||||
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. | ||||
Control | 0..1 | ||||
Type | Choice of: Range, Quantity(SimpleQuantity) | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | The amount of therapeutic or other substance given at one administration event. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
110. MedicationDispense.dosageInstruction.doseAndRate.rate[x] | |||||
Definition | Amount of medication per unit of time. | ||||
Short | Amount of medication per unit of time | ||||
Comments | It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. | ||||
Control | 0..1 | ||||
Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
112. MedicationDispense.dosageInstruction.maxDosePerPeriod | |||||
Definition | Upper limit on medication per unit of time. | ||||
Short | Upper limit on medication per unit of time | ||||
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". | ||||
Control | 0..1 | ||||
Type | Ratio | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
114. MedicationDispense.dosageInstruction.maxDosePerAdministration | |||||
Definition | Upper limit on medication per administration. | ||||
Short | Upper limit on medication per administration | ||||
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. | ||||
Control | 0..1 | ||||
Type | Quantity(SimpleQuantity) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
116. MedicationDispense.dosageInstruction.maxDosePerLifetime | |||||
Definition | Upper limit on medication per lifetime of the patient. | ||||
Short | Upper limit on medication per lifetime of the patient | ||||
Control | 0..1 | ||||
Type | Quantity(SimpleQuantity) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
118. MedicationDispense.substitution | |||||
Definition | Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. | ||||
Short | Whether a substitution was performed on the dispense | ||||
Control | 0..1 | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
120. MedicationDispense.substitution.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
122. MedicationDispense.substitution.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
124. MedicationDispense.substitution.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
126. MedicationDispense.substitution.wasSubstituted | |||||
Definition | True if the dispenser dispensed a different drug or product from what was prescribed. | ||||
Short | Whether a substitution was or was not performed on the dispense | ||||
Control | 1..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
128. MedicationDispense.substitution.type | |||||
Definition | A code signifying whether a different drug was dispensed from what was prescribed. | ||||
Short | Code signifying whether a different drug was dispensed from what was prescribed | ||||
Control | 0..1 | ||||
Binding | For example codes, see ActSubstanceAdminSubstitutionCode (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode )A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
130. MedicationDispense.substitution.reason | |||||
Definition | Indicates the reason for the substitution (or lack of substitution) from what was prescribed. | ||||
Short | Why was substitution made | ||||
Control | 0..* | ||||
Binding | For example codes, see SubstanceAdminSubstitutionReason (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason )A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
132. MedicationDispense.substitution.responsibleParty | |||||
Definition | The person or organization that has primary responsibility for the substitution. | ||||
Short | Who is responsible for the substitution | ||||
Control | 0..* | ||||
Type | Reference(Practitioner Profile (General), PractitionerRole Profile (General)) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
134. MedicationDispense.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. | ||||
Short | Clinical issue with action | ||||
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. | ||||
Control | 0..* | ||||
Type | Reference(DetectedIssue) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
136. MedicationDispense.eventHistory | |||||
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified. | ||||
Short | A list of relevant lifecycle events | ||||
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.). | ||||
Control | 0..* | ||||
Type | Reference(Provenance) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |