Australian Digital Health Agency FHIR Implementation Guide

Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• XML
• JSON
• TTL

Resource Profile: ADHA Dispense Record

The purpose of this profile is to provide a representation of a dispense record for the electronic exchange of health information between individuals, healthcare providers, and the My Health Record system infrastructure in Australia.

Usage:

• Refer to this Resource Profile: ADHA Prescription and or Dispense History List

Formal Views of Profile Content

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

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

This structure is derived from ADHAMedicationDispenseCore

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	ADHAMedicationDispenseCore	Dispense Record inv-dh-disp-01: If present, the authorising prescription shall at least have a reference or a valid identifier
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		1..*	Identifier, AULocalDispenseIdentifier	External identifier
status		1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Required Pattern: completed
Slices for medication[x]	S	1..1	Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	C	1..1	Reference(ADHA Core Medication)	Dispensed Medication inv-dh-disp-02: At least reference shall be present
performer		1..*	BackboneElement	Who performed event
actor		1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	SC	0..*	Reference(ADHA Core MedicationRequest)	Medication order that authorizes the dispense
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenHandedOver		1..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-disp-01	error	MedicationDispense	If present, the authorising prescription shall at least have a reference or a valid identifier : authorizingPrescription.exists() implies authorizingPrescription.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())
inv-dh-disp-02	error	MedicationDispense.medication[x]:medicationReference	At least reference shall be present : reference.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	ADHAMedicationDispenseCore	Dispense Record 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 inv-dh-disp-01: If present, the authorising prescription shall at least have a reference or a valid identifier
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	1..*	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 Required Pattern: completed
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	Reference(Medication)	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
medication[x]:medicationReference	ΣC	1..1	Reference(ADHA Core Medication)	Dispensed Medication ele-1: All FHIR elements must have a @value or children inv-dh-disp-02: At least reference shall be present
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
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)	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	SC	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	1..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 / Code	URI
MedicationDispense.status	required	Pattern: completed 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-disp-01	error	MedicationDispense	If present, the authorising prescription shall at least have a reference or a valid identifier : authorizingPrescription.exists() implies authorizingPrescription.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())
inv-dh-disp-02	error	MedicationDispense.medication[x]:medicationReference	At least reference shall be present : reference.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	ADHAMedicationDispenseCore	Dispense Record mdd-1: whenHandedOver cannot be before whenPrepared inv-dh-disp-01: If present, the authorising prescription shall at least have a reference or a valid identifier
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	1..*	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. Required Pattern: completed
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	Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medication[x]:medicationReference	ΣC	1..1	Reference(ADHA Core Medication)	Dispensed Medication inv-dh-disp-02: At least reference shall be present
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
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)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	SC	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	1..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 / Code	URI
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	Pattern: completed 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-disp-01	error	MedicationDispense	If present, the authorising prescription shall at least have a reference or a valid identifier : authorizingPrescription.exists() implies authorizingPrescription.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())
inv-dh-disp-02	error	MedicationDispense.medication[x]:medicationReference	At least reference shall be present : reference.exists()

This structure is derived from ADHAMedicationDispenseCore

Summary

Mandatory: 4 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• 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 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)

Differential View

This structure is derived from ADHAMedicationDispenseCore

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	ADHAMedicationDispenseCore	Dispense Record inv-dh-disp-01: If present, the authorising prescription shall at least have a reference or a valid identifier
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		1..*	Identifier, AULocalDispenseIdentifier	External identifier
status		1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Required Pattern: completed
Slices for medication[x]	S	1..1	Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	C	1..1	Reference(ADHA Core Medication)	Dispensed Medication inv-dh-disp-02: At least reference shall be present
performer		1..*	BackboneElement	Who performed event
actor		1..1	Reference(ADHA Authoring PractitionerRole | ADHA Core Organization)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	SC	0..*	Reference(ADHA Core MedicationRequest)	Medication order that authorizes the dispense
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenHandedOver		1..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-disp-01	error	MedicationDispense	If present, the authorising prescription shall at least have a reference or a valid identifier : authorizingPrescription.exists() implies authorizingPrescription.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())
inv-dh-disp-02	error	MedicationDispense.medication[x]:medicationReference	At least reference shall be present : reference.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	ADHAMedicationDispenseCore	Dispense Record 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 inv-dh-disp-01: If present, the authorising prescription shall at least have a reference or a valid identifier
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	1..*	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 Required Pattern: completed
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	Reference(Medication)	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
medication[x]:medicationReference	ΣC	1..1	Reference(ADHA Core Medication)	Dispensed Medication ele-1: All FHIR elements must have a @value or children inv-dh-disp-02: At least reference shall be present
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
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)	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	SC	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	1..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 / Code	URI
MedicationDispense.status	required	Pattern: completed 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-disp-01	error	MedicationDispense	If present, the authorising prescription shall at least have a reference or a valid identifier : authorizingPrescription.exists() implies authorizingPrescription.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())
inv-dh-disp-02	error	MedicationDispense.medication[x]:medicationReference	At least reference shall be present : reference.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	ADHAMedicationDispenseCore	Dispense Record mdd-1: whenHandedOver cannot be before whenPrepared inv-dh-disp-01: If present, the authorising prescription shall at least have a reference or a valid identifier
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	1..*	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. Required Pattern: completed
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	Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medication[x]:medicationReference	ΣC	1..1	Reference(ADHA Core Medication)	Dispensed Medication inv-dh-disp-02: At least reference shall be present
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
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)	Individual who was performing
location	S	0..1	Reference(ADHA Core Location)	Where the dispense occurred
authorizingPrescription	SC	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	1..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 / Code	URI
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	Pattern: completed 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-disp-01	error	MedicationDispense	If present, the authorising prescription shall at least have a reference or a valid identifier : authorizingPrescription.exists() implies authorizingPrescription.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())
inv-dh-disp-02	error	MedicationDispense.medication[x]:medicationReference	At least reference shall be present : reference.exists()

This structure is derived from ADHAMedicationDispenseCore

Summary

Mandatory: 4 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• 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 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)

Other representations of profile: CSV, Excel, Schematron

Notes: