HIV Screening Clinical Guidelines Implementation Guide
0.1.0 - CI Build Unknown region code '840'

HIV Screening Clinical Guidelines Implementation Guide, published by National Association of Community Health Centers, Inc. (NACHC). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/hiv-cds/ and changes regularly. See the Directory of published versions

Resource Profile: Prep Dispensed Medications

Official URL: http://fhir.org/guides/nachc/hiv-cds/StructureDefinition/prep-dispensed-medications Version: 0.1.0
Draft as of 2024-08-12 Computable Name: PrepDispensedMedications

Usage:Workflow Task: Prep

Copyright/Legal: Copyright National Association of Community Health Centers, Inc. (NACHC)

Prep Dispensed Medications

Usage:

Formal Views of Profile Content

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

This structure is derived from QICoreMedicationDispense

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense 0..* QICoreMedicationDispense Dispensing a medication to a named patient
... medication[x] S 1..1 CodeableConcept Prep Dispensed Medications
Binding: Prep Dispensed Medications Codes Grouper (required)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationDispense.medication[x]requiredPrepDispensedMedicationsCodesGrouper
http://fhir.org/guides/nachc/hiv-cds/ValueSet/nachc-g2-de26-codes-grouper
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
mdd-1: whenHandedOver cannot be before whenPrepared
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

.... statusReasonCodeableConcept CodeableConcept
.... statusReasonReference Reference(DetectedIssue)
... medication[x] SΣ 1..1 CodeableConcept Prep Dispensed Medications
Binding: Prep Dispensed Medications Codes Grouper (required)
... subject SΣ 0..1 Reference(QICorePatient) Who the dispense is for
... quantity S 0..1 SimpleQuantity Amount dispensed
... daysSupply S 0..1 SimpleQuantity Amount of medication expressed as a timing amount
... whenHandedOver S 0..1 dateTime When product was given out
... dosageInstruction 0..* Dosage 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
.... timing SΣ 0..1 Timing When medication should be administered
.... route SΣ 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.

.... doseAndRate SΣ 0..* Element Amount of medication administered
..... type SΣ 1..1 CodeableConcept The kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] SΣ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationDispense.statusrequiredMedicationDispense Status Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
from the FHIR Standard
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status-reason
from the FHIR Standard
MedicationDispense.medication[x]requiredPrepDispensedMedicationsCodesGrouper
http://fhir.org/guides/nachc/hiv-cds/ValueSet/nachc-g2-de26-codes-grouper
from this IG
MedicationDispense.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.typepreferredQICoreMedicationDoseType
http://hl7.org/fhir/us/qicore/ValueSet/qicore-medication-dose-type

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationDispenseIf 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-4errorMedicationDispenseIf 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-5errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mdd-1errorMedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
mdd-1: whenHandedOver cannot be before whenPrepared
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
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 ?!SΣ 1..1 code preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

... statusReason[x] S 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 CodeableConcept Prep Dispensed Medications
Binding: Prep Dispensed Medications Codes Grouper (required)
... subject SΣ 0..1 Reference(QICorePatient) 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 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 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription 0..* Reference(QICoreMedicationRequest) Medication order that authorizes the dispense
... type 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

... quantity S 0..1 SimpleQuantity Amount dispensed
... daysSupply S 0..1 SimpleQuantity Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
... whenHandedOver S 0..1 dateTime When product was given out
... destination 0..1 Reference(QICoreLocation) Where the medication was sent
... receiver 0..* Reference(QICorePatient | QICorePractitioner) Who collected the medication
... note 0..* Annotation Information about the dispense
... dosageInstruction 0..* Dosage How the medication is to be used by the patient or administered by the caregiver
.... id 0..1 string Unique id for inter-element referencing
.... 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 Σ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route SΣ 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 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 SΣ 1..1 CodeableConcept The kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] SΣ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... substitution 0..1 BackboneElement Whether a substitution was performed on the dispense
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1 boolean Whether a substitution was or was not performed on the dispense
.... type 0..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

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


.... responsibleParty 0..* Reference(QICorePractitioner) 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

PathConformanceValueSetURI
MedicationDispense.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationDispense.statusrequiredMedicationDispense Status Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
from the FHIR Standard
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status-reason
from the FHIR Standard
MedicationDispense.categorypreferredMedicationDispense Category Codes
http://hl7.org/fhir/ValueSet/medicationdispense-category
from the FHIR Standard
MedicationDispense.medication[x]requiredPrepDispensedMedicationsCodesGrouper
http://fhir.org/guides/nachc/hiv-cds/ValueSet/nachc-g2-de26-codes-grouper
from this IG
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
http://hl7.org/fhir/ValueSet/medicationdispense-performer-function
from the FHIR Standard
MedicationDispense.typeexampleActPharmacySupplyType
http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationDispense.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.typepreferredQICoreMedicationDoseType
http://hl7.org/fhir/us/qicore/ValueSet/qicore-medication-dose-type
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationDispenseIf 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-4errorMedicationDispenseIf 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-5errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mdd-1errorMedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

