## Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense vs http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense

Left: | US Core MedicationDispense Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense)
Right: | US Core MedicationDispense Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense)

### Messages

Information | MedicationDispense.language | Example/preferred bindings differ at MedicationDispense.language using binding from USCoreMedicationDispenseProfile
Information | MedicationDispense.category | Example/preferred bindings differ at MedicationDispense.category using binding from USCoreMedicationDispenseProfile
Error | MedicationDispense.performer.actor | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson], CanonicalType[http://hl7.org/fhir/StructureDefinition/Device]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson], CanonicalType[http://hl7.org/fhir/StructureDefinition/Device]])
Warning | MedicationDispense.dosageInstruction.route | Elements differ in definition for mustSupport: 'false' vs 'true'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/MedicationDispense |
copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |
description | The US Core MedicationDispense Profile inherits from the FHIR [MedicationDispense](https://hl7.org/fhir/R4/medicationdispense.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the MedicationDispense resource to record, search, and fetch the state of a patients medication with regards to dispensing or other activity. (e.g., dispensed, partially dispensed, not dispensed) It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. |
experimental |  |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreMedicationDispenseProfile |
publisher | HL7 International / Cross-Group Projects |
purpose |  |
status | active |
title | US Core MedicationDispense Profile |
type | MedicationDispense |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense |

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | Dispensing a medication to a named patient Constraints: us-core-20 | C | 0..* | MedicationDispense | Dispensing a medication to a named patient Constraints: us-core-20 |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
| Example/preferred bindings differ at MedicationDispense.language using binding from USCoreMedicationDispenseProfile
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..* | Resource | Contained, inline Resources |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier |  | 0..* | Identifier | External identifier |  | 0..* | Identifier | External identifier |
partOf |  | 0..* | Reference(Procedure) | Event that dispense is part of |  | 0..* | Reference(Procedure) | Event that dispense is part of |
status | ?!S Σ C | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: ?? (required): A coded concept specifying the state of the dispense event. | ?!S Σ C | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: ?? (required): A coded concept specifying the state of the dispense event. |
statusReason[x] |  | 0..1 | CodeableConcept, Reference(DetectedIssue) | Why a dispense was not performed Binding: ?? (example): A code describing why a dispense was not performed. |  | 0..1 | CodeableConcept, Reference(DetectedIssue) | Why a dispense was not performed Binding: ?? (example): A code describing why a dispense was not performed. |
category |  | 0..1 | CodeableConcept | Type of medication dispense Binding: ?? (preferred): A code describing where the dispensed medication is expected to be consumed or administered. |  | 0..1 | CodeableConcept | Type of medication dispense Binding: ?? (preferred): A code describing where the dispensed medication is expected to be consumed or administered. | Example/preferred bindings differ at MedicationDispense.category using binding from USCoreMedicationDispenseProfile
medication[x] | S Σ | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | What medication was supplied Binding: ?? (extensible) | S Σ | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | What medication was supplied Binding: ?? (extensible) |
subject | S Σ | 1..1 | Reference(US Core Patient Profile S | Group) | Who the dispense is for | S Σ | 1..1 | Reference(US Core Patient Profile S | Group) | Who the dispense is for |
context | S | 0..1 | Reference(US Core Encounter Profile S | EpisodeOfCare) | Encounter associated with MedicationDispense | S | 0..1 | Reference(US Core Encounter Profile S | EpisodeOfCare) | Encounter associated with MedicationDispense |
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication |
performer | S | 0..* | BackboneElement | Who performed event | S | 0..* | BackboneElement | Who performed event |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: ?? (example): A code describing the role an individual played in dispensing a medication. |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: ?? (example): A code describing the role an individual played in dispensing a medication. |
actor | S | 1..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Individual who was performing | S | 1..1 | Reference(US Core Organization Profile S | US Core Practitioner Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Individual who was performing | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson], CanonicalType[http://hl7.org/fhir/StructureDefinition/Device]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson], CanonicalType[http://hl7.org/fhir/StructureDefinition/Device]])
location |  | 0..1 | Reference(Location) | Where the dispense occurred |  | 0..1 | Reference(Location) | Where the dispense occurred |
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile) | Medication order that authorizes the dispense | S | 0..* | Reference(US Core MedicationRequest Profile) | Medication order that authorizes the dispense |
type | S | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ?? (extensible) | S | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ?? (extensible) |
quantity | S | 0..1 | ?? | Amount dispensed Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
| S | 0..1 | ?? | Amount dispensed Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
daysSupply |  | 0..1 | ?? | Amount of medication expressed as a timing amount |  | 0..1 | ?? | Amount of medication expressed as a timing amount |
whenPrepared | Σ | 0..1 | dateTime | When product was packaged and reviewed | Σ | 0..1 | dateTime | When product was packaged and reviewed |
whenHandedOver | S C | 0..1 | dateTime | When product was given out or mailed | S C | 0..1 | dateTime | When product was given out or mailed |
destination |  | 0..1 | Reference(Location) | Where the medication was sent |  | 0..1 | Reference(Location) | Where the medication was sent |
receiver |  | 0..* | Reference(Patient | Practitioner) | Who collected the medication |  | 0..* | Reference(Patient | Practitioner) | Who collected the medication |
note |  | 0..* | Annotation | Information about the dispense |  | 0..* | Annotation | Information about the dispense |
dosageInstruction | S | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver | S | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence | Σ | 0..1 | integer | The order of the dosage instructions | Σ | 0..1 | integer | The order of the dosage instructions |
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG |
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions | Σ | 0..1 | string | Patient or consumer oriented instructions |
timing | S Σ | 0..1 | Timing | When medication should be administered | S Σ | 0..1 | Timing | When medication should be administered |
asNeeded[x] | Σ | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) Binding: ?? (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | Σ | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) Binding: ?? (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. |
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | S Σ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (extensible): SNOMED CT and NCI Thesaurus SPL route of administration codes | Elements differ in definition for mustSupport: 'false' vs 'true'
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. |
doseAndRate | S Σ | 0..* | Element | Amount of medication administered | S Σ | 0..* | Element | Amount of medication administered |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified. | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified. |
dose[x] | S Σ | 0..1 | ??, Range | Amount of medication per dose Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
| S Σ | 0..1 | ??, Range | Amount of medication per dose Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
rate[x] | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | Σ | 0..1 | Ratio | Upper limit on medication per unit of time |
maxDosePerAdministration | Σ | 0..1 | ?? | Upper limit on medication per administration | Σ | 0..1 | ?? | Upper limit on medication per administration |
maxDosePerLifetime | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient |
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense |  | 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: ?? (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ?? (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. |
reason |  | 0..* | CodeableConcept | Why was substitution made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. |  | 0..* | CodeableConcept | Why was substitution made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. |
responsibleParty |  | 0..* | Reference(Practitioner | PractitionerRole) | Who is responsible for the substitution |  | 0..* | Reference(Practitioner | PractitionerRole) | Who is responsible for the substitution |
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical issue with action |  | 0..* | Reference(DetectedIssue) | Clinical issue with action |
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events |
Documentation for this format