NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/PROJ-PHILHEALTH-EA-NHDR/nhdr-fhir-ig-review-project-2/ and changes regularly. See the Directory of published versions

## Resource Profile: PH_MedicationDispense - Detailed Descriptions

Page standards status: Draft

Definitions for the PH-MedicationDispense resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
Definition | Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
Short | Dispensing a medication to a named patient
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) 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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) mdd-1: whenHandedOver cannot be before whenPrepared (`whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared`) mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..01
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationDispense.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..01
Binding | The codes SHOULD be taken from CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. MedicationDispense.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..01
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationDispense.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..0*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
10. MedicationDispense.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. MedicationDispense.modifierExtension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | ExtensionExtensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..0*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. MedicationDispense.identifier
Definition | Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External identifier
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..0*
Type | Identifier
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MedicationDispense.partOf
Definition | The procedure that trigger the dispense.
Short | Event that dispense is part of
Control | 0..0*
Type | Reference(Procedure)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. MedicationDispense.status
Definition | A code specifying the state of the set of dispense events.
Short | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1` ) A coded concept specifying the state of the dispense event.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. MedicationDispense.statusReason[x]
Definition | Indicates the reason why a dispense was not performed.
Short | Why a dispense was not performed
Control | 0..01
Binding | For example codes, see MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1 (example to `http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1` ) A code describing why a dispense was not performed.
Type | Choice of: CodeableConcept, Reference(DetectedIssue)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. MedicationDispense.category
Definition | Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Short | Type of medication dispense
Comments | The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.
Control | 0..01
Binding | The codes SHOULD be taken from MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1` ) A code describing where the dispensed medication is expected to be consumed or administered.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. MedicationDispense.medication[x]
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
Short | What medication was supplied
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
Control | 1..1
Binding | For example codes, see SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/medication-codes|4.0.1` ) A coded concept identifying which substance or product can be dispensed.
Type | Choice of: CodeableConcept, Reference(Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `MedicationDispense.medication[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
26. MedicationDispense.medication[x]:medicationReference
Slice Name | medicationReference
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
Short | What medication was supplied
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
Control | 01..1
Type | Reference(PH Medication, Medication), CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. MedicationDispense.subject
Definition | A link to a resource representing the person or the group to whom the medication will be given.
Short | Who the dispense is for
Comments | SubstanceAdministration->subject->Patient.
Control | 0..01
Type | Reference(Patient, Group)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. MedicationDispense.context
Definition | The encounter or episode of care that establishes the context for this event.
Short | Encounter / Episode associated with event
Control | 0..01
Type | Reference(Encounter, EpisodeOfCare)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. MedicationDispense.supportingInformation
Definition | Additional information that supports the medication being dispensed.
Short | Information that supports the dispensing of the medication
Control | 0..0*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. MedicationDispense.performer
Definition | Indicates who or what performed the event.
Short | Who performed event
Control | 0..0*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. MedicationDispense.location
Definition | The principal physical location where the dispense was performed.
Short | Where the dispense occurred
Control | 0..01
Type | Reference(Location)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. MedicationDispense.authorizingPrescription
Definition | Indicates the medication order that is being dispensed against.
Short | Medication order that authorizes the dispense
Comments | Maps to basedOn in Event logical model.
Control | 0..0*
Type | Reference(MedicationRequest)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. MedicationDispense.type
Definition | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
Short | Trial fill, partial fill, emergency fill, etc.
Control | 0..01
Binding | For example codes, see ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType (example to `http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType` ) Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. MedicationDispense.daysSupply
Definition | The amount of medication expressed as a timing amount.
Short | Amount of medication expressed as a timing amount
Control | 0..01
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. MedicationDispense.whenPrepared
Definition | The time when the dispensed product was packaged and reviewed.
Short | When product was packaged and reviewed
Control | 0..01
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. MedicationDispense.destination
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event.
Short | Where the medication was sent
Control | 0..01
Type | Reference(Location)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. MedicationDispense.receiver
Definition | Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.
Short | Who collected the medication
Control | 0..0*
Type | Reference(Patient, Practitioner)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. MedicationDispense.substitution
Definition | Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.
Short | Whether a substitution was performed on the dispense
Control | 0..01
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. MedicationDispense.detectedIssue
Definition | Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.
Short | Clinical issue with action
Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
Control | 0..0*
Type | Reference(DetectedIssue)
Is Modifier | false
Summary | false
Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. MedicationDispense.eventHistory
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified.
Short | A list of relevant lifecycle events
Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
Control | 0..0*
Type | Reference(Provenance)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
2. MedicationDispense.meta
4. MedicationDispense.meta.extension:hfRecordedDate
Slice Name | hfRecordedDate
Control | 0..1
Type | Extension(The recorded date indicating when the record was uploaded by the health facility.) (Extension Type: dateTime)
6. MedicationDispense.meta.extension:hfLastUpdated
Slice Name | hfLastUpdated
Control | 0..*
Type | Extension(The date indicating when the record was last updated by the health facility.) (Extension Type: dateTime)
8. MedicationDispense.meta.lastUpdated
Short | When the resource was uploaded to the NHDR.
10. MedicationDispense.implicitRules
Control | 0..0
12. MedicationDispense.language
Control | 0..0
14. MedicationDispense.text
Control | 0..0
16. MedicationDispense.contained
Control | 0..0
18. MedicationDispense.extension
Control | 0..0
20. MedicationDispense.modifierExtension
Control | 0..0
22. MedicationDispense.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..0
24. MedicationDispense.partOf
Control | 0..0
26. MedicationDispense.statusReason[x]
Control | 0..0
28. MedicationDispense.category
Control | 0..0
30. MedicationDispense.medication[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Slicing | This element introduces a set of slices on `MedicationDispense.medication[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
32. MedicationDispense.medication[x]:medicationReference
Slice Name | medicationReference
Control | 0..1
Type | Reference(PH Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
34. MedicationDispense.subject
Control | 0..0
36. MedicationDispense.context
Control | 0..0
38. MedicationDispense.supportingInformation
Control | 0..0
40. MedicationDispense.performer
Control | 0..0
42. MedicationDispense.location
Control | 0..0
44. MedicationDispense.authorizingPrescription
Control | 0..0
46. MedicationDispense.type
Control | 0..0
48. MedicationDispense.daysSupply
Control | 0..0
50. MedicationDispense.whenPrepared
Control | 0..0
52. MedicationDispense.destination
Control | 0..0
54. MedicationDispense.receiver
Control | 0..0
56. MedicationDispense.dosageInstruction
58. MedicationDispense.dosageInstruction.extension
Control | 0..0
60. MedicationDispense.dosageInstruction.modifierExtension
Control | 0..0
62. MedicationDispense.dosageInstruction.sequence
Control | 0..0
64. MedicationDispense.dosageInstruction.text
Control | 0..0
66. MedicationDispense.dosageInstruction.additionalInstruction
Control | 0..0
68. MedicationDispense.dosageInstruction.patientInstruction
Control | 0..0
70. MedicationDispense.dosageInstruction.timing
72. MedicationDispense.dosageInstruction.timing.id
Control | 0..0
74. MedicationDispense.dosageInstruction.timing.extension
Control | 0..0
76. MedicationDispense.dosageInstruction.timing.modifierExtension
Control | 0..0
78. MedicationDispense.dosageInstruction.timing.event
Control | 0..0
80. MedicationDispense.dosageInstruction.timing.repeat
82. MedicationDispense.dosageInstruction.timing.repeat.id
Control | 0..0
84. MedicationDispense.dosageInstruction.timing.repeat.extension
Control | 0..0
86. MedicationDispense.dosageInstruction.timing.repeat.bounds[x]
Control | 0..0
88. MedicationDispense.dosageInstruction.timing.repeat.count
Control | 0..0
90. MedicationDispense.dosageInstruction.timing.repeat.countMax
Control | 0..0
92. MedicationDispense.dosageInstruction.timing.repeat.duration
Control | 0..0
94. MedicationDispense.dosageInstruction.timing.repeat.durationMax
Control | 0..0
96. MedicationDispense.dosageInstruction.timing.repeat.durationUnit
Control | 0..0
98. MedicationDispense.dosageInstruction.timing.repeat.frequencyMax
Control | 0..0
100. MedicationDispense.dosageInstruction.timing.repeat.period
Control | 0..0
102. MedicationDispense.dosageInstruction.timing.repeat.periodMax
Control | 0..0
104. MedicationDispense.dosageInstruction.timing.repeat.periodUnit
Control | 0..0
106. MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek
Control | 0..0
108. MedicationDispense.dosageInstruction.timing.repeat.timeOfDay
Control | 0..0
110. MedicationDispense.dosageInstruction.timing.repeat.when
Control | 0..0
112. MedicationDispense.dosageInstruction.timing.repeat.offset
Control | 0..0
114. MedicationDispense.dosageInstruction.timing.code
Control | 0..0
116. MedicationDispense.dosageInstruction.asNeeded[x]
Control | 0..0
118. MedicationDispense.dosageInstruction.site
Control | 0..0
120. MedicationDispense.dosageInstruction.method
Control | 0..0
122. MedicationDispense.dosageInstruction.doseAndRate
124. MedicationDispense.dosageInstruction.doseAndRate.id
Control | 0..0
126. MedicationDispense.dosageInstruction.doseAndRate.extension
Control | 0..0
128. MedicationDispense.dosageInstruction.doseAndRate.type
Control | 0..0
130. MedicationDispense.dosageInstruction.doseAndRate.rate[x]
Control | 0..0
132. MedicationDispense.dosageInstruction.maxDosePerPeriod
Control | 0..0
134. MedicationDispense.dosageInstruction.maxDosePerAdministration
Control | 0..0
136. MedicationDispense.dosageInstruction.maxDosePerLifetime
Control | 0..0
138. MedicationDispense.substitution
Control | 0..0
140. MedicationDispense.detectedIssue
Control | 0..0
142. MedicationDispense.eventHistory
Control | 0..0

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
Definition | Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
Short | Dispensing a medication to a named patient
