CA Baseline MedicationDispense Profile

This profile sets minimum expectations for the MedicationDispense resource. This profile defines localization concepts for use in the Canadian context.

Mandatory Data Elements

All elements or attributes within the FHIR specification have cardinality as part of their definition - a minimum number of required appearances and a maximum number of allowable appearances.

Most elements in the FHIR specification have a minimum cardinality of 0, so most elements are not required and subsequently they may be missing from a resource when it is exchanged between systems.

Required elements in the Observation (General Use) profile:

• status (required in the base specification)
• medication (required in the base specification)
• subject

Must Support Data Elements

The following elements are marked as Must Support in this profile:

Must Support elements:

• status
• medication
• subject
• quantity
• whenPrepared
• dosageInstruction

CA Core Considerations

The whenHandedOver element was initially profiled as must support and was later relaxed through the Due Diligence Review Process with the goal of not constraining for certain use cases over others. Given the criticality to many clinical/pharmaceutical use cases, it has been identified as an element to consider for additional constraints in the CA Core Profiles which are to be developed in the future under the guidance of a larger collaborative of pan-Canadian governing bodies.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from MedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	MedicationDispense	MedicationDispense Profile
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:renderedDosageInstruction		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage]]	Socialized Optional Extension: PrescribeIT renderedDosageInstruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
extension:quantityRemaining		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining]]	Socialized Optional Extension: PrescribeIT quantityRemaining URL: http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining
partOf		0..*	Reference(Procedure Profile)	Event that dispense is part of
status	S	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
medication[x]	S	1..1		What medication was supplied Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): 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. Example DIN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"}]} Example NPN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"}]} Example CCDD: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"}]} Example SNOMED CT (Medications) - IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"}]} Example WHO ATC IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"}]}
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication Profile)
subject	S	1..1	Reference(Patient Profile)	Who the dispense is for
context		0..1	Reference(Encounter Profile | EpisodeOfCare)	Encounter / Episode associated with event
performer
actor	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson)	Individual who was performing
location		0..1	Reference(Location Profile)	Where the dispense occurred
authorizingPrescription		0..*	Reference(MedicationRequest Profile)	Medication order that authorizes the dispense
quantity	S	0..1	SimpleQuantity	Amount dispensed
whenPrepared	S	0..1	dateTime	When product was packaged and reviewed
destination		0..1	Reference(Location Profile)	Where the medication was sent
receiver		0..*	Reference(Patient Profile | Practitioner Profile (General))	Who collected the medication
dosageInstruction	S	0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:instructionRelationship		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship]]	Socialized Optional Extension: PrescribeIT dosageInstruction Relationship URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship
text	S	0..1	string	Free text dosage instructions e.g. SIG
substitution
responsibleParty		0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General))	Who is responsible for the substitution
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationDispense.medication[x]	preferred	https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	MedicationDispense Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management mdd-1: whenHandedOver cannot be before whenPrepared
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:renderedDosageInstruction		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage]]	Socialized Optional Extension: PrescribeIT renderedDosageInstruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:quantityRemaining		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining]]	Socialized Optional Extension: PrescribeIT quantityRemaining URL: http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
partOf		0..*	Reference(Procedure Profile)	Event that dispense is part of ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. ele-1: All FHIR elements must have a @value or children
medication[x]	SΣ	1..1		What medication was supplied Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): 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. ele-1: All FHIR elements must have a @value or children Example DIN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"}]} Example NPN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"}]} Example CCDD: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"}]} Example SNOMED CT (Medications) - IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"}]} Example WHO ATC IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"}]}
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication Profile)
subject	SΣ	1..1	Reference(Patient Profile)	Who the dispense is for ele-1: All FHIR elements must have a @value or children
context		0..1	Reference(Encounter Profile | EpisodeOfCare)	Encounter / Episode associated with event ele-1: All FHIR elements must have a @value or children
performer		0..*	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
actor	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson)	Individual who was performing ele-1: All FHIR elements must have a @value or children
location		0..1	Reference(Location Profile)	Where the dispense occurred ele-1: All FHIR elements must have a @value or children
authorizingPrescription		0..*	Reference(MedicationRequest Profile)	Medication order that authorizes the dispense ele-1: All FHIR elements must have a @value or children
quantity	S	0..1	SimpleQuantity	Amount dispensed ele-1: All FHIR elements must have a @value or children
whenPrepared	SΣ	0..1	dateTime	When product was packaged and reviewed ele-1: All FHIR elements must have a @value or children
destination		0..1	Reference(Location Profile)	Where the medication was sent ele-1: All FHIR elements must have a @value or children
receiver		0..*	Reference(Patient Profile | Practitioner Profile (General))	Who collected the medication ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:instructionRelationship		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship]]	Socialized Optional Extension: PrescribeIT dosageInstruction Relationship URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.medication[x]	preferred	https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	MedicationDispense Profile mdd-1: whenHandedOver cannot be before whenPrepared
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:renderedDosageInstruction		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage]]	Socialized Optional Extension: PrescribeIT renderedDosageInstruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
extension:quantityRemaining		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining]]	Socialized Optional Extension: PrescribeIT quantityRemaining URL: http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
partOf		0..*	Reference(Procedure Profile)	Event that dispense is part of
status	?!SΣ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
medication[x]	SΣ	1..1		What medication was supplied Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): 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. Example DIN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"}]} Example NPN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"}]} Example CCDD: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"}]} Example SNOMED CT (Medications) - IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"}]} Example WHO ATC IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"}]}
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication Profile)
subject	SΣ	1..1	Reference(Patient Profile)	Who the dispense is for
context		0..1	Reference(Encounter Profile | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer		0..*	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson)	Individual who was performing
location		0..1	Reference(Location Profile)	Where the dispense occurred
authorizingPrescription		0..*	Reference(MedicationRequest Profile)	Medication order that authorizes the dispense
type		0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity	S	0..1	SimpleQuantity	Amount dispensed
daysSupply		0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenPrepared	SΣ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver		0..1	dateTime	When product was given out
destination		0..1	Reference(Location Profile)	Where the medication was sent
receiver		0..*	Reference(Patient Profile | Practitioner Profile (General))	Who collected the medication
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:instructionRelationship		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship]]	Socialized Optional Extension: PrescribeIT dosageInstruction Relationship URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	Σ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
substitution		0..1	BackboneElement	Whether a substitution was performed on the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted		1..1	boolean	Whether a substitution was or was not performed on the dispense
type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General))	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	preferred	https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationDispense.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationDispense.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationDispense.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

