FHIR Clinical Guidelines (v1.0.0) (STU1)

Clinical Practice Guidelines, published by Clinical Decision Support WG. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

D.4.1 StructureDefinition-cpg-medicationdispense

Introduction:

Examples:

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-medicationdispense

Documents the dispensing of a particular medication as an activity within the context of a computable clinical practice guideline

This profile builds on MedicationDispense.

This profile was published on Thu Jun 06 00:00:00 UTC 2019 as a draft by Health Level Seven, Inc. - CDS WG.

Description of Profiles, Differentials, and Snapshots.

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense 0..*MedicationDispenseDispensing a medication to a named patient
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred

... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature

... identifier S0..*IdentifierExternal identifier
... status S1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
... statusReason[x] S0..1CodeableConcept, Reference(DetectedIssue)Why a dispense was not performed
... category S0..1CodeableConceptType of medication dispense
... medication[x] S1..1CodeableConcept, Reference(Medication)What medication was supplied
... subject S0..1Reference(Patient | Group)Who the dispense is for
... context S0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation S0..*Reference(Resource)Pertinent information
... authorizingPrescription S0..*Reference(MedicationRequest)Medication order that authorizes the dispense

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

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred


... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature


... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*IdentifierExternal identifier
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!SΣ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

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

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category S0..1CodeableConceptType of medication dispense
Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.

... medication[x] SΣ1..1What medication was supplied
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject SΣ0..1Reference(Patient | Group)Who the dispense is for
... context S0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation S0..*Reference(Resource)Pertinent information
... performer 0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptWho performed the dispense and what they did
Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.

.... actor 1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)Individual who was performing
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(MedicationRequest)Medication order that authorizes the dispense
... type 0..1CodeableConceptTrial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

... quantity 0..1SimpleQuantityAmount dispensed
... daysSupply 0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver 0..1dateTimeWhen product was given out
... destination 0..1Reference(Location)Where the medication was sent
... receiver 0..*Reference(Patient | Practitioner)Who collected the medication
... note 0..*AnnotationInformation about the dispense
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

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


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

doco Documentation for this format

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense 0..*MedicationDispenseDispensing a medication to a named patient
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred

... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature

... identifier S0..*IdentifierExternal identifier
... status S1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
... statusReason[x] S0..1CodeableConcept, Reference(DetectedIssue)Why a dispense was not performed
... category S0..1CodeableConceptType of medication dispense
... medication[x] S1..1CodeableConcept, Reference(Medication)What medication was supplied
... subject S0..1Reference(Patient | Group)Who the dispense is for
... context S0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation S0..*Reference(Resource)Pertinent information
... authorizingPrescription S0..*Reference(MedicationRequest)Medication order that authorizes the dispense

doco Documentation for this format

Snapshot View

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

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-instantiatesCaseFeature S0..1canonical(StructureDefinition)Definition of this case feature
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-instantiatesCaseFeature
... cpg-caseFeatureType S0..1codeasserted | inferred
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeatureType
Binding: CPG Case Feature Type (required): Whether the case feature is asserted or inferred


... cpg-caseFeaturePertinence S0..1codeweakly-positive | weakly-negative | strongly-positive | strongly-negative | pathognomonic
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-caseFeaturePertinence
Binding: CPG Case Feature Pertinence (required): Describes the pertinence of a case feature


... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*IdentifierExternal identifier
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!SΣ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

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

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category S0..1CodeableConceptType of medication dispense
Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.

... medication[x] SΣ1..1What medication was supplied
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject SΣ0..1Reference(Patient | Group)Who the dispense is for
... context S0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation S0..*Reference(Resource)Pertinent information
... performer 0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptWho performed the dispense and what they did
Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.

.... actor 1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)Individual who was performing
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(MedicationRequest)Medication order that authorizes the dispense
... type 0..1CodeableConceptTrial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

... quantity 0..1SimpleQuantityAmount dispensed
... daysSupply 0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver 0..1dateTimeWhen product was given out
... destination 0..1Reference(Location)Where the medication was sent
... receiver 0..*Reference(Patient | Practitioner)Who collected the medication
... note 0..*AnnotationInformation about the dispense
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

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


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

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet
MedicationDispense.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationDispense.statusrequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
MedicationDispense.categorypreferredMedicationDispense Category Codes
MedicationDispense.medication[x]exampleSNOMEDCTMedicationCodes
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
MedicationDispense.typeexampleActPharmacySupplyType
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonexampleSubstanceAdminSubstitutionReason

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2MedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3MedicationDispenseIf 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-4MedicationDispenseIf 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-5MedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6MedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
mdd-1MedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
ele-1MedicationDispense.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.extension:instantiatesCaseFeatureAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.extension:instantiatesCaseFeatureMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.extension:caseFeatureTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.extension:caseFeatureTypeMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.extension:caseFeaturePertinenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.extension:caseFeaturePertinenceMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.statusReason[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.medication[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.contextAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.supportingInformationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.performer.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.performer.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.performer.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.performer.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.performer.functionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.performer.actorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.locationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.authorizingPrescriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.quantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.daysSupplyAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.whenPreparedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.whenHandedOverAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.destinationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.receiverAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.dosageInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.substitutionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.substitution.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.substitution.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.substitution.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationDispense.substitution.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationDispense.substitution.wasSubstitutedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.substitution.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.substitution.reasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.substitution.responsiblePartyAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.detectedIssueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationDispense.eventHistoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())