Medication Scheme Implementation Guide
1.0.0 - draft Estonia flag

Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions

Resource Profile: EETISPrescriptionDispense - Detailed Descriptions

Draft as of 2024-01-31

Definitions for the ee-tis-prescription-dispense resource profile.

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

0. MedicationDispense
Definition

Ravimi väljastamine patsiendile.

ShortDispensation of prescribed medication to the patient
2. MedicationDispense.contained
Control0..0
4. MedicationDispense.extension
SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. MedicationDispense.extension:extensionEETISBuyerEPC
    Slice NameextensionEETISBuyerEPC
    Control0..*
    TypeExtension(ExtensionEETISBuyerEPC) (Extension Type: Choice of: string, Identifier)
    8. MedicationDispense.extension:extensionEETISBuyerEPC.value[x]
    Definition

    OSTJA ISIKUKOOD

    ShortPersonal identification code of the buyer
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    10. MedicationDispense.extension:extensionEETISReimbursementRate
    Slice NameextensionEETISReimbursementRate
    Control0..*
    TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
    12. MedicationDispense.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0
    14. MedicationDispense.basedOn
    Control0..0
    16. MedicationDispense.partOf
    Control0..0
    18. MedicationDispense.status
    Definition

    Ravimi väljamüük saab olla ainult "completed" staatuses, kui ravimit ei saa müüa siis muutub kas retsepti või ravimiskeemi rea staatus ja dispense pole üldse.

    ShortWhen dispensation occurres it is always completed.
    Fixed Valuecompleted
    20. MedicationDispense.notPerformedReason
    Control0..0
    22. MedicationDispense.statusChanged
    Control0..0
    24. MedicationDispense.category
    Control0..0
    26. MedicationDispense.medication
    Definition

    Väljastatud ravim

    ShortDispensed medication
    TypeCodeableReference(EETISMedicationDispensedToPatient, EETISMedicationExtemporal)
    28. MedicationDispense.subject
    Definition

    Patsient, kellele ravim väljastatakse

    ShortPatient recieving the medication
    TypeReference(EE MPI Patient Verified)
    30. MedicationDispense.encounter
    Control0..0
    32. MedicationDispense.supportingInformation
    Control0..0
    34. MedicationDispense.performer
    Definition

    Väljastuse teostaja ehk kes väljastas ravimi patsiendile.

    ShortIndicates who or what performed the event.
    Control1..1
    36. MedicationDispense.performer.function
    Control0..0
    38. MedicationDispense.performer.actor
    Definition

    Proviisor või farmatseut, kellel on õigus väljastada ravimit

    ShortPharmacist or assistant pharmacist who has the rights to dispense meditcation.
    TypeReference(EETISPractitionerRole)
    40. MedicationDispense.location
    Definition

    APTEEK ja SELLE KOOD KUS RAVIM VÄLJASTATI.Apteegi tegevuskoha kood.

    ShortThe principal physical location where the dispense was performed.
    TypeReference(EETISPharmacyLocation)
    42. MedicationDispense.location.identifier
    Definition

    APTEEGI TEGEVUSKOHA KOOD. Logical reference, when literal reference is not known

    NoteThis is a business identifier, not a resource identifier (see discussion)
    44. MedicationDispense.authorizingPrescription
    ShortRetsept, mille alusel ravim väljastati patsiendile.
    Control1..?
    TypeReference(EETISPrescription)
    46. MedicationDispense.type
    Control0..0
    48. MedicationDispense.quantity
    Definition

    Väljastatud ravimi kogus. Pakendite arv, mis väljastati.

    ShortThe amount of medication that has been dispensed. Includes unit of measure.
    Control1..?
    50. MedicationDispense.quantity.unit
    Control0..0
    52. MedicationDispense.quantity.system
    Control0..0
    54. MedicationDispense.quantity.code
    Control0..0
    56. MedicationDispense.daysSupply
    Definition

    müüdud kogus ümber arvutatud ravipäevadeks

    ShortDispensed medication calculated in days. How many days is covered with this amount of medication.
    58. MedicationDispense.recorded
    Control0..0
    60. MedicationDispense.whenPrepared
    Control0..0
    62. MedicationDispense.whenHandedOver
    Definition

    Väljastamise aeg. Kuupäev ja kellaaeg, millal ravim anti üle patsiendile, või tema esindajale.

    ShortThe time the dispensed product was provided to the patient or their representative.
    Control1..?
    64. MedicationDispense.destination
    Control0..0
    66. MedicationDispense.receiver
    Definition

    KUI RAVIMI OSTAB VÄLJA KEEGI TEINE KUI SEE, KELLELE RAVIM ON VÄLJAKIRJUTATUD EI KASUTATA SEDA VAID ExtensionEETISBuyerEPC.

    Control0..1
    68. MedicationDispense.receiver.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    70. MedicationDispense.receiver.identifier.value
    Definition

    OSTJA ISIKUKOOD

    ShortBuyers personal identification code. Logical reference, when literal reference is not known
    Control1..?
    72. MedicationDispense.note
    Definition

    Kommentaar väljastuse kohta. Kommentaari saab lisada ainult see, kes teostas ravimi väljastuse apteegis.

    ShortExtra information about the dispense that could not be conveyed in the other attributes.
    Control0..1
    74. MedicationDispense.note.author[x]
    Control0..0
    76. MedicationDispense.renderedDosageInstruction
    Control0..0
    78. MedicationDispense.dosageInstruction
    Control0..0
    93. MedicationDispense.substitution
    Control0..0
    95. MedicationDispense.eventHistory
    Control0..0

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

    0. MedicationDispense
    Definition

    Ravimi väljastamine patsiendile.


    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.

    ShortDispensation of prescribed medication to the patientDispensing a medication to a named patient
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsdom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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.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.

    ShortA 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 its narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. MedicationDispense.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

    ShortContained, 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.

    Control0..0*
    This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    6. 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 managable, 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.

    ShortExtensionAdditional 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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 8. MedicationDispense.extension:extensionEETISBuyerEPC
      Slice NameextensionEETISBuyerEPC
      Definition

      Ostja. Keegi teine kui see, kellele ravim välja kirjutati.

      ShortIdentity code of the buyer of medicine when the buyer is someone else than the subject of prescription.
      Control0..*
      TypeExtension(ExtensionEETISBuyerEPC) (Extension Type: Choice of: string, Identifier)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-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())
      10. MedicationDispense.extension:extensionEETISBuyerEPC.extension
      Definition

      An Extension


      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 managable, 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.

      ShortExtensionAdditional 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.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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())
      SlicingThis element introduces a set of slices on MedicationDispense.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 12. MedicationDispense.extension:extensionEETISBuyerEPC.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttps://fhir.ee/StructureDefinition/ee-tis-buyer-epc
        14. MedicationDispense.extension:extensionEETISBuyerEPC.value[x]
        Definition

        OSTJA ISIKUKOOD


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortPersonal identification code of the buyerValue of extension
        Control10..1
        This element is affected by the following invariants: ext-1
        TypeChoice of: string, Identifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, RatioRange, Coding, SampledData, id, positiveInt, Distance, Availability, integer64, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ExtendedContactDetail, CodeableConcept, ParameterDefinition, dateTime, code, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, CodeableReference, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. MedicationDispense.extension:extensionEETISReimbursementRate
        Slice NameextensionEETISReimbursementRate
        Definition

        Ravimi soodustuse määr protsentides Retseptikeskuse loendist "Soodustuste määrad" ning tingimused "Vajalikud tingimused" -loendist soodustuse saamiseks.

        ShortReimbursement rate and reason of prescription medicine.
        Control0..*
        TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-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())
        18. MedicationDispense.modifierExtension
        Definition

        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 managable, 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).

        ShortExtensions 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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Must Supportfalse
        Summarytrue
        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 Namesextensions, user content
        Invariantsele-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())
        20. 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.

        ShortExternal identifier
        Comments

        This is a business identifier, not a resource identifier.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..0*
        TypeIdentifier
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. MedicationDispense.basedOn
        Definition

        A plan that is fulfilled in whole or in part by this MedicationDispense.

        ShortPlan that is fulfilled by this dispense
        Control0..0*
        TypeReference(CarePlan)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationDispense.partOf
        Definition

        The procedure or medication administration that triggered the dispense.

        ShortEvent that dispense is part of
        Comments

        While both a procedure and a medication administration may have triggered the dispense, but it is not expected that multiple procedures and/or multiple medication administrations would be triggers.

        Control0..0*
        TypeReference(Procedure, MedicationAdministration)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MedicationDispense.status
        Definition

        Ravimi väljamüük saab olla ainult "completed" staatuses, kui ravimit ei saa müüa siis muutub kas retsepti või ravimiskeemi rea staatus ja dispense pole üldse.


        A code specifying the state of the set of dispense events.

        ShortWhen dispensation occurres it is always completed.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.

        Control1..1
        BindingThe codes SHALL be taken from MedicationDispenseStatusCodeshttp://hl7.org/fhir/ValueSet/medicationdispense-status|5.0.0
        (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|5.0.0)

        Describes the lifecycle of the dispense.

        Typecode
        Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Fixed Valuecompleted
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. MedicationDispense.notPerformedReason
        Definition

        Indicates the reason why a dispense was not performed.

        ShortWhy a dispense was not performed
        Control0..01
        BindingFor example codes, see MedicationDispenseStatusReasonCodeshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reason
        (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason)
        TypeCodeableReference(DetectedIssue)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. MedicationDispense.statusChanged
        Definition

        The date (and maybe time) when the status of the dispense record changed.

        ShortWhen the status changed
        Control0..01
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. MedicationDispense.category
        Definition

        Indicates the type of medication dispense (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

        ShortType 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.

        Control0..0*
        BindingFor example codes, see MedicationDispenseAdministrationLocationCodeshttp://hl7.org/fhir/ValueSet/medicationdispense-admin-location
        (example to http://hl7.org/fhir/ValueSet/medicationdispense-admin-location)

        A code describing where the dispensed medication is expected to be consumed or administered.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MedicationDispense.medication
        Definition

        Väljastatud ravim


        Identifies the medication supplied. 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.

        ShortDispensed medicationWhat 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.

        Control1..1
        BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
        (example to http://hl7.org/fhir/ValueSet/medication-codes)

        A coded concept identifying which substance or product can be dispensed.

        TypeCodeableReference(EETISMedicationDispensedToPatient, EETISMedicationExtemporal, Medication)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. MedicationDispense.subject
        Definition

        Patsient, kellele ravim väljastatakse


        A link to a resource representing the person or the group to whom the medication will be given.

        ShortPatient recieving the medicationWho the dispense is for
        Comments

        SubstanceAdministration->subject->Patient.

        Control1..1
        TypeReference(EE MPI Patient Verified, Patient, Group)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. MedicationDispense.encounter
        Definition

        The encounter that establishes the context for this event.

        ShortEncounter associated with event
        Control0..01
        TypeReference(Encounter)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. MedicationDispense.supportingInformation
        Definition

        Additional information that supports the medication being dispensed. For example, there may be requirements that a specific lab test has been completed prior to dispensing or the patient's weight at the time of dispensing is documented.

        ShortInformation that supports the dispensing of the medication
        Control0..0*
        TypeReference(Resource)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationDispense.performer
        Definition

        Väljastuse teostaja ehk kes väljastas ravimi patsiendile.


        Indicates who or what performed the event.

        ShortIndicates who or what performed the event.Who performed event
        Control10..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MedicationDispense.performer.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 managable, 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. 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).

        ShortExtensions that cannot be ignored even if unrecognized
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        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 Namesextensions, user content, modifiers
        Invariantsele-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())
        46. MedicationDispense.performer.function
        Definition

        Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

        ShortWho performed the dispense and what they did
        Control0..01
        BindingFor example codes, see MedicationDispensePerformerFunctionCodeshttp://hl7.org/fhir/ValueSet/medicationdispense-performer-function
        (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function)

        A code describing the role an individual played in dispensing a medication.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

        Allows disambiguation of the types of involvement of different performers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationDispense.performer.actor
        Definition

        Proviisor või farmatseut, kellel on õigus väljastada ravimit


        The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

        ShortPharmacist or assistant pharmacist who has the rights to dispense meditcation.Individual who was performing
        Control1..1
        TypeReference(EETISPractitionerRole, Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. MedicationDispense.location
        Definition

        APTEEK ja SELLE KOOD KUS RAVIM VÄLJASTATI.Apteegi tegevuskoha kood.


        The principal physical location where the dispense was performed.

        ShortThe principal physical location where the dispense was performed.Where the dispense occurred
        Control0..1
        TypeReference(EETISPharmacyLocation, Location)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. MedicationDispense.location.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control0..1
        This element is affected by the following invariants: ref-2, ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. MedicationDispense.location.identifier
        Definition

        APTEEGI TEGEVUSKOHA KOOD. Logical reference, when literal reference is not known


        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

        ShortLogical reference, when literal reference is not known
        Comments

        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

        This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        This element is affected by the following invariants: ref-2
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. MedicationDispense.authorizingPrescription
        Definition

        Indicates the medication order that is being dispensed against.

        ShortRetsept, mille alusel ravim väljastati patsiendile.Medication order that authorizes the dispense
        Comments

        Maps to basedOn in Event logical model.

        Control10..*
        TypeReference(EETISPrescription, MedicationRequest)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. 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.

        ShortTrial fill, partial fill, emergency fill, etc
        Control0..01
        BindingFor example codes, see ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
        (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

        ActPharmacySupplyType

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. MedicationDispense.quantity
        Definition

        Väljastatud ravimi kogus. Pakendite arv, mis väljastati.


        The amount of medication that has been dispensed. Includes unit of measure.

        ShortThe amount of medication that has been dispensed. Includes unit of measure.Amount dispensed
        Control10..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. MedicationDispense.quantity.comparator
        Definition

        Not allowed to be used in this context


        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

        Short< | <= | >= | > | ad - how to understand the value
        Control0..01
        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. MedicationDispense.quantity.unit
        Definition

        A human-readable form of the unit.

        ShortUnit representation
        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. MedicationDispense.quantity.system
        Definition

        The identification of the system that provides the coded form of the unit.

        ShortSystem that defines coded unit form
        Control0..01
        This element is affected by the following invariants: qty-3
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to know the system that defines the coded form of the unit.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. MedicationDispense.quantity.code
        Definition

        A computer processable form of the unit in some unit representation system.

        ShortCoded form of the unit
        Comments

        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

        Control0..01
        This element is affected by the following invariants: qty-3
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. MedicationDispense.daysSupply
        Definition

        müüdud kogus ümber arvutatud ravipäevadeks


        The amount of medication expressed as a timing amount.

        ShortDispensed medication calculated in days. How many days is covered with this amount of medication.Amount of medication expressed as a timing amount
        Control0..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. MedicationDispense.recorded
        Definition

        The date (and maybe time) when the dispense activity started if whenPrepared or whenHandedOver is not populated.

        ShortWhen the recording of the dispense started
        Control0..01
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. MedicationDispense.whenPrepared
        Definition

        The time when the dispensed product was packaged and reviewed.

        ShortWhen product was packaged and reviewed
        Control0..01
        This element is affected by the following invariants: mdd-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. MedicationDispense.whenHandedOver
        Definition

        Väljastamise aeg. Kuupäev ja kellaaeg, millal ravim anti üle patsiendile, või tema esindajale.


        The time the dispensed product was provided to the patient or their representative.

        ShortThe time the dispensed product was provided to the patient or their representative.When product was given out
        Control10..1
        This element is affected by the following invariants: mdd-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. MedicationDispense.destination
        Definition

        Identification of the facility/location where the medication was/will be shipped to, as part of the dispense event.

        ShortWhere the medication was/will be sent
        Control0..01
        TypeReference(Location)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. MedicationDispense.receiver
        Definition

        KUI RAVIMI OSTAB VÄLJA KEEGI TEINE KUI SEE, KELLELE RAVIM ON VÄLJAKIRJUTATUD EI KASUTATA SEDA VAID ExtensionEETISBuyerEPC.


        Identifies the person who picked up the medication or the location of where the medication was delivered. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional or a location.

        ShortWho collected the medication or where the medication was delivered
        Control0..1*
        TypeReference(Patient, Practitioner, RelatedPerson, Location, PractitionerRole)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. MedicationDispense.receiver.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control0..1
        This element is affected by the following invariants: ref-2, ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. MedicationDispense.note
        Definition

        Kommentaar väljastuse kohta. Kommentaari saab lisada ainult see, kes teostas ravimi väljastuse apteegis.


        Extra information about the dispense that could not be conveyed in the other attributes.