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) 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 (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) mdd-1: whenHandedOver cannot be before whenPrepared (`whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared`)
2. MedicationDispense.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. MedicationDispense.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. MedicationDispense.meta.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
8. MedicationDispense.meta.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationDispense.meta.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. MedicationDispense.meta.extension:hfRecordedDate
Slice Name | hfRecordedDate
Definition | The recorded date indicating when the record was uploaded by the health facility.
Short | The recorded date indicating when the record was uploaded by the health facility.
Control | 0..1
Type | Extension(The recorded date indicating when the record was uploaded by the health facility.) (Extension Type: dateTime)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
12. MedicationDispense.meta.extension:hfLastUpdated
Slice Name | hfLastUpdated
Definition | The date indicating when the record was last updated by the health facility.
Short | The date indicating when the record was last updated by the health facility.
Control | 0..*
Type | Extension(The date indicating when the record was last updated by the health facility.) (Extension Type: dateTime)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
14. MedicationDispense.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Version specific identifier
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. MedicationDispense.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Short | When the resource was uploaded to the NHDR.
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. MedicationDispense.meta.source
Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Short | Identifies where the resource comes from
Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. MedicationDispense.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. MedicationDispense.meta.security
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Short | Security Labels applied to this resource
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. MedicationDispense.meta.tag
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Short | Tags applied to this resource
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | For example codes, see CommonTags (example to `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` ) Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. MedicationDispense.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..0
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. MedicationDispense.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..0
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. MedicationDispense.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..0
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. MedicationDispense.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..0
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
34. MedicationDispense.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
36. MedicationDispense.modifierExtension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
38. MedicationDispense.identifier
Definition | Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Short | External identifier
Comments | This is a business identifier, not a resource identifier.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..0
Type | Identifier
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. MedicationDispense.partOf
Definition | The procedure that trigger the dispense.
Short | Event that dispense is part of
Control | 0..0
Type | Reference(Procedure)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. MedicationDispense.status
Definition | A code specifying the state of the set of dispense events.
Short | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from MedicationDispense Status Codes (required to `http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1` ) A coded concept specifying the state of the dispense event.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. MedicationDispense.statusReason[x]
Definition | Indicates the reason why a dispense was not performed.
Short | Why a dispense was not performed
Control | 0..0
Binding | For example codes, see MedicationDispense Status Reason Codes (example to `http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1` ) A code describing why a dispense was not performed.
Type | Choice of: CodeableConcept, Reference(DetectedIssue)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. MedicationDispense.category
Definition | Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Short | Type of medication dispense
Comments | The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.
Control | 0..0
Binding | The codes SHOULD be taken from MedicationDispense Category Codes (preferred to `http://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1` ) A code describing where the dispensed medication is expected to be consumed or administered.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. MedicationDispense.medication[x]
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
Short | What medication was supplied
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
Control | 1..1
Binding | For example codes, see SNOMEDCTMedicationCodes (example to `http://hl7.org/fhir/ValueSet/medication-codes|4.0.1` ) A coded concept identifying which substance or product can be dispensed.
