QI-Core Implementation Guide
7.0.2 - STU 7 United States of America flag

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 7.0.2 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

Resource Profile: QICore MedicationDispense Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationdispensedone Version: 7.0.2
Standards status: Trial-use Maturity Level: 4 Computable Name: QICoreMedicationDispenseDone

Positive profile of MedicationDispense for decision support/quality metrics. Indicates that a medication is being or was dispensed

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:
  • medication[x]: (QI) What medication was supplied
  • status: (QI) preparation​ | in-progress​ | on-hold​ | completed​ | stopped​
  • subject: (QI) Who the dispense is for
QI Elements:
  • authorizingPrescription: (QI) Medication order that authorizes the dispense
  • extension(recorded): (QI) When recorded
  • dosageInstruction: (QI) How the medication is to be used by the patient or administered by the caregiver
  • medication[x].extension(codeOptions): (QI) Url of a value set of candidate medications
  • daysSupply: (QI) Amount of medication expressed as a timing amount
  • whenPrepared: (QI) When product was packaged and reviewed
  • quantity: (QI) Amount dispensed
  • whenHandedOver: (QI) When product was given out or mailed
  • type: (QI) Trial fill, partial fill, emergency fill, etc.
Primary code path: medication
(PCPath) This element is the primary code path for this resource CQL Retrieve

Usage

The MedicationDispense profile defines the conformance expectations for a MedicationDispense event, regardless of whether it is a positive or negative statement. The MedicationDispenseDone and MedicationDispenseDeclined profiles represent the positive and negative statements for a MedicationDispense event.

To create an expression indicating existence of a MedicationDispense event, use the profile QICoreMedicationDispenseDone; to specifically request information that a MedicationDispense intentionally did not occur for a medical, patient or system reason, use the profile QICoreMedicationDispenseDeclined.

The following example illustrates the use of the MedicationDispenseDone profile

define "Dementia Medication Dispensed":
  ["MedicationDispenseDone": "Dementia Medications"]

Note that the statuses indicating positive intent are implied by the use of the MedicationDispenseDone profile.

See the patterns page for implementation and usage patterns.

Examples

Penicillin MedicationDispense Example

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20, mdp-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:recorded 0..1 dateTime (QI) When recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... medication[x] SΣ 1..1 (QI) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medication[x]All Types Content/Rules for all Types
..... Slices for extension Content/Rules for all slices
...... extension:codeOptions 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who the dispense is for
... context S 0..1 Reference(US Core Encounter Profile S | EpisodeOfCare) Encounter associated with MedicationDispense
... performer S 0..* BackboneElement Who performed event
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... 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) Individual who was performing
... authorizingPrescription S 0..* Reference(QICore MedicationRequest) (QI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (QI) Trial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (extensible)
... quantity S 0..1 SimpleQuantity (QI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... whenHandedOver SC 0..1 dateTime (QI) When product was given out or mailed
... dosageInstruction S 0..* Dosage (QI) 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) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (QI) When medication should be administered
.... doseAndRate SΣ 0..* Element (QI) Amount of medication administered
..... dose[x] SΣ 0..1 (QI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S(SimpleQuantity)
...... doseRange Range

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Positive MedicationDispense Status 📦7.0.2 This IG
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.type Base extensible ActPharmacySupplyType 📦3.0.0 THO v6.5
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
mdp-1 error MedicationDispense To indicate what medication, either a reference to a Medication, or at least one coding in the medication or a codeOptions extension shall be provided (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.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 QICoreMedicationDispense

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense 0..* QICoreMedicationDispense Dispensing a medication to a named patient
... status 1..1 code (QI) preparation​ | in-progress​ | on-hold​ | completed​ | stopped​
Binding: Positive MedicationDispense Status (required)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Positive MedicationDispense Status 📦7.0.2 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20, mdp-1
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recorded 0..1 dateTime (QI) When recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.recorded
... 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) preparation​ | in-progress​ | on-hold​ | completed​ | stopped​
Binding: Positive 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) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medication[x]All Types Content/Rules for all Types
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... extension:codeOptions 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who the dispense is for
... context S 0..1 Reference(US Core Encounter Profile S | EpisodeOfCare) Encounter associated with MedicationDispense
... supportingInformation 0..* Reference(Resource) Information that supports the dispensing of the medication
... performer S 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(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription S 0..* Reference(QICore MedicationRequest) (QI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (QI) Trial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (extensible)
... quantity S 0..1 SimpleQuantity (QI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... daysSupply 0..1 SimpleQuantity (QI) Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime (QI) When product was packaged and reviewed
... whenHandedOver SC 0..1 dateTime (QI) 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) 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) 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) 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) 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) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S(SimpleQuantity)
...... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationDispense.status Base required Positive MedicationDispense Status 📦7.0.2 This IG
MedicationDispense.statusReason[x] Base example Medication dispense status reason codes 📦4.0.1 FHIR Std.
MedicationDispense.category Base preferred Medication dispense category codes 📦4.0.1 FHIR Std.
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.performer.​function Base example Medication dispense performer function codes 📦4.0.1 FHIR Std.
MedicationDispense.type Base extensible ActPharmacySupplyType 📦3.0.0 THO v6.5
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.substitution.​type Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v6.5
MedicationDispense.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v6.5