        ShortExtra information about the dispense that could not be conveyed in the other attributes.Information about the dispense
        Control0..1*
        TypeAnnotation
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. MedicationDispense.note.author[x]
        Definition

        The individual responsible for making the annotation.

        ShortIndividual responsible for the annotation
        Comments

        Organization is used when there's no need for specific attribution as to who made the comment.

        Control0..01
        TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. MedicationDispense.note.text
        Definition

        The text of the annotation in markdown format.

        ShortThe annotation - text content (as markdown)
        Control1..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. MedicationDispense.renderedDosageInstruction
        Definition

        The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

        ShortFull representation of the dosage instructions
        Comments

        The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

        Control0..01
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        92. MedicationDispense.dosageInstruction
        Definition

        Indicates how the medication is to be used by the patient.

        ShortHow 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.

        Control0..0*
        TypeDosage
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. 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.

        ShortWhether a substitution was performed on the dispense
        Control0..01
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        112. MedicationDispense.eventHistory
        Definition

        A summary of the events of interest that have occurred, such as when the dispense was verified.

        ShortA 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.).

        Control0..0*
        TypeReference(Provenance)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-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 found here

        0. MedicationDispense
        Definition

        Ravimi väljastamine patsiendile.

        ShortDispensation of prescribed medication to the patient
        Control0..*
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsdom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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.

        ShortLogical id of this artifact
        Comments

        Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

        Control0..1
        Typeid
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        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.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. 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.

        ShortA 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 its narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. MedicationDispense.language
        Definition

        The base language in which the resource is written.

        ShortLanguage 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).

        Control0..1
        BindingThe codes SHALL be taken from AllLanguages
        (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

        IETF language tag for a human language

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. 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.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have a 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.

        Control0..1
        This element is affected by the following invariants: dom-6
        TypeNarrative
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. MedicationDispense.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

        ShortContained, 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.

        Control0..0
        This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
        TypeResource
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        14. MedicationDispense.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-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())
        SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. MedicationDispense.extension:extensionEETISBuyerEPC
          Slice NameextensionEETISBuyerEPC
          Definition

          Ostja. Keegi teine kui see, kellele ravim välja kirjutati.

          ShortIdentity code of the buyer of medicine when the buyer is someone else than the subject of prescription.
          Control0..*
          TypeExtension(ExtensionEETISBuyerEPC) (Extension Type: Choice of: string, Identifier)
          Is Modifierfalse
          Must Supportfalse
          Invariantsele-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())
          18. MedicationDispense.extension:extensionEETISBuyerEPC.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          This element is affected by the following invariants: ele-1
          Typeid
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          20. MedicationDispense.extension:extensionEETISBuyerEPC.extension
          Definition

          An Extension

          ShortExtension
          Control0..0
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-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())
          SlicingThis element introduces a set of slices on MedicationDispense.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 22. MedicationDispense.extension:extensionEETISBuyerEPC.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttps://fhir.ee/StructureDefinition/ee-tis-buyer-epc
            24. MedicationDispense.extension:extensionEETISBuyerEPC.value[x]
            Definition

            OSTJA ISIKUKOOD

            ShortPersonal identification code of the buyer
            Control1..1
            This element is affected by the following invariants: ext-1
            TypeChoice of: string, Identifier
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. MedicationDispense.extension:extensionEETISReimbursementRate
            Slice NameextensionEETISReimbursementRate
            Definition

            Ravimi soodustuse määr protsentides Retseptikeskuse loendist "Soodustuste määrad" ning tingimused "Vajalikud tingimused" -loendist soodustuse saamiseks.

            ShortReimbursement rate and reason of prescription medicine.
            Control0..*
            TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-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())
            28. MedicationDispense.modifierExtension
            Definition

            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 managable, 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).

            ShortExtensions 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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Must Supportfalse
            Summarytrue
            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 Namesextensions, user content
            Invariantsele-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())
            30. 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.

            ShortExternal identifier
            Comments

            This is a business identifier, not a resource identifier.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..0
            TypeIdentifier
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. MedicationDispense.basedOn
            Definition

            A plan that is fulfilled in whole or in part by this MedicationDispense.