Type | Choice of: CodeableConcept, Reference(Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `MedicationDispense.medication[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
50. MedicationDispense.medication[x]:medicationReference
Slice Name | medicationReference
Definition | Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
Short | What medication was supplied
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
Control | 0..1
Type | Reference(PH Medication)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. MedicationDispense.subject
Definition | A link to a resource representing the person or the group to whom the medication will be given.
Short | Who the dispense is for
Comments | SubstanceAdministration->subject->Patient.
Control | 0..0
Type | Reference(Patient, Group)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. MedicationDispense.context
Definition | The encounter or episode of care that establishes the context for this event.
Short | Encounter / Episode associated with event
Control | 0..0
Type | Reference(Encounter, EpisodeOfCare)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. MedicationDispense.supportingInformation
Definition | Additional information that supports the medication being dispensed.
Short | Information that supports the dispensing of the medication
Control | 0..0
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. MedicationDispense.performer
Definition | Indicates who or what performed the event.
Short | Who performed event
Control | 0..0
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
65. MedicationDispense.location
Definition | The principal physical location where the dispense was performed.
Short | Where the dispense occurred
Control | 0..0
Type | Reference(Location)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
67. MedicationDispense.authorizingPrescription
Definition | Indicates the medication order that is being dispensed against.
Short | Medication order that authorizes the dispense
Comments | Maps to basedOn in Event logical model.
Control | 0..0
Type | Reference(MedicationRequest)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
69. MedicationDispense.type
Definition | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
Short | Trial fill, partial fill, emergency fill, etc.
Control | 0..0
Binding | For example codes, see ActPharmacySupplyType (example to `http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType` ) Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
71. MedicationDispense.quantity
Definition | The amount of medication that has been dispensed. Includes unit of measure.
Short | Amount dispensed
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
73. MedicationDispense.daysSupply
Definition | The amount of medication expressed as a timing amount.
Short | Amount of medication expressed as a timing amount
Control | 0..0
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
75. MedicationDispense.whenPrepared
Definition | The time when the dispensed product was packaged and reviewed.
Short | When product was packaged and reviewed
Control | 0..0
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
77. MedicationDispense.whenHandedOver
Definition | The time the dispensed product was provided to the patient or their representative.
Short | When product was given out
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
79. MedicationDispense.destination
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event.
Short | Where the medication was sent
Control | 0..0
Type | Reference(Location)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
81. MedicationDispense.receiver
Definition | Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.
Short | Who collected the medication
Control | 0..0
Type | Reference(Patient, Practitioner)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
83. MedicationDispense.note
Definition | Extra information about the dispense that could not be conveyed in the other attributes.
Short | Information about the dispense
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
85. MedicationDispense.dosageInstruction
Definition | Indicates how the medication is to be used by the patient.
Short | How the medication is to be used by the patient or administered by the caregiver
Comments | When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
Control | 0..*
Type | Dosage
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
87. MedicationDispense.dosageInstruction.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
89. MedicationDispense.dosageInstruction.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationDispense.dosageInstruction.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
91. MedicationDispense.dosageInstruction.modifierExtension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
93. MedicationDispense.dosageInstruction.sequence
Definition | Indicates the order in which the dosage instructions should be applied or interpreted.
Short | The order of the dosage instructions
Control | 0..0
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
95. MedicationDispense.dosageInstruction.text
Definition | Free text dosage instructions e.g. SIG.
Short | Free text dosage instructions e.g. SIG
Control | 0..0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
97. MedicationDispense.dosageInstruction.additionalInstruction
Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.
Control | 0..0
Binding | For example codes, see SNOMEDCTAdditionalDosageInstructions (example to `http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1` ) A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
99. MedicationDispense.dosageInstruction.patientInstruction
Definition | Instructions in terms that are understood by the patient or consumer.
Short | Patient or consumer oriented instructions
Control | 0..0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
101. MedicationDispense.dosageInstruction.timing
Definition | When medication should be administered.
Short | When medication should be administered
Comments | This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
Control | 0..1
Type | Timing
Is Modifier | false
Summary | true
Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
103. MedicationDispense.dosageInstruction.timing.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..0
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
105. MedicationDispense.dosageInstruction.timing.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationDispense.dosageInstruction.timing.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
107. MedicationDispense.dosageInstruction.timing.modifierExtension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
109. MedicationDispense.dosageInstruction.timing.event
Definition | Identifies specific times when the event occurs.