Constraints

Id Grade Path(s) Description Expression
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()
mdp-1 error MedicationDispense To indicate what medication, either a reference to a Medication, or at least one coding in the medication or a codeOptions extension shall be provided (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.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 QICoreMedicationDispense

Summary

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20, mdp-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:recorded 0..1 dateTime (QI) When recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... medication[x] SΣ 1..1 (QI) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medication[x]All Types Content/Rules for all Types
..... Slices for extension Content/Rules for all slices
...... extension:codeOptions 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who the dispense is for
... context S 0..1 Reference(US Core Encounter Profile S | EpisodeOfCare) Encounter associated with MedicationDispense
... performer S 0..* BackboneElement Who performed event
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... 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) Individual who was performing
... authorizingPrescription S 0..* Reference(QICore MedicationRequest) (QI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (QI) Trial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (extensible)
... quantity S 0..1 SimpleQuantity (QI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... whenHandedOver SC 0..1 dateTime (QI) When product was given out or mailed
... dosageInstruction S 0..* Dosage (QI) 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) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (QI) When medication should be administered
.... doseAndRate SΣ 0..* Element (QI) Amount of medication administered
..... dose[x] SΣ 0..1 (QI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S(SimpleQuantity)
...... doseRange Range

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Positive MedicationDispense Status 📦7.0.2 This IG
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.type Base extensible ActPharmacySupplyType 📦3.0.0 THO v6.5
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()
mdp-1 error MedicationDispense To indicate what medication, either a reference to a Medication, or at least one coding in the medication or a codeOptions extension shall be provided (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.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()

Differential View

This structure is derived from QICoreMedicationDispense

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense 0..* QICoreMedicationDispense Dispensing a medication to a named patient
... status 1..1 code (QI) preparation​ | in-progress​ | on-hold​ | completed​ | stopped​
Binding: Positive MedicationDispense Status (required)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Positive MedicationDispense Status 📦7.0.2 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20, mdp-1
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recorded 0..1 dateTime (QI) When recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.recorded
... 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) preparation​ | in-progress​ | on-hold​ | completed​ | stopped​
Binding: Positive 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) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medication[x]All Types Content/Rules for all Types
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... extension:codeOptions 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who the dispense is for
... context S 0..1 Reference(US Core Encounter Profile S | EpisodeOfCare) Encounter associated with MedicationDispense
... supportingInformation 0..* Reference(Resource) Information that supports the dispensing of the medication
... performer S 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(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription S 0..* Reference(QICore MedicationRequest) (QI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (QI) Trial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (extensible)
... quantity S 0..1 SimpleQuantity (QI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... daysSupply 0..1 SimpleQuantity (QI) Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime (QI) When product was packaged and reviewed
... whenHandedOver SC 0..1 dateTime (QI) 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) 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) 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) 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) 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) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S(SimpleQuantity)
...... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationDispense.status Base required Positive MedicationDispense Status 📦7.0.2 This IG
MedicationDispense.statusReason[x] Base example Medication dispense status reason codes 📦4.0.1 FHIR Std.
MedicationDispense.category Base preferred Medication dispense category codes 📦4.0.1 FHIR Std.
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.performer.​function Base example Medication dispense performer function codes 📦4.0.1 FHIR Std.
MedicationDispense.type Base extensible ActPharmacySupplyType 📦3.0.0 THO v6.5
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.substitution.​type Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v6.5
MedicationDispense.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v6.5

Constraints

Id Grade Path(s) Description Expression
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()
mdp-1 error MedicationDispense To indicate what medication, either a reference to a Medication, or at least one coding in the medication or a codeOptions extension shall be provided (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.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 QICoreMedicationDispense

Summary

Maturity: 4

 

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