            ShortPlan that is fulfilled by this dispense
            Control0..0
            TypeReference(CarePlan)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. MedicationDispense.partOf
            Definition

            The procedure or medication administration that triggered the dispense.

            ShortEvent that dispense is part of
            Comments

            While both a procedure and a medication administration may have triggered the dispense, but it is not expected that multiple procedures and/or multiple medication administrations would be triggers.

            Control0..0
            TypeReference(Procedure, MedicationAdministration)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. MedicationDispense.status
            Definition

            Ravimi väljamüük saab olla ainult "completed" staatuses, kui ravimit ei saa müüa siis muutub kas retsepti või ravimiskeemi rea staatus ja dispense pole üldse.

            ShortWhen dispensation occurres it is always completed.
            Comments

            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

            Control1..1
            BindingThe codes SHALL be taken from MedicationDispenseStatusCodes
            (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|5.0.0)

            Describes the lifecycle of the dispense.

            Typecode
            Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Fixed Valuecompleted
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. MedicationDispense.notPerformedReason
            Definition

            Indicates the reason why a dispense was not performed.

            ShortWhy a dispense was not performed
            Control0..0
            BindingFor example codes, see MedicationDispenseStatusReasonCodes
            (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason)
            TypeCodeableReference(DetectedIssue)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. MedicationDispense.statusChanged
            Definition

            The date (and maybe time) when the status of the dispense record changed.

            ShortWhen the status changed
            Control0..0
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. MedicationDispense.category
            Definition

            Indicates the type of medication dispense (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

            ShortType 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.

            Control0..0
            BindingFor example codes, see MedicationDispenseAdministrationLocationCodes
            (example to http://hl7.org/fhir/ValueSet/medicationdispense-admin-location)

            A code describing where the dispensed medication is expected to be consumed or administered.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. MedicationDispense.medication
            Definition

            Väljastatud ravim

            ShortDispensed medication
            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.

            Control1..1
            BindingFor example codes, see SNOMEDCTMedicationCodes
            (example to http://hl7.org/fhir/ValueSet/medication-codes)

            A coded concept identifying which substance or product can be dispensed.

            TypeCodeableReference(EETISMedicationDispensedToPatient, EETISMedicationExtemporal)
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. MedicationDispense.subject
            Definition

            Patsient, kellele ravim väljastatakse

            ShortPatient recieving the medication
            Comments

            SubstanceAdministration->subject->Patient.

            Control1..1
            TypeReference(EE MPI Patient Verified)
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. MedicationDispense.encounter
            Definition

            The encounter that establishes the context for this event.

            ShortEncounter associated with event
            Control0..0
            TypeReference(Encounter)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. MedicationDispense.supportingInformation
            Definition

            Additional information that supports the medication being dispensed. For example, there may be requirements that a specific lab test has been completed prior to dispensing or the patient's weight at the time of dispensing is documented.

            ShortInformation that supports the dispensing of the medication
            Control0..0
            TypeReference(Resource)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. MedicationDispense.performer
            Definition

            Väljastuse teostaja ehk kes väljastas ravimi patsiendile.

            ShortIndicates who or what performed the event.
            Control1..1
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. MedicationDispense.performer.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            This element is affected by the following invariants: ele-1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            56. MedicationDispense.performer.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 managable, 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.

            ShortAdditional 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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-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())
            58. MedicationDispense.performer.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 managable, 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. 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).

            ShortExtensions that cannot be ignored even if unrecognized
            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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 Namesextensions, user content, modifiers
            Invariantsele-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())
            60. MedicationDispense.performer.function
            Definition

            Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

            ShortWho performed the dispense and what they did
            Control0..0
            BindingFor example codes, see MedicationDispensePerformerFunctionCodes
            (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function)

            A code describing the role an individual played in dispensing a medication.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Allows disambiguation of the types of involvement of different performers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. MedicationDispense.performer.actor
            Definition

            Proviisor või farmatseut, kellel on õigus väljastada ravimit

            ShortPharmacist or assistant pharmacist who has the rights to dispense meditcation.
            Control1..1
            TypeReference(EETISPractitionerRole)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. MedicationDispense.location
            Definition

            APTEEK ja SELLE KOOD KUS RAVIM VÄLJASTATI.Apteegi tegevuskoha kood.