Differential View

This structure is derived from MedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	MedicationDispense	MedicationDispense Profile
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:renderedDosageInstruction		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage]]	Socialized Optional Extension: PrescribeIT renderedDosageInstruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
extension:quantityRemaining		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining]]	Socialized Optional Extension: PrescribeIT quantityRemaining URL: http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining
partOf		0..*	Reference(Procedure Profile)	Event that dispense is part of
status	S	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
medication[x]	S	1..1		What medication was supplied Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): 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. Example DIN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"}]} Example NPN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"}]} Example CCDD: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"}]} Example SNOMED CT (Medications) - IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"}]} Example WHO ATC IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"}]}
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication Profile)
subject	S	1..1	Reference(Patient Profile)	Who the dispense is for
context		0..1	Reference(Encounter Profile | EpisodeOfCare)	Encounter / Episode associated with event
performer
actor	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson)	Individual who was performing
location		0..1	Reference(Location Profile)	Where the dispense occurred
authorizingPrescription		0..*	Reference(MedicationRequest Profile)	Medication order that authorizes the dispense
quantity	S	0..1	SimpleQuantity	Amount dispensed
whenPrepared	S	0..1	dateTime	When product was packaged and reviewed
destination		0..1	Reference(Location Profile)	Where the medication was sent
receiver		0..*	Reference(Patient Profile | Practitioner Profile (General))	Who collected the medication
dosageInstruction	S	0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:instructionRelationship		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship]]	Socialized Optional Extension: PrescribeIT dosageInstruction Relationship URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship
text	S	0..1	string	Free text dosage instructions e.g. SIG
substitution
responsibleParty		0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General))	Who is responsible for the substitution
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationDispense.medication[x]	preferred	https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	MedicationDispense Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management mdd-1: whenHandedOver cannot be before whenPrepared
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:renderedDosageInstruction		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage]]	Socialized Optional Extension: PrescribeIT renderedDosageInstruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:quantityRemaining		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining]]	Socialized Optional Extension: PrescribeIT quantityRemaining URL: http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
partOf		0..*	Reference(Procedure Profile)	Event that dispense is part of ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. ele-1: All FHIR elements must have a @value or children
medication[x]	SΣ	1..1		What medication was supplied Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): 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. ele-1: All FHIR elements must have a @value or children Example DIN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"}]} Example NPN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"}]} Example CCDD: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"}]} Example SNOMED CT (Medications) - IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"}]} Example WHO ATC IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"}]}
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication Profile)
subject	SΣ	1..1	Reference(Patient Profile)	Who the dispense is for ele-1: All FHIR elements must have a @value or children
context		0..1	Reference(Encounter Profile | EpisodeOfCare)	Encounter / Episode associated with event ele-1: All FHIR elements must have a @value or children
performer		0..*	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
actor	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson)	Individual who was performing ele-1: All FHIR elements must have a @value or children
location		0..1	Reference(Location Profile)	Where the dispense occurred ele-1: All FHIR elements must have a @value or children
authorizingPrescription		0..*	Reference(MedicationRequest Profile)	Medication order that authorizes the dispense ele-1: All FHIR elements must have a @value or children
quantity	S	0..1	SimpleQuantity	Amount dispensed ele-1: All FHIR elements must have a @value or children
whenPrepared	SΣ	0..1	dateTime	When product was packaged and reviewed ele-1: All FHIR elements must have a @value or children
destination		0..1	Reference(Location Profile)	Where the medication was sent ele-1: All FHIR elements must have a @value or children
receiver		0..*	Reference(Patient Profile | Practitioner Profile (General))	Who collected the medication ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:instructionRelationship		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship]]	Socialized Optional Extension: PrescribeIT dosageInstruction Relationship URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.medication[x]	preferred	https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	MedicationDispense Profile mdd-1: whenHandedOver cannot be before whenPrepared
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:renderedDosageInstruction		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage]]	Socialized Optional Extension: PrescribeIT renderedDosageInstruction URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage
extension:quantityRemaining		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining]]	Socialized Optional Extension: PrescribeIT quantityRemaining URL: http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
partOf		0..*	Reference(Procedure Profile)	Event that dispense is part of
status	?!SΣ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
medication[x]	SΣ	1..1		What medication was supplied Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): 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. Example DIN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"}]} Example NPN: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"}]} Example CCDD: {"coding":[{"system":"https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"}]} Example SNOMED CT (Medications) - IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"}]} Example WHO ATC IPS: {"coding":[{"system":"http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"}]}
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication Profile)
subject	SΣ	1..1	Reference(Patient Profile)	Who the dispense is for
context		0..1	Reference(Encounter Profile | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer		0..*	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson)	Individual who was performing
location		0..1	Reference(Location Profile)	Where the dispense occurred
authorizingPrescription		0..*	Reference(MedicationRequest Profile)	Medication order that authorizes the dispense
type		0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity	S	0..1	SimpleQuantity	Amount dispensed
daysSupply		0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenPrepared	SΣ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver		0..1	dateTime	When product was given out
destination		0..1	Reference(Location Profile)	Where the medication was sent
receiver		0..*	Reference(Patient Profile | Practitioner Profile (General))	Who collected the medication
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:instructionRelationship		0..1	?gen-e1? [CanonicalType[http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship]]	Socialized Optional Extension: PrescribeIT dosageInstruction Relationship URL: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	Σ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
substitution		0..1	BackboneElement	Whether a substitution was performed on the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted		1..1	boolean	Whether a substitution was or was not performed on the dispense
type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General))	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	preferred	https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationDispense.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationDispense.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationDispense.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

This structure is derived from MedicationDispense

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

• Procedure Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-procedure)
• Medication Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication)
• Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
• Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
• Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
• PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
• Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
• Device Profile (Implantable) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device)
• Location Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location)
• MedicationRequest Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest)

Extensions

This structure refers to these extensions:

• Unable to summarise extension http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage (no extension found)
• Unable to summarise extension http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining (no extension found)
• Unable to summarise extension http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship (no extension found)