Short | When the event occurs
Control | 0..0
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
111. MedicationDispense.dosageInstruction.timing.repeat
Definition | A set of rules that describe when the event is scheduled.
Short | When the event is to occur
Control | 0..1
Type | Element
Is Modifier | false
Summary | true
Requirements | Many timing schedules are determined by regular repetitions.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) tim-1: if there's a duration, there needs to be duration units (`duration.empty() or durationUnit.exists()`) tim-2: if there's a period, there needs to be period units (`period.empty() or periodUnit.exists()`) tim-4: duration SHALL be a non-negative value (`duration.exists() implies duration >= 0`) tim-5: period SHALL be a non-negative value (`period.exists() implies period >= 0`) tim-6: If there's a periodMax, there must be a period (`periodMax.empty() or period.exists()`) tim-7: If there's a durationMax, there must be a duration (`durationMax.empty() or duration.exists()`) tim-8: If there's a countMax, there must be a count (`countMax.empty() or count.exists()`) tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (`offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))`) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (`timeOfDay.empty() or when.empty()`)
113. MedicationDispense.dosageInstruction.timing.repeat.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..0
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
115. MedicationDispense.dosageInstruction.timing.repeat.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationDispense.dosageInstruction.timing.repeat.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
117. MedicationDispense.dosageInstruction.timing.repeat.bounds[x]
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Short | Length/Range of lengths, or (Start and/or end) limits
Control | 0..0
Type | Choice of: Duration, Range, Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
119. MedicationDispense.dosageInstruction.timing.repeat.count
Definition | A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.
Short | Number of times to repeat
Comments | If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
Control | 0..0
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Repetitions may be limited by end time or total occurrences.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
121. MedicationDispense.dosageInstruction.timing.repeat.countMax
Definition | If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.
Short | Maximum number of times to repeat
Control | 0..0
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
123. MedicationDispense.dosageInstruction.timing.repeat.duration
Definition | How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.
Short | How long when it happens
Comments | For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Control | 0..0
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Some activities are not instantaneous and need to be maintained for a period of time.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
125. MedicationDispense.dosageInstruction.timing.repeat.durationMax
Definition | If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.
Short | How long when it happens (Max)
Comments | For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Control | 0..0
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Some activities are not instantaneous and need to be maintained for a period of time.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
127. MedicationDispense.dosageInstruction.timing.repeat.durationUnit
Definition | The units of time for the duration, in UCUM units.
Short | s | min | h | d | wk | mo | a - unit of time (UCUM)
Control | 0..0
Binding | The codes SHALL be taken from UnitsOfTime (required to `http://hl7.org/fhir/ValueSet/units-of-time|4.0.1` ) A unit of time (units from UCUM).
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
129. MedicationDispense.dosageInstruction.timing.repeat.frequency
Definition | The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.
Short | Event occurs frequency times per period
Control | 0..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Meaning if Missing | If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
131. MedicationDispense.dosageInstruction.timing.repeat.frequencyMax
Definition | If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.
Short | Event occurs up to frequencyMax times per period
Control | 0..0
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
133. MedicationDispense.dosageInstruction.timing.repeat.period
Definition | Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.
Short | Event occurs frequency times per period
Control | 0..0
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
135. MedicationDispense.dosageInstruction.timing.repeat.periodMax
Definition | If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.
Short | Upper limit of period (3-4 hours)
Control | 0..0
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
137. MedicationDispense.dosageInstruction.timing.repeat.periodUnit
Definition | The units of time for the period in UCUM units.
Short | s | min | h | d | wk | mo | a - unit of time (UCUM)
Control | 0..0
Binding | The codes SHALL be taken from UnitsOfTime (required to `http://hl7.org/fhir/ValueSet/units-of-time|4.0.1` ) A unit of time (units from UCUM).
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
139. MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek
Definition | If one or more days of week is provided, then the action happens only on the specified day(s).
Short | mon | tue | wed | thu | fri | sat | sun
Comments | If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.
Control | 0..0
Binding | The codes SHALL be taken from DaysOfWeek (required to `http://hl7.org/fhir/ValueSet/days-of-week|4.0.1` )
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
141. MedicationDispense.dosageInstruction.timing.repeat.timeOfDay
Definition | Specified time of day for action to take place.
Short | Time of day for action
Comments | When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.
Control | 0..0
Type | time
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
143. MedicationDispense.dosageInstruction.timing.repeat.when
Definition | An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.
Short | Code for time period of occurrence
Comments | When more than one event is listed, the event is tied to the union of the specified events.