            ShortThe principal physical location where the dispense was performed.
            Control0..1
            TypeReference(EETISPharmacyLocation)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. MedicationDispense.location.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            This element is affected by the following invariants: ele-1
            Typeid
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            68. MedicationDispense.location.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 managable, 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.

            ShortAdditional 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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-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())
            SlicingThis element introduces a set of slices on MedicationDispense.location.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 70. MedicationDispense.location.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control0..1
              This element is affected by the following invariants: ref-2, ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. MedicationDispense.location.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. MedicationDispense.location.identifier
              Definition

              APTEEGI TEGEVUSKOHA KOOD. Logical reference, when literal reference is not known

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              This element is affected by the following invariants: ref-2
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. MedicationDispense.location.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..1
              This element is affected by the following invariants: ref-2
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. MedicationDispense.authorizingPrescription
              Definition

              Indicates the medication order that is being dispensed against.

              ShortRetsept, mille alusel ravim väljastati patsiendile.
              Comments

              Maps to basedOn in Event logical model.

              Control1..*
              TypeReference(EETISPrescription)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. 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.

              ShortTrial fill, partial fill, emergency fill, etc
              Control0..0
              BindingFor example codes, see ActPharmacySupplyType
              (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

              ActPharmacySupplyType

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. MedicationDispense.quantity
              Definition

              Väljastatud ravimi kogus. Pakendite arv, mis väljastati.

              ShortThe amount of medication that has been dispensed. Includes unit of measure.
              Control1..1
              TypeQuantity(SimpleQuantity)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. MedicationDispense.quantity.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              86. MedicationDispense.quantity.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 managable, 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.

              ShortAdditional 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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-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())
              SlicingThis element introduces a set of slices on MedicationDispense.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 88. MedicationDispense.quantity.value
                Definition

                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                ShortNumerical value (with implicit precision)
                Comments

                The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Precision is handled implicitly in almost all cases of measurement.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                90. MedicationDispense.quantity.comparator
                Definition

                Not allowed to be used in this context

                Short< | <= | >= | > | ad - how to understand the value
                Control0..0
                BindingThe codes SHALL be taken from QuantityComparator
                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                How the Quantity should be understood and represented.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                Meaning if MissingIf there is no comparator, then there is no modification of the value
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. MedicationDispense.quantity.unit
                Definition

                A human-readable form of the unit.

                ShortUnit representation
                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                94. MedicationDispense.quantity.system
                Definition

                The identification of the system that provides the coded form of the unit.

                ShortSystem that defines coded unit form
                Control0..0
                This element is affected by the following invariants: qty-3
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to know the system that defines the coded form of the unit.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. MedicationDispense.quantity.code
                Definition

                A computer processable form of the unit in some unit representation system.

                ShortCoded form of the unit
                Comments

                The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                Control0..0
                This element is affected by the following invariants: qty-3
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. MedicationDispense.daysSupply
                Definition

                müüdud kogus ümber arvutatud ravipäevadeks

                ShortDispensed medication calculated in days. How many days is covered with this amount of medication.
                Control0..1
                TypeQuantity(SimpleQuantity)
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                100. MedicationDispense.recorded
                Definition

                The date (and maybe time) when the dispense activity started if whenPrepared or whenHandedOver is not populated.

                ShortWhen the recording of the dispense started
                Control0..0
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                102. MedicationDispense.whenPrepared
                Definition

                The time when the dispensed product was packaged and reviewed.

                ShortWhen product was packaged and reviewed
                Control0..0
                This element is affected by the following invariants: mdd-1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                104. MedicationDispense.whenHandedOver
                Definition

                Väljastamise aeg. Kuupäev ja kellaaeg, millal ravim anti üle patsiendile, või tema esindajale.

                ShortThe time the dispensed product was provided to the patient or their representative.
                Control1..1
                This element is affected by the following invariants: mdd-1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. MedicationDispense.destination
                Definition

                Identification of the facility/location where the medication was/will be shipped to, as part of the dispense event.

                ShortWhere the medication was/will be sent
                Control0..0
                TypeReference(Location)
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. MedicationDispense.receiver
                Definition

                KUI RAVIMI OSTAB VÄLJA KEEGI TEINE KUI SEE, KELLELE RAVIM ON VÄLJAKIRJUTATUD EI KASUTATA SEDA VAID ExtensionEETISBuyerEPC.

