Australian Digital Health Agency FHIR Implementation Guide

This profile identifies the additional constraints, extensions, and value sets that build on and extend MedicationDispense that are supported.

Where a more specific MedicationDispense profile is applicable, e.g. dispense record, an implementation SHALL ensure the resource conforms to that specific profile.

This profile is designed to set a core MedicationDispense standard for:

• Query medications dispensed or intended to be dispensed for a patient
• Record or update a record of dispense intended or completed for a patient

This profile may be referred to by APIs, which will be listed here when available.

Profile specific guidance

• See the Medicine information section for guidance.
• MedicationDispense resources can represent a medication using either a code, or reference a Medication resource.
  • When referencing a Medication resource, it is preferred the resource is contained but it may be an external resource.

Boundaries and relationships

These profiles build on this profile (ADHA Core MedicationDispense) to define specific roles:

• ADHA Dispense Record

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

This structure is derived from AUBaseMedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
status	S	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
statusReason[x]	S	0..1	CodeableConcept, Reference(DetectedIssue)	Why a dispense was not performed
category	S	0..1	CodeableConcept	Type of medication dispense
Slices for medication[x]	S	1..1	CodeableConcept, Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept		0..1	CodeableConcept	Coded Dispensed Medication
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	S	0..*	Coding	Code defined by a terminology system
coding:amt	S	0..*	Coding	Code defined by a terminology system
medication[x]:medicationReference		0..1	Reference(ADHA Core Medication)	Dispensed Medication
subject	SC	1..1	Reference(ADHA Core Patient)	Who the dispense is for inv-dh-medisp-01: At least reference or a valid identifier shall be present
context	S	0..1	Reference(ADHA Core Encounter)	Encounter / Episode associated with event
performer	SC	1..*	BackboneElement	Who performed event inv-dh-medisp-02: The actor shall at least have a reference, an identifier or a display
function	S	1..1	CodeableConcept	Who performed the dispense and what they did
actor	SC	1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(ADHA Core MedicationRequest)	Medication order that authorizes the dispense
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
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-medisp-01	error	MedicationDispense.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-medisp-02	error	MedicationDispense.performer	The actor shall at least have a reference, an identifier or a display : actor.exists() implies actor.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management mdd-1: whenHandedOver cannot be before whenPrepared
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category	S	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. ele-1: All FHIR elements must have a @value or children
Slices for medication[x]	SΣ	1..1		What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed. ele-1: All FHIR elements must have a @value or children
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example) Additional Bindings Purpose Australian Medication Preferred PBS Item Codes Preferred MIMS Preferred GTIN Preferred ele-1: All FHIR elements must have a @value or children
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children
coding:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:pbs	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:amt	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
medication[x]:medicationReference	Σ	0..1	Reference(ADHA Core Medication)	Dispensed Medication ele-1: All FHIR elements must have a @value or children
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who the dispense is for ele-1: All FHIR elements must have a @value or children inv-dh-medisp-01: At least reference or a valid identifier shall be present
context	S	0..1	Reference(ADHA Core Encounter)	Encounter / Episode associated with event ele-1: All FHIR elements must have a @value or children
performer	SC	1..*	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children inv-dh-medisp-02: The actor shall at least have a reference, an identifier or a display
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
function	S	1..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. ele-1: All FHIR elements must have a @value or children
actor	SC	1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson)	Individual who was performing ele-1: All FHIR elements must have a @value or children
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred ele-1: All FHIR elements must have a @value or children
authorizingPrescription	S	0..*	Reference(ADHA Core MedicationRequest)	Medication order that authorizes the dispense ele-1: All FHIR elements must have a @value or children
quantity	S	0..1	SimpleQuantity	Amount dispensed ele-1: All FHIR elements must have a @value or children
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount ele-1: All FHIR elements must have a @value or children
whenHandedOver	S	0..1	dateTime	When product was given out ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	Information about the dispense ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context ele-1: All FHIR elements must have a @value or children
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense ele-1: All FHIR elements must have a @value or children
reason		0..1	CodeableConcept	Why was substitution made Binding: Medicine Substitution Reason (preferred) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.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]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.substitution.reason	preferred	MedicineSubstitutionReason https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-medisp-01	error	MedicationDispense.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-medisp-02	error	MedicationDispense.performer	The actor shall at least have a reference, an identifier or a display : actor.exists() implies actor.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context mdd-1: whenHandedOver cannot be before whenPrepared
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	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	S	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.
Slices for medication[x]	SΣ	1..1		What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example) Additional Bindings Purpose Australian Medication Preferred PBS Item Codes Preferred MIMS Preferred GTIN Preferred
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:pbs	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:amt	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Medication primary text
medication[x]:medicationReference	Σ	0..1	Reference(ADHA Core Medication)	Dispensed Medication
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who the dispense is for inv-dh-medisp-01: At least reference or a valid identifier shall be present
context	S	0..1	Reference(ADHA Core Encounter)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	SC	1..*	BackboneElement	Who performed event inv-dh-medisp-02: The actor shall at least have a reference, an identifier or a display
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	S	1..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	SC	1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(ADHA Core MedicationRequest)	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(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	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	S	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..1	CodeableConcept	Why was substitution made Binding: Medicine Substitution Reason (preferred)
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 http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	preferred	MedicineSubstitutionReason https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-medisp-01	error	MedicationDispense.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-medisp-02	error	MedicationDispense.performer	The actor shall at least have a reference, an identifier or a display : actor.exists() implies actor.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())

Differential View

This structure is derived from AUBaseMedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
status	S	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
statusReason[x]	S	0..1	CodeableConcept, Reference(DetectedIssue)	Why a dispense was not performed
category	S	0..1	CodeableConcept	Type of medication dispense
Slices for medication[x]	S	1..1	CodeableConcept, Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept		0..1	CodeableConcept	Coded Dispensed Medication
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	S	0..*	Coding	Code defined by a terminology system
coding:amt	S	0..*	Coding	Code defined by a terminology system
medication[x]:medicationReference		0..1	Reference(ADHA Core Medication)	Dispensed Medication
subject	SC	1..1	Reference(ADHA Core Patient)	Who the dispense is for inv-dh-medisp-01: At least reference or a valid identifier shall be present
context	S	0..1	Reference(ADHA Core Encounter)	Encounter / Episode associated with event
performer	SC	1..*	BackboneElement	Who performed event inv-dh-medisp-02: The actor shall at least have a reference, an identifier or a display
function	S	1..1	CodeableConcept	Who performed the dispense and what they did
actor	SC	1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(ADHA Core MedicationRequest)	Medication order that authorizes the dispense
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
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-medisp-01	error	MedicationDispense.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-medisp-02	error	MedicationDispense.performer	The actor shall at least have a reference, an identifier or a display : actor.exists() implies actor.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management mdd-1: whenHandedOver cannot be before whenPrepared
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category	S	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. ele-1: All FHIR elements must have a @value or children
Slices for medication[x]	SΣ	1..1		What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed. ele-1: All FHIR elements must have a @value or children
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example) Additional Bindings Purpose Australian Medication Preferred PBS Item Codes Preferred MIMS Preferred GTIN Preferred ele-1: All FHIR elements must have a @value or children
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children
coding:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:pbs	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
coding:amt	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
medication[x]:medicationReference	Σ	0..1	Reference(ADHA Core Medication)	Dispensed Medication ele-1: All FHIR elements must have a @value or children
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who the dispense is for ele-1: All FHIR elements must have a @value or children inv-dh-medisp-01: At least reference or a valid identifier shall be present
context	S	0..1	Reference(ADHA Core Encounter)	Encounter / Episode associated with event ele-1: All FHIR elements must have a @value or children
performer	SC	1..*	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children inv-dh-medisp-02: The actor shall at least have a reference, an identifier or a display
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
function	S	1..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. ele-1: All FHIR elements must have a @value or children
actor	SC	1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson)	Individual who was performing ele-1: All FHIR elements must have a @value or children
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred ele-1: All FHIR elements must have a @value or children
authorizingPrescription	S	0..*	Reference(ADHA Core MedicationRequest)	Medication order that authorizes the dispense ele-1: All FHIR elements must have a @value or children
quantity	S	0..1	SimpleQuantity	Amount dispensed ele-1: All FHIR elements must have a @value or children
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount ele-1: All FHIR elements must have a @value or children
whenHandedOver	S	0..1	dateTime	When product was given out ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	Information about the dispense ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context ele-1: All FHIR elements must have a @value or children
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense ele-1: All FHIR elements must have a @value or children
reason		0..1	CodeableConcept	Why was substitution made Binding: Medicine Substitution Reason (preferred) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.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]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.substitution.reason	preferred	MedicineSubstitutionReason https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-medisp-01	error	MedicationDispense.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-medisp-02	error	MedicationDispense.performer	The actor shall at least have a reference, an identifier or a display : actor.exists() implies actor.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context mdd-1: whenHandedOver cannot be before whenPrepared
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	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	S	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.
Slices for medication[x]	SΣ	1..1		What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationCodeableConcept	Σ	0..1	CodeableConcept	Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example) Additional Bindings Purpose Australian Medication Preferred PBS Item Codes Preferred MIMS Preferred GTIN Preferred
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:pbs	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:amt	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Medication primary text
medication[x]:medicationReference	Σ	0..1	Reference(ADHA Core Medication)	Dispensed Medication
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who the dispense is for inv-dh-medisp-01: At least reference or a valid identifier shall be present
context	S	0..1	Reference(ADHA Core Encounter)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	SC	1..*	BackboneElement	Who performed event inv-dh-medisp-02: The actor shall at least have a reference, an identifier or a display
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	S	1..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	SC	1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA Authoring RelatedPerson)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(ADHA Core MedicationRequest)	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(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	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	S	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..1	CodeableConcept	Why was substitution made Binding: Medicine Substitution Reason (preferred)
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 http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	preferred	MedicineSubstitutionReason https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-medisp-01	error	MedicationDispense.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-medisp-02	error	MedicationDispense.performer	The actor shall at least have a reference, an identifier or a display : actor.exists() implies actor.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())

This structure is derived from AUBaseMedicationDispense

Summary

Mandatory: 4 elements
Must-Support: 22 elements

Structures

This structure refers to these other structures:

• ADHA Core Medication (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-medication-core-1)
• ADHA Core Patient (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-patient-core-1)
• ADHA Core Encounter (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-encounter-core-1)
• ADHA Authoring PractitionerRole (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitionerrole-author-1)
• ADHA Core Organization (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-organization-core-1)
• ADHA Authoring RelatedPerson (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-relatedperson-author-1)
• ADHA Core Location (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-location-core-1)
• ADHA Core MedicationRequest (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-medicationrequest-core-1)

Extensions

This structure refers to these extensions:

• http://hl7.org.au/fhir/StructureDefinition/dispense-number

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationDispense.medication[x] (Closed)
• The element 1 is sliced based on the value of MedicationDispense.medication[x].coding

Below is an overview of the mandatory and optional search parameters. FHIR search operations and the syntax used to describe the interactions is described here.