This structure is derived from QICoreMedicationDispense

Summary

Mandatory: 1 element
Must-Support: 1 element

Differential View

This structure is derived from QICoreMedicationDispense

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense 0..* QICoreMedicationDispense Dispensing a medication to a named patient
... medication[x] S 1..1 CodeableConcept Prep Dispensed Medications
Binding: Prep Dispensed Medications Codes Grouper (required)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationDispense.medication[x]requiredPrepDispensedMedicationsCodesGrouper
http://fhir.org/guides/nachc/hiv-cds/ValueSet/nachc-g2-de26-codes-grouper
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
mdd-1: whenHandedOver cannot be before whenPrepared
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

.... statusReasonCodeableConcept CodeableConcept
.... statusReasonReference Reference(DetectedIssue)
... medication[x] SΣ 1..1 CodeableConcept Prep Dispensed Medications
Binding: Prep Dispensed Medications Codes Grouper (required)
... subject SΣ 0..1 Reference(QICorePatient) Who the dispense is for
... quantity S 0..1 SimpleQuantity Amount dispensed
... daysSupply S 0..1 SimpleQuantity Amount of medication expressed as a timing amount
... whenHandedOver S 0..1 dateTime When product was given out
... dosageInstruction 0..* Dosage 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
.... timing SΣ 0..1 Timing When medication should be administered
.... route SΣ 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.

.... doseAndRate SΣ 0..* Element Amount of medication administered
..... type SΣ 1..1 CodeableConcept The kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] SΣ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationDispense.statusrequiredMedicationDispense Status Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
from the FHIR Standard
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status-reason
from the FHIR Standard
MedicationDispense.medication[x]requiredPrepDispensedMedicationsCodesGrouper
http://fhir.org/guides/nachc/hiv-cds/ValueSet/nachc-g2-de26-codes-grouper
from this IG
MedicationDispense.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.typepreferredQICoreMedicationDoseType
http://hl7.org/fhir/us/qicore/ValueSet/qicore-medication-dose-type

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationDispenseIf 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-4errorMedicationDispenseIf 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-5errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mdd-1errorMedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C 0..* QICoreMedicationDispense Dispensing a medication to a named patient
mdd-1: whenHandedOver cannot be before whenPrepared
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
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 ?!SΣ 1..1 code preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.

... statusReason[x] S 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 CodeableConcept Prep Dispensed Medications
Binding: Prep Dispensed Medications Codes Grouper (required)
... subject SΣ 0..1 Reference(QICorePatient) 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 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 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription 0..* Reference(QICoreMedicationRequest) Medication order that authorizes the dispense
... type 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc.
Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

... quantity S 0..1 SimpleQuantity Amount dispensed
... daysSupply S 0..1 SimpleQuantity Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
... whenHandedOver S 0..1 dateTime When product was given out
... destination 0..1 Reference(QICoreLocation) Where the medication was sent
... receiver 0..* Reference(QICorePatient | QICorePractitioner) Who collected the medication
... note 0..* Annotation Information about the dispense
... dosageInstruction 0..* Dosage How the medication is to be used by the patient or administered by the caregiver
.... id 0..1 string Unique id for inter-element referencing
.... 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 Σ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route SΣ 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 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 SΣ 1..1 CodeableConcept The kind of dose or rate specified
Binding: SNOMED CT Dosages Codes (preferred): Medication dose types (e.g., loading, maintenance, etc.)

..... dose[x] SΣ 0..1 Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... substitution 0..1 BackboneElement Whether a substitution was performed on the dispense
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1 boolean Whether a substitution was or was not performed on the dispense
.... type 0..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

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


.... responsibleParty 0..* Reference(QICorePractitioner) 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

PathConformanceValueSetURI
MedicationDispense.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationDispense.statusrequiredMedicationDispense Status Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
from the FHIR Standard
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationdispense-status-reason
from the FHIR Standard
MedicationDispense.categorypreferredMedicationDispense Category Codes
http://hl7.org/fhir/ValueSet/medicationdispense-category
from the FHIR Standard
MedicationDispense.medication[x]requiredPrepDispensedMedicationsCodesGrouper
http://fhir.org/guides/nachc/hiv-cds/ValueSet/nachc-g2-de26-codes-grouper
from this IG
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
http://hl7.org/fhir/ValueSet/medicationdispense-performer-function
from the FHIR Standard
MedicationDispense.typeexampleActPharmacySupplyType
http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationDispense.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.typepreferredQICoreMedicationDoseType
http://hl7.org/fhir/us/qicore/ValueSet/qicore-medication-dose-type
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationDispenseIf 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-4errorMedicationDispenseIf 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-5errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mdd-1errorMedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

This structure is derived from QICoreMedicationDispense

Summary

Mandatory: 1 element
Must-Support: 1 element

 

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