Control | 0..0
Binding | The codes SHALL be taken from EventTiming (required to `http://hl7.org/fhir/ValueSet/event-timing|4.0.1` ) Real world event relating to the schedule.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Timings are frequently determined by occurrences such as waking, eating and sleep.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
145. MedicationDispense.dosageInstruction.timing.repeat.offset
Definition | The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.
Short | Minutes from event (before or after)
Control | 0..0
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
147. MedicationDispense.dosageInstruction.timing.code
Definition | A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).
Short | BID | TID | QID | AM | PM | QD | QOD | +
Comments | BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).
Control | 0..0
Binding | The codes SHOULD be taken from TimingAbbreviation (preferred to `http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1` ) Code for a known / defined timing pattern.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
149. MedicationDispense.dosageInstruction.asNeeded[x]
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Short | Take "as needed" (for x)
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Control | 0..0
Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes (example to `http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1` ) 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.
Type | Choice of: boolean, CodeableConcept
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
151. MedicationDispense.dosageInstruction.site
Definition | Body site to administer to.
Short | Body site to administer to
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.
Control | 0..0
Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example to `http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1` ) A coded concept describing the site location the medicine enters into or onto the body.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | A coded specification of the anatomic site where the medication first enters the body.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
153. MedicationDispense.dosageInstruction.route
Definition | How drug should enter body.
Short | How drug should enter body
Control | 0..1
Binding | For example codes, see SNOMEDCTRouteCodes (example to `http://hl7.org/fhir/ValueSet/route-codes|4.0.1` ) A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
155. MedicationDispense.dosageInstruction.method
Definition | Technique for administering medication.
Short | Technique for administering medication
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration.
Control | 0..0
Binding | For example codes, see SNOMEDCTAdministrationMethodCodes (example to `http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1` ) A coded concept describing the technique by which the medicine is administered.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
157. MedicationDispense.dosageInstruction.doseAndRate
Definition | The amount of medication administered.
Short | Amount of medication administered
Control | 0..*
Type | Element
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
159. MedicationDispense.dosageInstruction.doseAndRate.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..0
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
161. MedicationDispense.dosageInstruction.doseAndRate.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `MedicationDispense.dosageInstruction.doseAndRate.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
163. MedicationDispense.dosageInstruction.doseAndRate.type
Definition | The kind of dose or rate specified, for example, ordered or calculated.
Short | The kind of dose or rate specified
Control | 0..0
Binding | For example codes, see DoseAndRateType (example to `http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1` ) The kind of dose or rate specified.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | If the type is not populated, assume to be "ordered".
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
165. MedicationDispense.dosageInstruction.doseAndRate.dose[x]
Definition | Amount of medication per dose.
Short | Amount of medication per dose
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.
Control | 0..1
Type | Choice of: Range, Quantity(SimpleQuantity)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | The amount of therapeutic or other substance given at one administration event.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
167. MedicationDispense.dosageInstruction.doseAndRate.rate[x]
Definition | Amount of medication per unit of time.
Short | Amount of medication per unit of time
Comments | It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Control | 0..0
Type | Choice of: Ratio, Range, Quantity(SimpleQuantity)
Is Modifier | false
Summary | true
Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
169. MedicationDispense.dosageInstruction.maxDosePerPeriod
Definition | Upper limit on medication per unit of time.
Short | Upper limit on medication per unit of time
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
Control | 0..0
Type | Ratio
Is Modifier | false
Summary | true
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
171. MedicationDispense.dosageInstruction.maxDosePerAdministration
Definition | Upper limit on medication per administration.
Short | Upper limit on medication per administration
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.
Control | 0..0
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | true
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
173. MedicationDispense.dosageInstruction.maxDosePerLifetime
Definition | Upper limit on medication per lifetime of the patient.
Short | Upper limit on medication per lifetime of the patient
Control | 0..0
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | true
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
175. MedicationDispense.substitution
Definition | Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.
Short | Whether a substitution was performed on the dispense
Control | 0..0
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. MedicationDispense.detectedIssue
Definition | Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.
Short | Clinical issue with action
Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
Control | 0..0
Type | Reference(DetectedIssue)
Is Modifier | false
Summary | false
Alternate Names | Contraindication, Drug Utilization Review (DUR), Alert
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. MedicationDispense.eventHistory
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified.
Short | A list of relevant lifecycle events
Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
Control | 0..0
Type | Reference(Provenance)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)