QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• XML
• JSON
• TTL

Resource Profile: QICore MedicationDispense

Profile of MedicationDispense for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

define "Dementia Medication Dispensed":
  ["MedicationDispense": "Dementia Medications"] MedicationDispense
    where MedicationDispense.status in { 'active', 'completed', 'on-hold' }

Usage:

• Examples for this Resource Profile: MedicationDispense/cmd-example and MedicationDispense/example

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

This structure is derived from USCoreMedicationDispenseProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient
status		1..1	code	(QI-Core)(USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown Binding: Non-Negative MedicationDispense Status (required)
medication[x]		1..1		(QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(QICore Medication)
subject		1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who the dispense is for
authorizingPrescription		0..*	Reference(QICore MedicationRequest)	(QI-Core)(USCDI) Medication order that authorizes the dispense
type		0..1	CodeableConcept	(QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity		0..1	Quantity	(QI-Core)(USCDI) Amount dispensed
daysSupply		0..1	SimpleQuantity	(QI-Core) Amount of medication expressed as a timing amount
whenPrepared		0..1	dateTime	(QI-Core) When product was packaged and reviewed
whenHandedOver		0..1	dateTime	(QI-Core)(USCDI) When product was given out or mailed
dosageInstruction		0..*	Dosage	(QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver
text		0..1	string	(QI-Core)(USCDI) Free text dosage instructions e.g. SIG
timing		0..1	Timing	(QI-Core)(USCDI) When medication should be administered
doseAndRate		0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]		0..1		(QI-Core)(USCDI) Amount of medication per dose
doseQuantity			Quantity
doseRange			Range
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	NonNegativeMedicationDispenseStatus http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-status from this IG
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣC	1..1	code	(QI-Core)(USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown Binding: Non-Negative MedicationDispense Status (required)
medication[x]	SΣ	1..1		(QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(QICore Medication)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who the dispense is for
performer	S	0..*	BackboneElement	(USCDI) Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	S	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile)	(USCDI) Individual who was performing
authorizingPrescription	S	0..*	Reference(QICore MedicationRequest)	(QI-Core)(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	(QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	0..1	Quantity	(QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
daysSupply		0..1	SimpleQuantity	(QI-Core) Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	(QI-Core) When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(QI-Core)(USCDI) When product was given out or mailed
dosageInstruction	S	0..*	Dosage	(QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(QI-Core)(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(QI-Core)(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	NonNegativeMedicationDispenseStatus http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-status from this IG
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

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
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
partOf		0..*	Reference(Procedure)	Event that dispense is part of
status	?!SΣC	1..1	code	(QI-Core)(USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown Binding: Non-Negative MedicationDispense Status (required)
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
medication[x]	SΣ	1..1		(QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(QICore Medication)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who the dispense is for
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	S	0..*	BackboneElement	(USCDI) Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor	S	1..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Individual who was performing
location		0..1	Reference(Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(QICore MedicationRequest)	(QI-Core)(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	(QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	0..1	Quantity	(QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
daysSupply		0..1	SimpleQuantity	(QI-Core) Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	(QI-Core) When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(QI-Core)(USCDI) When product was given out or mailed
destination		0..1	Reference(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	Dosage	(QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	(QI-Core)(USCDI) Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	(QI-Core)(USCDI) When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	(QI-Core)(USCDI) Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		(QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
substitution		0..1	BackboneElement	Whether a substitution was performed on the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted		1..1	boolean	Whether a substitution was or was not performed on the dispense
type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationDispense.status	required	NonNegativeMedicationDispenseStatus http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-status from this IG
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]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
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.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common 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
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

This structure is derived from USCoreMedicationDispenseProfile

Summary

Structures

This structure refers to these other structures:

• QICore Medication (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication)
• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore MedicationRequest (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest)

Differential View

This structure is derived from USCoreMedicationDispenseProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient
status		1..1	code	(QI-Core)(USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown Binding: Non-Negative MedicationDispense Status (required)
medication[x]		1..1		(QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(QICore Medication)
subject		1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who the dispense is for
authorizingPrescription		0..*	Reference(QICore MedicationRequest)	(QI-Core)(USCDI) Medication order that authorizes the dispense
type		0..1	CodeableConcept	(QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity		0..1	Quantity	(QI-Core)(USCDI) Amount dispensed
daysSupply		0..1	SimpleQuantity	(QI-Core) Amount of medication expressed as a timing amount
whenPrepared		0..1	dateTime	(QI-Core) When product was packaged and reviewed
whenHandedOver		0..1	dateTime	(QI-Core)(USCDI) When product was given out or mailed
dosageInstruction		0..*	Dosage	(QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver
text		0..1	string	(QI-Core)(USCDI) Free text dosage instructions e.g. SIG
timing		0..1	Timing	(QI-Core)(USCDI) When medication should be administered
doseAndRate		0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]		0..1		(QI-Core)(USCDI) Amount of medication per dose
doseQuantity			Quantity
doseRange			Range
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	NonNegativeMedicationDispenseStatus http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-status from this IG
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣC	1..1	code	(QI-Core)(USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown Binding: Non-Negative MedicationDispense Status (required)
medication[x]	SΣ	1..1		(QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(QICore Medication)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who the dispense is for
performer	S	0..*	BackboneElement	(USCDI) Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	S	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile)	(USCDI) Individual who was performing
authorizingPrescription	S	0..*	Reference(QICore MedicationRequest)	(QI-Core)(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	(QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	0..1	Quantity	(QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
daysSupply		0..1	SimpleQuantity	(QI-Core) Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	(QI-Core) When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(QI-Core)(USCDI) When product was given out or mailed
dosageInstruction	S	0..*	Dosage	(QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(QI-Core)(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(QI-Core)(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	NonNegativeMedicationDispenseStatus http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-status from this IG
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

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
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
partOf		0..*	Reference(Procedure)	Event that dispense is part of
status	?!SΣC	1..1	code	(QI-Core)(USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown Binding: Non-Negative MedicationDispense Status (required)
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
medication[x]	SΣ	1..1		(QI-Core)(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible): The set of RxNorm codes to represent medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(QICore Medication)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who the dispense is for
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	S	0..*	BackboneElement	(USCDI) Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor	S	1..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Individual who was performing
location		0..1	Reference(Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(QICore MedicationRequest)	(QI-Core)(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	(QI-Core)(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	0..1	Quantity	(QI-Core)(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
daysSupply		0..1	SimpleQuantity	(QI-Core) Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	(QI-Core) When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(QI-Core)(USCDI) When product was given out or mailed
destination		0..1	Reference(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	Dosage	(QI-Core)(USCDI) How the medication is to be used by the patient or administered by the caregiver
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	(QI-Core)(USCDI) Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	(QI-Core)(USCDI) When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	(QI-Core)(USCDI) Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		(QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
substitution		0..1	BackboneElement	Whether a substitution was performed on the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted		1..1	boolean	Whether a substitution was or was not performed on the dispense
type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationDispense.status	required	NonNegativeMedicationDispenseStatus http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medicationdispense-status from this IG
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]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
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.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common 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
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

This structure is derived from USCoreMedicationDispenseProfile

Summary

Structures

This structure refers to these other structures:

• QICore Medication (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication)
• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore MedicationRequest (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest)

Other representations of profile: CSV, Excel, Schematron