                ShortWho collected the medication or where the medication was delivered
                Control0..1
                TypeReference(Patient, Practitioner, RelatedPerson, Location, PractitionerRole)
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. MedicationDispense.receiver.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                This element is affected by the following invariants: ele-1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                112. MedicationDispense.receiver.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 managable, 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.

                ShortAdditional 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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-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())
                SlicingThis element introduces a set of slices on MedicationDispense.receiver.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 114. MedicationDispense.receiver.reference
                  Definition

                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                  ShortLiteral reference, Relative, internal or absolute URL
                  Comments

                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                  Control0..1
                  This element is affected by the following invariants: ref-2, ref-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  116. MedicationDispense.receiver.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  118. MedicationDispense.receiver.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                  ShortLogical reference, when literal reference is not known
                  Comments

                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  This element is affected by the following invariants: ref-2
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  120. MedicationDispense.receiver.identifier.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  122. MedicationDispense.receiver.identifier.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 managable, 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.

                  ShortAdditional 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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-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())
                  SlicingThis element introduces a set of slices on MedicationDispense.receiver.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 124. MedicationDispense.receiver.identifier.use
                    Definition

                    The purpose of this identifier.

                    Shortusual | official | temp | secondary | old (If known)
                    Comments

                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                    Control0..1
                    BindingThe codes SHALL be taken from IdentifierUse
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

                    Identifies the purpose for this identifier, if known .

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    126. MedicationDispense.receiver.identifier.type
                    Definition

                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                    ShortDescription of identifier
                    Comments

                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from IdentifierTypeCodes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows users to make use of identifiers when the identifier system is not known.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    128. MedicationDispense.receiver.identifier.system
                    Definition

                    Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

                    Control0..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    130. MedicationDispense.receiver.identifier.value
                    Definition

                    OSTJA ISIKUKOOD

                    ShortBuyers personal identification code. Logical reference, when literal reference is not known
                    Comments

                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                    Control1..1
                    This element is affected by the following invariants: ident-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Example<br/><b>General</b>:123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    132. MedicationDispense.receiver.identifier.period
                    Definition

                    Time period during which identifier is/was valid for use.

                    ShortTime period when id is/was valid for use
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    134. MedicationDispense.receiver.identifier.assigner
                    Definition

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                    Control0..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    136. MedicationDispense.receiver.display
                    Definition

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    ShortText alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control0..1
                    This element is affected by the following invariants: ref-2
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    138. MedicationDispense.note
                    Definition

                    Kommentaar väljastuse kohta. Kommentaari saab lisada ainult see, kes teostas ravimi väljastuse apteegis.

                    ShortExtra information about the dispense that could not be conveyed in the other attributes.
                    Control0..1
                    TypeAnnotation
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    140. MedicationDispense.note.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    142. MedicationDispense.note.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 managable, 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.

                    ShortAdditional 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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-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())
                    SlicingThis element introduces a set of slices on MedicationDispense.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 144. MedicationDispense.note.author[x]
                      Definition

                      The individual responsible for making the annotation.

                      ShortIndividual responsible for the annotation
                      Comments

                      Organization is used when there's no need for specific attribution as to who made the comment.

                      Control0..0
                      TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      146. MedicationDispense.note.time
                      Definition

                      Indicates when this particular annotation was made.

                      ShortWhen the annotation was made
                      Control0..1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      148. MedicationDispense.note.text
                      Definition

                      The text of the annotation in markdown format.

                      ShortThe annotation - text content (as markdown)
                      Control1..1
                      Typemarkdown
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      150. MedicationDispense.renderedDosageInstruction
                      Definition

                      The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

                      ShortFull representation of the dosage instructions
                      Comments

                      The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

                      Control0..0
                      Typemarkdown
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      152. MedicationDispense.dosageInstruction
                      Definition

                      Indicates how the medication is to be used by the patient.

                      ShortHow 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.

                      Control0..0
                      TypeDosage
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      176. 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.

                      ShortWhether a substitution was performed on the dispense
                      Control0..0
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      185. MedicationDispense.eventHistory
                      Definition

                      A summary of the events of interest that have occurred, such as when the dispense was verified.

                      ShortA 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.).

                      Control0..0
                      TypeReference(Provenance)
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))